Citation Nr: A21020217 Decision Date: 12/17/21 Archive Date: 12/17/21 DOCKET NO. 191024-40925 DATE: December 17, 2021 REMANDED Entitlement to service connection for irregular heartbeat is remanded. REASONS FOR REMAND The Veteran served on active duty from April 1967 to January 1971. On August 23, 2017, the President signed into law the Veterans Appeals Improvement and Modernization Act, also known as the Appeals Modernization Act (AMA). This law, which went into effect in February 2019, creates a new framework for veterans dissatisfied with VA's decision on their claim to seek review. The framework applies to all decisions issued after the effective date of the legislation. 38 C.F.R. §§ 3.2400(a)(1), 19.2(a). The matter comes before the Board of Veterans' Appeals (Board) on appeal from an August 2019 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO). The Veteran timely appealed to the Board and selected the evidence review docket. 38 C.F.R. §§ 3.2500(a)(1)(ii), 20.202, 20.203. Therefore, the Board may only consider the evidence of record at the time of the agency of original jurisdiction (AOJ) decision on appeal, as well as any evidence submitted by the Veteran or his representative with, or within 90 days from receipt of, the VA Form 10182. 38 C.F.R. § 20.303. Here, the Board notes that the Veteran filed claims and supplemental claims relating to an irregular heartbeat and coronary artery disease (CAD) subsequent to the closing of the evidentiary window. Specifically, and most recently, the AOJ granted an earlier effective date for service-connected CAD in an August 2021 rating decision that has not been appealed. Thus, such claim, and any other heart-related claims not set out in the October 2019 VA Form 10182, are not presently before the Board. Evidence was added to the claims file during a period of time when new evidence was not allowed. As the Board is remanding the claims of [list claims] for further development, this additional evidence will be considered by the RO in the adjudication of those claims. A motion to advance this appeal on the Board's docket has been raised by the Veteran's representative. See May 2021 VA Form 21-4138 (statement in support of claim). The motion indicates that the Veteran was recently diagnosed with bladder cancer. The undersigned is hereby granting the motion and advancing the appeal on the docket based on serious illness. 38 C.F.R. §§ 20.800, 20.902(c). Entitlement to service connection for irregular heartbeat is remanded. The Board finds that a remand is warranted in order to correct a duty to assist error that occurred prior to the August 2019 rating decision on appeal. 38 C.F.R. § 20.802. The RO obtained a July 2019 VA medical opinion. The opinion states that the Veteran's claimed irregular heartbeat disability, diagnosed as premature ventricular contractions (PVC), was not at least as likely as not proximately due to or the result of his service-connected diabetes mellitus, type II. The Board finds that this opinion, regarding secondary causation, is adequate as it offers a reasoned medical explanation. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008). However, the July 2019 VA medical opinion is incomplete. It does not address whether the Veteran's PVC was aggravated by his service-connected, diabetes mellitus, type II. Thus, the case must be returned for an addendum opinion. See El-Amin v. Shinseki, 26 Vet. App. 136 (2013) (holding that a medical opinion that only addresses whether a service-connected disability caused a nonservice-connected disability does not address whether the service-connected disability aggravated a nonservice-connected disability). The matter is REMANDED for the following action: 1. Obtain an addendum opinion from the examiner who performed the July 2019 VA examination or an appropriate medical professional if the examiner is unavailable. After reviewing the claims folder in its entirety, the examiner should address the following: Is it at least as likely as not (50 percent or greater probability) that the Veteran's premature ventricular contractions were aggravated by his service-connected diabetes mellitus, type II? A new examination of the Veteran is only necessary if deemed so by the examiner. A complete rationale should be given for all opinions and conclusions expressed. If the examiner cannot provide an opinion without resort to speculation, the examiner should provide an explanation as to why this is so and must state whether there is additional evidence that would permit the necessary opinion to be made. D. Martz Ames Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M. Minaya, Associate Counsel The Board's decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.