Citation Nr: A21020339 Decision Date: 12/21/21 Archive Date: 12/21/21 DOCKET NO. 210514-172884 DATE: December 21, 2021 REMANDED Entitlement to service connection for the cause of the Veteran's death is remanded. REASONS FOR REMAND The Veteran served on active duty from January 1951 to December 1954. He died in January 2021. The Appellant is his surviving spouse, so widow. She appealed to this Board from an April 2021 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO) and requested the evidence-submission option, allowing her 90 days after that election to submit additional evidence and/or argument in support of this appeal. That 90-day "grace period" since has expired. However, there are pre-decisional, duty-to-assist errors nevertheless requiring correcting before deciding this appeal. Entitlement to service connection for the cause of the Veteran's death The Veteran's death certificate shows that the immediate cause of his death was congestive heart failure (CHF) due to or as a cause of ischemic cardiomyopathy. Hypertension and atrial fibrillation were listed as significant conditions contributing to death but not the underlying cause. Before he died, he had established entitlement to service connection for: bilateral hearing loss, otitis media suppurative, and tinnitus. The appellant-widow contends that, although the Veteran's death certificate indicates his cause of death was CHF, dizziness caused by his service-connected ear conditions contributed substantially and materially to his death. In support of her claim, she submitted a July 2021 private opinion. This commenting physician posited the Veteran's service-connected ear conditions contributed to his ultimate demise. This commenting private clinician noted that, in October 2020, the Veteran fell because of chronic severe dizziness cause by his service-connected ear conditions. This clinician surmised that, due to the injuries suffered in that fall, the Veteran never again walked until his death in early January 2021. In DeLaRosa v. Peake, 515 F.3d 1319, 1322 (Fed. Cir. 2008), the U.S. Court of Appeals for the Federal Circuit (Federal Circuit Court) indicated that, while 38 U.S.C. § 5103A (a) does not always require VA to assist a claimant in obtaining a medical nexus opinion for a dependency and indemnity compensation (DIC) claim, so including for cause of death, it does require VA to assist a claimant in obtaining such whenever necessary to substantiate the DIC claim. See also Wood v. Peake, 520 F.3d 1345 (Fed. Cir. 2008) (holding that, in the context of a DIC claim, VA must also consider that 38 U.S.C. § 5103A(a) only excuses VA from making reasonable efforts to provide an opinion when no reasonable possibility exists that such assistance would aid in substantiating the claim). In this particular case at hand, prior to deciding this claim, a medical opinion was not obtained regarding whether there is any correlation ("nexus") between the conditions that caused or contributed substantially or materially to the Veteran's death and his military service, including by way of his service-connected disabilities. Accordingly, this claim is REMANDED for the following action: Obtain a medical opinion from an appropriate clinician to assist in determining whether any of the Veteran's service-connected disabilities either caused or contributed substantially or materially to his death. To assist in making this important determination, a complete copy of this remand and all relevant medical and other records including the July 2021 private opinion, must be made available to the examiner for consideration. When responding, regardless of whether favorably or unfavorably, it is essential the examiner provide discussion of the underlying rationale for the opinion, preferably citing to evidence in the file supporting conclusions and/or accepted medical authority. KEITH W. ALLEN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board P. Poindexter 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.