Citation Nr: 21005493 Decision Date: 02/01/21 Archive Date: 02/01/21 DOCKET NO. 17-04 014 DATE: February 1, 2021 ORDER Entitlement to service connection for a heart disability as secondary to the service-connected right radial ulnar disability is granted. FINDING OF FACT Resolving reasonable doubt in favor of the Veteran, the Veteran’s heart disability was aggravated by his service-connected right radial ulnar disability. CONCLUSION OF LAW The criteria for entitlement to service connection for a heart disability, to include as secondary to the service-connected right radial ulnar disability, have been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from October 1967 to November 1967. The matter comes before the Board of Veterans’ Appeals (Board) on appeal from a February 2015 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified at a videoconference hearing before the undersigned Veterans Law Judge (VLJ) in January 2020. The hearing transcript is of record. The Board remanded the claim in April 2020 for further development by the RO. The case has been returned to the Board for further appellate action. Entitlement to service connection for a heart disability, to include as secondary to the service-connected right radial ulnar disability The Veteran seeks service connection for a heart disability, claimed as arteriosclerosis, to include as secondary to his service-connected right non-dominant radial ulnar articulation deformity. Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. § 3.303. The three-element test for service connection requires evidence of: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004). Service connection may also be granted for a disability that is proximately due to, or aggravated by, service-connected disease or injury. 38 U.S.C. §§ 1110, 1131; Allen v. Brown, 7 Vet. App. 439 (1995) (en banc); 38 C.F.R. § 3.310(a). The Board notes that the Veteran has diagnoses of coronary artery disease (CAD); myocardial infarction due to CAD; coronary artery bypass graft (CABG) with residual chest pain syndrome due to CAD; and valvular heart disease. See October 2020 VA examination. Therefore, the first element of service connection is met. The Veteran’s service treatment records (STRs) contain nothing suggestive of a heart disability for VA purposes during service. The induction report of medical examination dated July 17, 1967, indicate that the vascular system was normal. As for the heart, the clinician noted “no NVH” without further elaboration elsewhere in the report. The Board notes that the Veteran has not alleged, nor does the record reasonably raise, any pre-existing injury or disease related to his heart. Furthermore, the report of medical examination dated October 30, 1967, indicates that the heart and vascular system were normal. The STRs do not contain any record of complaints of or treatment for cardio-vascular conditions, and they are not otherwise suggestive of a heart disability during service. After review of this evidence, the Board finds that direct service connection is not warranted. Regarding secondary service connection, the Board finds that the examiner’s October 2020 opinion supports a finding of aggravation. Considering the facts and rationale used, the Board finds that this opinion is sufficient basis to grant service connection based on aggravation. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008). The same examiner opined against secondary service causation by aggravation, and the Board does not find other basis to grant on secondary by causation. Accordingly, the Board must resolve reasonable doubt in the Veteran’s favor and finds that service connection for a heart disability is warranted. 38 U.S.C. § 5107 (b); 39 C.F.R § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). Nathaniel J. Doan 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.