Citation Nr: 21008446 Decision Date: 02/17/21 Archive Date: 02/17/21 DOCKET NO. 20-26 706 DATE: February 17, 2021 REMANDED Entitlement to an evaluation in excess of 60 percent for service-connected valvular heart disease with heart valve replacement (claimed as heart condition) is remanded. Entitlement to Total Disability Individual Unemployability (TDIU) is remanded. REASONS FOR REMAND The Veteran served in the Army during the Vietnam era from November 1965, to August 1967. He received the Combat Infantryman Badge, among other decorations, for this service. This matter comes before the Board of Veteran’s Appeals (Board) from a November 2018 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO). The Veteran had a Board hearing on these claims before the undersigned; a transcript of that hearing is of record. This appeal has been advanced on the Board’s docket pursuant to 38 C.F.R. § 20.900(c) (2017). 38 U.S.C. § 7107(a)(2) (2012). 1. Entitlement to an evaluation in excess of 60 percent for service-connected valvular heart disease with heart valve replacement (claimed as heart condition) is remanded. The Veteran contends that he is entitled to an evaluation in excess of 60 percent for service-connected heart condition. He also contests the adequacy of the most recent VA medical examination upon which the last heart condition disability rating is based. The Veteran at the January 2021 Board hearing said that the most recent VA medical heart examination in April 2020 did not have input from him, was based on old information, and should therefore not be used for rating his current heart condition. Based on the Veteran’s 2021 hearing testimony and other evidence of record, the Board believes remanding for a new VA heart examination is necessary. The April 2020 VA examination consisted of a review of the available record without in-person, video or even telephonic communications with the Veteran. The Veteran at the Board hearing said he was told he would be allowed to participate in the examination by the VA Decision Review Officer (DRO) but was never properly notified. The Veteran claims he had updated information to share with examiner, that is missing from the examination report. According to Veteran his recent Metabolic Equivalent (MET) score is 2.6, and he is diagnosed with congestive heart failure with symptoms that include fatigue, dyspnea, and angina. If verified these factors could support the Veteran’s claim for a higher rating. Because the Veteran has made a credible argument that the April 2020 examiner based his opinion on incorrect or outdated medical evidence and suggests the condition has worsened, the Board is remanding the Veteran’s heart disability issue for a new examination and affording the Veteran the opportunity to update the record by submitting current MET test results and other medical proof to the claims file while on remand to the RO. 2. Entitlement to Total Disability Individual Unemployability (TDIU) is remanded. The Veteran contends that his service-connected disabilities prevent him from securing or following any substantially gainful occupation. The claim of entitlement to TDIU is inextricably intertwined with the issue of entitlement to an increased heart disability rating as the outcome of that claim may affect his eligibility for TDIU. Therefore, the Board finds that the claims should be considered together. See Parker v. Brown, 7 Vet. App. 116 (1994); Harris v. Derwinski, 2 Vet. App. 180, 183 (1991) (issues are "inextricably intertwined" when a decision on one issue would have a "significant impact" on a Veteran's claim for the second issue). The matters are REMANDED for the following action: 1. Obtain any updated VA treatment records and additional private treatment records related to the Veteran’s claims. Contact the Veteran and specifically ask for evidence the Veteran has showing his most recent MET score and all other recent heart disability treatment records. All records/responses received must be obtained and associated with the electronic claims file along with this Remand Order. 2. Schedule the Veteran for a new VA examination to determine the current severity of his heart condition. Ensure that the examiner knows the examination must be an in-person examination to test the Veteran’s current MET score and determine if the Veteran is suffering from chronic congestive heart failure. The examiner is asked to: (a.) List the Veteran’s diagnoses regarding his heart conditions; (b.) Test or otherwise determine the Veteran’s CURRENT MET score. (c.) Determine based on all the evidence of record if the Veteran is currently suffering from chronic heart failure. H. SEESEL Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. Black, 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.