Citation Nr: 21009682 Decision Date: 02/23/21 Archive Date: 02/23/21 DOCKET NO. 17-12 427 DATE: February 23, 2021 REMANDED Entitlement to service connection for a heart condition, to include an irregular heartbeat is remanded. REFERRED The issue of hypertension was raised in a January 2020 lay statement and is referred to the Agency of Original Jurisdiction (AOJ) for adjudication. REASONS FOR REMAND The Veteran served on active duty from July 1979 to July 1983 and from September 1984 to August 1992. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a March 2015 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). The claim was previously remanded by the Board in January 2019 and August 2020 for further development. On closer look, further clarification is needed to determine whether the Veteran is diagnosed with a current heart disability. The Veteran was afforded a VA examination in March 2020. The examiner diagnosed the Veteran as having an onset of supraventricular arrhythmia in 1980 even though the examiner’s report stated the condition began in 1981. The examiner was unable to document any evidence of an irregular heartbeat during the examination because the EKG performed showed a sinus rhythm. However, the examiner found that the Veteran had supraventricular tachycardia intermittently with more than four episodes in the past year. The examiner did not determine the etiology of the Veteran’s irregular heartbeat or if the Veteran has a current heart disability. Rather, the examiner stated that he did not find any EKG showing an irregular heartbeat, which is inconsistent with the record. The Veteran’s September 2011 private treatment records state the Veteran is “mildly tachycardic” and the November 2015 private treatment records showed the Veteran underwent an EKG with a finding of tachycardia. In light of the above, it is unclear whether the Veteran is diagnosed with a current heart disability. The Board cannot make a fully-informed decision on the issue of service connection for irregular heartbeat because no VA examiner has opined whether the Veteran has a current heart disability. The Board notes that a November 2020 VA opinion was obtained acknowledging that the Veteran had an incident of supraventricular tachycardia while in service, but the opinion did not provide any diagnosis or current heart disability. While the Board regrets the delay, a remand is required to obtain a clarification of whether the Veteran is diagnosed as having a current heart disability. The matters are REMANDED for the following action: 1. Schedule the Veteran for an in-person VA examination with an appropriate examiner to obtain an addendum opinion as the nature and etiology of the Veteran’s heart condition, including irregular heartbeat. 2. Provide the examiner the claims file, to include the January 2019 Remand, August 2020 Remand, and this Remand order. The examination report should reflect that such review was accomplished. 3. The examiner is advised that the Veteran is competent to report symptoms, treatment, and injuries, and that his reports must be considered in formulating the requested opinions. 4. Based on review of the record and examination of the Veteran, and after eliciting a detailed history from the Veteran, the examiner is requested to: a. Identify any and all current diagnoses of the heart, including an opinion of whether the Veteran has or has had supraventricular tachycardia. b. Opine as to whether the Veteran’s tachycardia, as documented in September 2011 and November 2015 private treatment records and elsewhere, is a manifestation of an underlying heart disability or constitutes a disability on its own. c. For each diagnosis, opine whether such diagnosis is at least as likely as not (50 percent probability or greater) caused by or is otherwise attributable to service. 5. A reasoned rationale supporting the examiner’s conclusions must be provided for any and all opinions offered. All appropriate studies and consultations should be accomplished, and all clinical findings should be reported in detail. If any requested opinion cannot be provided without resorting to mere speculation, the examiner must fully explain why this is the case and identify what, if any, additional evidence or information might allow for a more definitive opinion. 6. After completing the foregoing and any other development necessary, readjudicate the Veteran’s claim. 7. If any benefit sought on appeal remains denied, a Supplemental Statement of the Case (SSOC) should be furnished to the Veteran and his representative, and he should be afforded a reasonable opportunity to respond. Cynthia M. Bruce Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. Agarwal, 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.