Citation Nr: 21010548 Decision Date: 02/25/21 Archive Date: 02/25/21 DOCKET NO. 18-18 242 DATE: February 25, 2021 REMANDED Service connection for a heart condition, to include bicuspid heart valve, systolic murmur, coronary artery disease, and aortic stenosis, is remanded. REASONS FOR REMAND The Veteran served on active duty in the U.S. Army from November 1969 to September 1970. 1. Service connection for a heart condition The Veteran contends he has a current heart condition due to service. The Board previously remanded this issue for an examination and medical opinion in October 2019 and again in June 2020 to obtain a new medical opinion to adequately consider the lay reports of symptoms and experiences and provide opinions on the diagnoses of heart valve disorder, aortic stenosis, systolic murmur, and coronary artery disease. Three medical opinions were obtained on remand in July and August 2020. In them, the expert addressed the etiology of aortic stenosis, systolic heart murmur, and bicuspid aortic valve. However, although the expert mentioned the diagnosis of coronary artery disease, she did not address whether the Veteran’s coronary artery disease could be related to his reports of symptoms in service and subsequent issues. In this regard, the July and August 2020 opinions fail to comply with the Board’s prior remand directives, and additional remand is required. See Stegall v. West, 11 Vet. App. 268 (1998). The matters are REMANDED for the following action: 1. Obtain and associate with the claims file any outstanding VA treatment records. 2. Obtain an opinion for the Veteran’s coronary artery disease. The expert should review the claims file and address whether the Veteran’s coronary artery disease is at least as likely as not related to or concurrent with his service. The expert should consider all relevant lay and medical evidence, including the Veteran’s reports of shortness of breath and chest pain on exertion in service and having a heart attack around 1978, within 10 years of discharge. All opinions must be supported by detailed rationale. If the opinion cannot be provided without resort to speculation, the expert should explain why, and state whether the inability is due to the absence of evidence or limits of scientific/medical knowledge. A. S. CARACCIOLO Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A.P. Armstrong 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.