Citation Nr: 21011104 Decision Date: 02/26/21 Archive Date: 02/26/21 DOCKET NO. 16-30 202 DATE: February 26, 2021 REMANDED Entitlement to a disability rating in excess of 10 percent from March 1, 2016 forward for coronary artery disease is remanded. REASONS FOR REMAND The Veteran served on active duty from April 1961 to April 1965. This matter comes before the Board of Veterans’ Appeals (Board) from a December 2015 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). This issue was subject to a joint motion for remand by the United States Court of Appeals for Veterans Claims in July 2020. Although the Board regrets additional delay, remand is necessary to properly evaluate the Veteran’s disability. The Veteran most recently underwent a VA examination in November 2016. He was found to have to use continuous medication, but he did not have myocardial infarction, congestive heart failure, cardiac arrhythmia, heart valve issues, infectious heart condition, or pericardial adhesions. His left ventricular ejection fraction was 55 to 60 percent. The Veteran reported pressure in the left side of his chest when carrying heavy items, walking with a fast pace, climbing stairs, or walking up an incline. The examiner estimated that a METS level of greater than 3 but 5 or less resulted in symptoms; such activity level was consistent with activities such as light yard work, mowing the lawn, and brisk walking. The examiner stated that the ejection fraction was the most accurate indicator of the Veteran’s current cardiac functioning as the METS was based on an estimation of what the Veteran says he is physically able to do. Treatment records demonstrate that the Veteran was very active, and he denied breathing problems, chest pain or pressure, claudication, edema, exercise intolerance, fainting or blackouts, palpitations, or shortness of breath. His examination revealed a regular heart rate and rhythm, and he denied anginal chest pain, syncope, dyspnea on exertion, or edema. The Board finds that a new VA examination is necessary to properly evaluate the Veteran’s current symptoms. Although the November 2016 examiner stated that he had a METS level of greater than 3 but 5 or less, treatment records are in conflict with whether the Veteran is so limited, and the examiner only provided a METS estimate, instead stating that his ejection fraction was more accurate. As such, a new examination is necessary to properly evaluate the current severity of his symptoms and determine if the Veteran does suffer from a more limited METS workload. The matters are REMANDED for the following action: 1. Ask the Veteran to identify all outstanding treatment records relevant to treatment for coronary artery disease. All identified VA records should be added to the claims file. All other properly identified records should be obtained if the necessary authorization to obtain the records is provided by the Veteran. If any records are not available, or the Veteran identifies sources of treatment but does not provide authorization to obtain records, appropriate action should be taken (see 38 C.F.R. § 3.159(c)-(e)), to include notifying the Veteran of the unavailability of the records 2. After records development is completed, schedule the Veteran for a VA heart examination to determine the current symptoms, level of severity, and functional impairment associated with his coronary artery disease. The claims file should be reviewed by the examiner. All necessary tests should be performed, and the results reported. The examiner should specifically comment on the November 2016 VA examination that estimated the Veteran’s METS level to determine whether his METS level is currently so limited upon examination and in light of the other evidence of record. 3. Readjudicate the claim. C.B. Iwanowski Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. Hofmeister, Attorney Advisor 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.