Citation Nr: 21011226 Decision Date: 03/01/21 Archive Date: 03/01/21 DOCKET NO. 14-32 813 DATE: March 1, 2021 REMANDED Entitlement to service connection for ischemic heart disease, to include enlarged heart, congestive heart failure, and atrial fibrillation (heart condition) is remanded. REASONS FOR REMAND The Veteran served in the United States Army, including from February 1968 to April 1970. In February 2016, he died due to conjunctive heart failure. The appellant is the Veteran’s surviving spouse, who was substituted for the Veteran in June 2018. By way of procedural history, this claim was originally filed by the Veteran in May 2006. The claim was denied in a November 2006 rating decision that went unappealed by the Veteran and, therefore, became final. 38 U.S.C. § 7105(c); 38 C.F.R. § 3.156. In a September 2011 rating decision, the Regional Office, pursuant to Nehmer v. United States Veterans Administration, 284 F.3d 1158, 1161 (9th Cir. 2002), readjudicated and denied the claim. The Veteran properly appealed this issue to the Board. In September 2018, the appellant testified before the undersigned Veterans Law Judge. The Board issued a decision in May 2019 denying the appellant’s claim. The appellant appealed the matter to the United States Court of Appeals for Veterans Claims (Court), resulting in a May 2020 Joint Motion for Remand (JMR). In the JMR, the parties agreed that the Board did not provide adequate reasons and bases. Specifically, the parties agreed that a remand is warranted to provide an adequate statement of reasons and bases to properly consider the scope of the claim, to include all theories of entitlement. See May 2020 JMR. Here, the Board finds that a remand is warranted to obtain a new medical opinion. The Board finds that a new VA medical opinion is warranted to address whether the Veteran’s heart condition was a result of or aggravated by his diabetes mellitus. Notably, the VA medical opinion in August 2002 regarding whether the Veteran’s diabetes mellitus caused or aggravated his heart condition does not consider the new medical evidence submitted since the medical opinion. Therefore, a new VA medical opinion should be obtained to provide an accurate medical opinion. Next, the Board finds that the VA medical opinions of record fail to address whether his heart condition was incurred in or the result of service. The Board finds that the Veteran’s service treatment records (STRs) evidence that he sought treatment for chest pains during service. The Board finds that an opinion is necessary to determine whether the Veteran’s heart condition had its onset during service. Lastly, the Board notes that the VA examinations and medical opinions fail to address the Veteran’s heart diagnoses and merely found that he did not suffer from ischemic heart disease. The evidence establishes that the Veteran suffers from enlarged heart, congestive heart failure, and atrial fibrillation, but the VA medical opinions failed to specifically address each of these diagnoses separately. The Board finds this medical opinion is necessary to determine whether direct service connection is warranted. The matters are REMANDED for the following action: 1. Obtain any additional private and/or VA medical treatment records pertaining to the Veteran’s heart condition, to include, but not limited to, enlarged heart, congestive heart failure, and atrial fibrillation. 2. After the above is completed, obtain a new VA medical opinion. (a.) The examiner should specifically list all heart diagnoses the Veteran suffered from. For each of the listed heart diagnoses, to include enlarged heart, congestive heart failure, and atrial fibrillation, the examiner should address the following: (b.) Whether it is at least as likely as not (50 percent probability or more) that the Veteran’s heart condition was incurred in or caused by active service. In explaining the rationale, please address the Veteran’s in-service complaints and treatment of chest pain. (c.) Whether it is at least as likely as not (50 percent probability or more) that the Veteran’s heart condition was proximately due to or the result of herbicide exposure, which has been conceded.  (d.) Whether it is at least as likely as not (50 percent or greater probability) that the Veteran’s heart condition was caused by his diabetes mellitus. (e.) Whether it is at least as likely as not (50 percent or greater probability) that the Veteran’s heart condition was aggravated by diabetes mellitus. All opinions must be supported by a rationale. A. C. MACKENZIE Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. Glaeser, 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.