Citation Nr: 21011560 Decision Date: 03/02/21 Archive Date: 03/02/21 DOCKET NO. 18-01 591 DATE: March 2, 2021 ORDER Entitlement to service connection for a heart condition, to include atrial fibrillation, atrial flutter, and supraventricular tachycardia, is granted. FINDING OF FACT The Veteran’s heart condition, to include atrial fibrillation, atrial flutter, and supraventricular tachycardia, began during a period of active duty for training. CONCLUSION OF LAW The criteria for service connection for a heart condition, to include atrial fibrillation, atrial flutter, and supraventricular tachycardia, are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States from August 1982 to November 1982, and on a period of active duty for training (ACDUTRA) from July 12, 1993 to July 29, 1993. This matter comes before the Board of Veterans’ Appeals (Board) from a March 2016 rating decision from the Department of Veterans Affairs (VA) Regional Office (RO). The Veteran appeared for a hearing in January 2020. A transcript of the proceeding is of record. This claim was previously remanded by the Board in April 2020 for further development, to include verifying the Veteran’s periods of service and providing a VA examination. The Board finds substantial compliance with the remand directives and therefore another remand is not necessary. Stegall v. West, 11 Vet. App. 268 (1998). Where there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, VA shall resolve reasonable doubt in favor of the claimant. 38 U.S.C. § 5107 (b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). To deny a claim on its merits, the evidence must preponderate against the claim. Alemany v. Brown, 9 Vet. App. 518 (1996). Entitlement to service connection for a heart condition, to include atrial fibrillation, atrial flutter, and supraventricular tachycardia The Veteran contends that she incurred her heart conditions, to include supraventricular tachycardia (SVT), atrial fibrillation and atrial flutter, during a period of ACDUTRA in July 1993 which have persisted to the present. The Board concludes that the Veteran has a current disability that began during her period of ACDUTRA in July 1993. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a). Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. § 3.303. The three-element test for service connection requires evidence of: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004). Active military service includes: 1) active duty; 2) any period of active duty for training (ACDUTRA) during which the individual concerned was disabled from a disease or injury incurred or aggravated in the line of duty; and 3) any period of inactive duty for training (INACDUTRA) during which the individual concerned was disabled from an injury incurred or aggravated in the line of duty. 38 U.S.C. § 101 (2), (24); 38 C.F.R. § 3.6 (a). Presumptive periods do not apply to ACDUTRA or INACDUTRA. Biggins v. Derwinski, 1 Vet. App. 474, 477-78 (1991). The June 2020 VA examination shows the Veteran has current diagnoses of supraventricular tachycardia (SVT), atrial fibrillation and atrial flutter. At the January 2020 Board hearing, the Veteran competently and credibly testified that she first experienced SVT and heart palpitations during a period of ACDUTRA in July 1993 and has continued with the same symptoms intermittently to the present day. Military personnel records confirm she was on a period of ACDUTRA at Camp Lejeune for 17 days beginning on July 12, 1993. During service, the Veteran was seen for complaints of irregular heartbeat on July 22, 1993 at Camp Lejeune. She was diagnosed with SVT and heat exhaustion. Additionally, in February 1994 the Veteran was placed in non-drill status due to cardiac arrhythmia requiring medication. Additionally, a July 1993 medical evaluation memorandum indicates a history of mitral valve prolapse, and that her SVT was aggravated by the physical requirements of ACDUTRA. A memorandum issued few days later indicates she is diagnosed with mitral valve prolapse which was incurred in the line of duty. However, emergency room documentation on the day of the incident does not diagnose mitral valve prolapse, and subsequent evaluations reveal no mitral valve prolapse. See, e.g., July 2001 Private treatment records; June 2020 VA examination. Post-service treatment records reveal she was diagnosed with atrial fibrillation in August 1999. In September 1999 she reported intermittent palpitations since the episode of SVT in July 1993, continuing to the present. Private medical records between 2000 and 2015 reveal ongoing treatment and testing for SVT, atrial fibrillation, and persistent chest pain. August 2015 private treatment records indicate her atrial fibrillation may be related to her SVT. The January 2016 VA examination revealed chest pain with atrial fibrillation occurring approximately twice per month. The examiner opined that atrial fibrillation and flutter could be caused by her history of mitral valve prolapse of unknown etiology, and that her SVT was of unknown etiology. However, this opinion is not probative as it is speculative in nature, indicating that her conditions “could” be caused by mitral valve prolapse. Therefore, the Board assigns the opinion no probative weight. See Obert v. Brown, 5 Vet. App. 30, 33 (1993); see also Bloom v. West, 12 Vet. App. 185, 187 (1999). The June 2020 VA examination indicated her SVT began in July 1993 and was therefore not incurred in service. However, the examiner was not aware that the Veteran was on a period of ACDUTRA at this time. Therefore, this opinion was based on an inaccurate factual premise and is of no probative weight. See Reonal v. Brown, 5 Vet. App. 458, 461 (1993). In summary, the evidence in favor of the claim is treatment for SVT during a period of ACDUTRA, the Veteran’s competent and credible statements indicating palpitations during that event, and STRs indicating she was placed in non-drill status as of February 1994 due to a cardiac arrhythmia. Though there is some question whether the Veteran’s condition is due to mitral valve prolapse, the Board finds the weight of the evidence is against such a finding.   Therefore, the Board finds the evidence to at least be in equipoise as to whether the Veteran’s current heart conditions of SVT, atrial fibrillation, and atrial flutter arose in a period of ACDUTRA. Accordingly, after resolving all doubt in favor of the Veteran, the Board finds that service connection for SVT, atrial fibrillation, and atrial flutter is warranted. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. Nathaniel J. Doan Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board K.L. Blevins, 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.