Citation Nr: 21013276 Decision Date: 03/09/21 Archive Date: 03/09/21 DOCKET NO. 12-05 952 DATE: March 9, 2021 REMANDED Service connection for hypertension is remanded. Service connection for congestive heart failure is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from August 1974 to October 1974. He offered testimony during a November 2015 travel board hearing. A transcript of this proceeding has been associated with the record. These appeals were then remanded by the Board in April 2016 for additional development. See Stegall v. West, 11 Vet. App. 268, 271 (1998). In that same decision, the Board remanded a claim seeking service connection for a psychiatric disorder. Service connection for depression was subsequently awarded in a July 2020 rating decision. This constitutes a complete grant of the service connection claim, and the appellant has not disagreed with any aspect of this award, to include the initial rating or effective date as assigned. Thus, this matter is no longer for the Board’s consideration. See Grantham v. Brown, 114 F.3d 1156 (Fed. Cir. 1997) (noting that a grant of service connection extinguishes appeals before the Board). Additionally, in April 2016, the Board remanded two claims seeking a higher rating for a service-connected back disability and a total disability rating based on individual employability (TDIU). Therein, the Board instructed that a Statement of the Case (SOC) be issued for these matters pursuant to Manlincon v. West, 12 Vet. App. 238 (1999). The requested SOC was issued in November 2016; a VA Form 9 was submitted in April 2017. In November 2017, the Veteran was informed that his substantive appeal was not timely and could not be accepted. Thus, there is no further action to be taken with respect to these appeals. Regrettably, the Veteran died in December 2017, during the pendency of this appeal. The appellant has been recognized as a properly substituted claimant. See 38 U.S.C. § 5121A; see also January 2018 letter (indicating the appellant has been substituted for the Veteran in the present appeal). In January 2021, the appellant was informed that the Veterans Law Judge (VLJ) who presided over the November 2015 hearing was no longer with the Board, and was offered a hearing before a different VLJ. As she did not request a new hearing within 30 days of this notice, the Board may proceed with its review of the matters on appeal. 38 U.S.C. § 7107(c); 38 C.F.R. § 20.707. In May 2014, the Veteran requested a temporary total evaluation due to upcoming surgery. Although VA requested that such a claim be initiated, no such action was undertaken. As this issue has not yet been adjudicated by the Agency of Original Jurisdiction (AOJ), the Board does not have jurisdiction over it, and it is referred to the AOJ for appropriate action. 38 C.F.R. § 19.9(b). Although the Board sincerely regrets the additional delay this will cause, further development is necessary prior to the adjudication of these appeals. First, in April 2016, the Board instructed that the Veteran be provided with the opportunity to identify additional evidence to be obtained (including private treatment records) and provide the necessary authorization therefor. It does not appear that this information was solicited from the Veteran or appellant at any time. Such action is warranted on remand. See Stegall v. West, 11 Vet. App. 268, 271 (1998). Further, the April 2016 remand instructed that VA nexus opinions be obtained. Although opinions were provided in May 2020, they are inadequate for adjudication purposes. Notably, the Veteran had argued that his claimed disorders were secondarily related to his service-connected back disability, which greatly restricted his physical activities. See November 2015 hearing transcript, p. 15. There is medical evidence to support this theory, but the May 2020 opinion does not address this potential causal relationship. See, e.g., VA treatment record dated March 2015 (reporting severe shortness of breath upon mild exertion, as documented during a cardiac evaluation). Moreover, no opinion was offered as to the potential causal relationship between the two claimed disorders, despite evidence of such. Thus, an additional opinion is needed. The matters are REMANDED for the following actions: 1. Contact the appellant and request that she identify all private providers of medical treatment for the claimed disabilities since the Veteran’s service, and request that she provide authorization for release of all identified private medical records to VA. All actions to obtain the requested records should be fully documented in the record. The RO must make two attempts to obtain any private records identified, unless the first attempt demonstrates that further attempts would be futile. If private records are identified, but not obtained, the RO must notify the appellant of (1) the identity of the records sought, (2) the steps taken to obtain them, (3) that the claim will be adjudicated based on the evidence available, and (4) that if the records are later obtained, the claim may be readjudicated. If possible, the appellant should attempt to obtain the records herself. 2. Obtain an addendum opinion addressing the questions below.  The claims file and a copy of this remand must be made available for review, and the examination report must reflect that review of the claims file occurred.    In particular, the examiner must address the following: (a.) Were the Veteran’s hypertension or congestive heart failure caused or aggravated by his service-connected back or bilateral lower extremity disabilities (including related limitation of movement and the inability to exercise) or the treatment thereof? In doing so, the examiner must explicitly address VA treatment records which note increased shortness of breath upon minor exertion and the possible impact on the Veteran’s cardiac disorders. (b.) Was the Veteran’s congestive heart failure caused or aggravated by his hypertension or the treatment thereof? Here, the examiner must explicitly address VA treatment records which note that the Veteran’s cardiac symptoms were secondary to his hypertension. See, e.g., March 2015 VA treatment record. In formulating the opinion, the examiner is advised that the term “at least as likely as not” does not mean “within the realm of possibility.”  Rather, it means that the weight of the medical evidence for and against the claim is so evenly divided that it is as medically sound to find in favor of the claim as it is to find against it.  A complete rationale should be provided for all opinions or conclusions expressed.  It should be noted that the Veteran was competent to attest to observable symptomatology.  If there is a medical basis to support or doubt the history provided by the Veteran, the examiner should provide a fully reasoned explanation.  Evan M. Deichert Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board K. Kovarovic, 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.