Citation Nr: 21015789 Decision Date: 03/18/21 Archive Date: 03/18/21 DOCKET NO. 18-04 767 DATE: March 18, 2021 REMANDED The claim of entitlement to service connection fort a heart disorder is remanded. REASONS FOR REMAND The Veteran served on active duty from September 1966 to September 1968. The Veteran testified at a virtual teleconference hearing before the undersigned Veterans Law Judge in March 2021. By way of procedural background, the Veteran was initially denied service connection for various disorders, to include a heart disorder, in a July 2013 rating decision. He was notified in correspondence dated on July 22, 2013. On July 14, 2014, he requested ”reconsideration” of all the claims adjudicated in the July 2013 rating decision, to include a heart disorder. In a September 2014 rating decision, the Regional Office (RO) continued the denial for service connection for a heart disorder. In July 2015, the Veteran filed a Notice of Disagreement (NOD) (VA FORM 21-0958) with the September 2014 rating decision. The RO acknowledged receipt of the NOD in a letter to the Veteran and issued a statement of the case (SOC) in November 2017 enumerating that the claim of service connection for a heart disorder had been denied as no new and material evidence had been submitted since the final rating decision of July 2013. Upon review, the Board finds that the Veteran’s July 2014 statement for “reconsideration should have been accepted by the RO as a valid NOD with the July 2013 rating decision. A NOD is a written communication from a claimant or his representative expressing dissatisfaction or disagreement with an adjudicative determination by the agency of original jurisdiction and a desire to contest the result. A liberal standard is applied in determining whether a communication constitutes a NOD. While special wording is not required, the communication in question must at least refer to the rating decision in question and must be in terms which can be construed reasonably as disagreement with that determination and a desire for appellate review. Thus, a NOD relates to a specific adjudicative determination on a specific date. 38 C.F.R. § 20.201 (2020); see also Gallegos v. Principi, 283 F.3d 1309, 1313-15 (Fed. Cir. 2002) (upholding the validity of the regulatory requirement that a notice of disagreement include “terms that can be reasonably construed... as a desire for appellate review”); Stokes v. Derwinski, 1 Vet. App. 201, 203 (1991). Here, the Veteran’s July 14, 2014, statement specifically indicated that he was in disagreement with the July 2013 rating decision, and the statement was received within one year after notification of the July 2013 initial denial of the claim. As such, because the July 2013 rating decision did not become final, new and material evidence is not required. The claim of entitlement to service connection for a heart disorder is remanded. The service treatment records (STRs) reflect occasional reports of chest pain and/or pressure, as well as shortness of breath (SOB) and dizziness. No chronic heart disorder was diagnosed, to include upon service separation. Post service records include a naval reserve examination in March 1971 wherein the Veteran gave a history of pain or pressure in the chest. Private records dated in 1997 include reports of ventricular tachycardia, SOB, diaphoresis and chest discomfort. Private records from 2000 reflect similar complaints but echocardiogram testing was normal, as was treadmill testing in August 2005. VA records dated in 2009 reflect a past medical history significant for vasovagal with the last episode approximately 15 years earlier. Coronary artery disease (CAD), arrythmia, and an overactive vagus nerve were noted. Hypertension (HTN) was also noted in 2014. Subsequently dated private records dated in 2017 forward also include diagnoses of cardiovascular disorders of essential HTN and coronary arteriosclerosis. Remand is required for an opinion as to the etiology of cardiovascular disorders. The matters are REMANDED for the following action: 1. Obtain all updated relevant treatment records (private and VA) and associate them with the claims file. 2. After the above development is completed, schedule the Veteran for an appropriate VA examination to obtain medical opinions regarding all disabilities of the heart, to include CAD with overactive vagus nerve and HTN. The claim file must be reviewed by the examiner. Following a review of the claim file and examination of the Veteran, the examiner should diagnose all cardiovascular disabilities exhibited by the Veteran. For each disability diagnosed, the examiner should offer an opinion as to whether it is at least as likely as not (i.e. 50 percent probability or more) that such disability is related to service. In providing his or her opinion, the VA examiner should discuss the in-service episodes of chest pain and pressure. All opinions are to be accompanied by a rationale consistent with the evidence of record. A discussion of the pertinent evidence, relevant medical treatises, and generally accepted medical principles is requested. If the examiner cannot provide an opinion without resorting to speculation, he or she shall provide complete explanations stating why this is so. In so doing, the examiner shall explain whether any inability to provide a more definitive opinion is the result of a need for additional information, or that he or she has exhausted the limits of current medical knowledge in providing an answer to that particular question. 4. If upon completion of the above the issue remains denied, the appeal should be returned to the Board after compliance with appellate procedure. E. I. VELEZ Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board T. Hal Smith, 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.