Citation Nr: 21016074
Decision Date: 03/18/21	Archive Date: 03/19/21

DOCKET NO. 15-43 977
DATE: March 18, 2021

REMANDED

Entitlement to service connection for chest area nerve damage, claimed secondary to the service-connected surgical repair of the atrial septal defect is remanded.

REASONS FOR REMAND

The Veteran served on active duty from May 2002 to January 2005.  

This matter was previously before the Board in July 2019, at which time it was remanded for a for an examination to determine the nature and etiology of the Veteran’s chest pain. Unfortunately, the Board finds that another remand is needed before the claim may be considered.

The Veteran contends his left side chest pain is due to nerve damage from his in-service heart surgery.  In pertinent part, he is service connected for disability characterized as residuals of atrial septal defect surgical repair with transient sternum pain, evaluated as 10 percent disabling; and a sternotomy scar, evaluated as non-compensable.  At the November 2019 VA examination that followed the Board’s Remand, the examiner found there was no distinct nerve or muscle damage condition present, but instead linked the Veteran’s current complaints to costochondritis that coincided with a post service truck/motor vehicle accident in 2013.  As such, it was unrelated to the Veteran’s service connected disability.  

Although adequate as far as it goes, case law requires medical opinions in cases such as these also to address whether service connected disability has aggravated the claimed condition.  An addendum opinion will be sought.  

The matters are REMANDED for the following action:

1. Provide the claims file to an appropriate clinician, who should be asked to review it and render an opinion as to whether it is at least as likely as not the Veteran’s service connected atrial septal defect surgical repair with transient sternum pain, and/or sternotomy scar has aggravated (worsened beyond the natural progression) the Veteran’s costochondritis.  

If the reviewer concludes costochondritis is not responsible for the Veteran’s more current left chest side pain, a corrected diagnosis should be identified, and an opinion offered as to whether that disability was caused by atrial septal defect surgical repair with transient sternum pain, and/or sternotomy scar; as well as whether it has been aggravated by the atrial septal defect surgical repair with transient sternum pain, and/or sternotomy scar.  

If it is necessary to examine the Veteran to obtain the requested opinion/s, that should be arranged.  

The reviewer should explain the reasons for the conclusions expressed.  

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2. After any further development as may be indicated has been accomplished, readjudicate the issue on appeal.

 

 

M. E. KILCOYNE

Veterans Law Judge

Board of Veterans’ Appeals

Attorney for the Board	B. Jaigirdar, 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.