Citation Nr: 21023283 Decision Date: 04/20/21 Archive Date: 04/20/21 DOCKET NO. 17-56 104 DATE: April 20, 2021 ORDER Service connection for the cause of the Veteran’s death is granted. FINDINGS OF FACT 1. The Veteran died in 2015. 2. The Veteran’s death certificate listed the immediate cause of death as cardiac arrest with underlying causes of death being congestive heart failure, coronary artery disease (CAD), and hypertension. 3. The Veteran’s CAD began in service. CONCLUSION OF LAW The criteria for service connection for the cause of the Veteran’s death have been met. 38 U.S.C. §§ 1101, 1110, 1310, 5103, 5103A, 5107; 38 C.F.R. §§ 3.5, 3.102, 3.303, 3.304, 3.312. REASONS AND BASES FOR FINDINGS AND CONCLUSION The Veteran served on active duty in the United States Air Force from March 1978 until his honorable retirement in February 1995. The Veteran died in 2015, and the appellant is the Veteran’s surviving spouse. She was substituted for the Veteran in claims that were pending at the time of his death. On her October 2017 VA Form 9, the appellant requested a Board hearing. In October 2020, she withdrew her hearing request. Therefore, the Board will proceed to adjudicate the case based on the evidence of record. See 38 C.F.R. § 20.704(e) Entitlement to service connection for the cause of the Veteran’s death. The death of a veteran will be considered as having been due to a service connected disability when the evidence establishes that such disability was either the principal or a contributory cause of death. The issue involved will be determined by exercise of sound judgment, without recourse to speculation, after a careful analysis has been made of all the facts and circumstances surrounding the death of the veteran, including, particularly, autopsy reports. 38 C.F.R. § 3.312(a). At the time of the Veteran’s death, service connection was in effect for migraine headaches and bilateral thumb disabilities. His death certificate shows that the immediate cause of death was cardiac arrest. His underlying causes of death were congestive heart failure, CAD, and hypertension. An April 1994 service treatment record (STR) indicates that the Veteran was treated for symptoms of sharp, intermittent chest pain. He was diagnosed with acute pericarditis. In March 2015, the Veteran was afforded a VA heart conditions examination. He reported that he began having chest pains in the 1970s to early 1980s, and that he was evaluated for heart symptoms but never treated. He stated that he was told he had an enlarged heart. The examiner diagnosed CAD status-post myocardial infarction and stent placement with severely impaired left ventricular function and moderate pulmonary insufficiency with pulmonary hypertension. The examiner stated that the Veteran’s heart disorders were not caused by service because there was no evidence of in service treatment for a heart disorder or symptoms. The STRs indicate treatment for chest pain, however, and a diagnosis of acute pericarditis. Therefore, it appears that the examiner was not familiar with the record when making this opinion. Additionally, the examiner gave no reason for discounting the Veteran’s reports of in-service heart symptoms. This opinion is inadequate and of no probative value. A November 2019 private physician reviewed the Veteran’s file and provided an opinion. He stated that the Veteran likely did not have acute pericarditis in service because his symptoms and the EKG taken at the time did not support such a diagnosis. Instead the EKG showed progressive early changes of left ventricular hypertrophy. The physician concluded that the Veteran was likely misdiagnosed at that time and, instead, that his chest pain in service was the start of CAD. He stated that the Veteran was treated in 1998, 1999, and 2000 for similar chest pain and, then, in 2000 had a myocardial infarction and underwent catheterization. He concluded that CAD began in service and continued throughout the Veteran’s life, eventually causing his death. (Continued on the next page)   The only probative opinion of record states that CAD began in service, continued throughout the Veteran’s life, and eventually caused the Veteran’s death. Therefore, service connection for the cause of the Veteran’s death is warranted and the appeal is granted. Jacqueline E. Miller Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. F. Sawka, 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.