Citation Nr: 21026908
Decision Date: 05/04/21	Archive Date: 05/04/21

DOCKET NO. 16-35 584
DATE: May 4, 2021

REMANDED

Entitlement to service connection for ischemic heart disease, to include as due to herbicide exposure, is remanded.

Entitlement to service connection for central retinal artery occlusion (claimed as left eye), to include as due to herbicide exposure, is remanded.

REASONS FOR REMAND

The Veteran served on active duty from July 1965 to June 1967.  

This matter comes before the Board of Veterans' Appeals (Board) on appeal from a March 2015 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO).  The Veteran died on March [REDACTED], 2020. The case was most recently before the Board in May 2020, at which time the appeal was dismissed due to the Veteran's death. In August 2020, the RO accepted the Veteran's son's request for substitution.  38 U.S.C. § 5121A.

The Veteran contended that he suffered from ischemic heart disease and central retina artery occlusion as a result of his active service, including as due to herbicide exposure. VA treatment records reflect diagnoses of a trans-ischemic attack and central retinal artery occlusion, also described as a stroke with consequent sensory loss, in February 2014.

In accordance with the March 2019 remand directives, VA opinions were obtained in December 2019; however, those opinions are not fully responsive.  Specifically, although the examiner concluded that the Veteran had no current diagnosis of a heart condition, the examiner failed to address whether the Veteran was diagnosed with a heart condition at any time during appeal period, to include the VA treatment notes reflecting a diagnosis of trans-ischemic attack and stroke.  Additionally, although the examiner opined that it is less likely than not that central retinal artery occlusion (CRAO) is due to active service, the examiner failed to provide adequate rationale in support of that conclusion.

The Board regrets the additional delay but finds that a remand is warranted for substantial compliance with its prior remand.  See Stegall v. West, 11 Vet. App. 268, 271 (1998). 

The matters are REMANDED for the following actions:

1. Obtain an addendum opinion from a cardiologist regarding the nature and etiology of the Veteran's claimed heart disease and central retinal artery occlusion.  Following a review of the claims file, the examiner should address the following:

(a.) Whether the Veteran at any point during the appeal period had any diseases affecting the heart and cardiovascular system and specify the precise diagnosis of this disease (if shown).

**Specifically address VA treatment records noting diagnoses of trans-ischemic attack and stroke.

(b.) For each diagnosed disorder, it is requested that the examiner opine whether it is at least as likely as not (50 percent or greater probability) that such diagnosis is etiologically related to service, including as due to the Veteran's herbicide exposure while serving in Vietnam from 1965 to 1967.

(c.) Whether the Veteran's diagnosed central retinal artery occlusion (claimed as left eye) is at least as likely as not (50 percent or greater probability) due to or the result of the Veteran's active service, including as due to herbicide exposure or as secondary (caused or aggravated by) to any disability found to be at least as likely as not due to the Veteran's active service, including claimed ischemic heart disease.

All opinions must be supported by a rationale.

2. Then, readjudicate the claims on appeal.

 

 

Romina A. Casadei

Acting Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	A. Asare, 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.