Citation Nr: 21028502 Decision Date: 05/11/21 Archive Date: 05/11/21 DOCKET NO. 13-04 636 DATE: May 11, 2021 REMANDED Entitlement to service connection for an acquired cardiovascular disorder is remanded. REASONS FOR REMAND The Veteran served on active duty from March 1973 to November 1991.This matter comes before the Board of Veterans' Appeals (Board) on appeal of a June 2011 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO). In January 2019, the Board denied service connection for a heart disability. The Veteran appealed the Board's January 2019 decision to the United States Court of Appeals for Veterans Claims (Court). In February 2020, the Court granted a Joint Motion for Remand (JMR) filed by both parties to the case, vacated the January 2019 Board decision, and remanded the matter to the Board for further development and analysis consistent with the terms of the Joint Motion. This claim was last before the Board in January 2021 where it was remanded for additional development. 1. Entitlement to service connection for an acquired cardiovascular disorder is remanded. While further delay is regrettable, the Board finds that additional development is needed prior to adjudication of this claim. In accordance with prior remand instructions, an addendum opinion was obtained in February 2021. The VA examiner was instructed to opine as to the following: whether the Veteran's Grade I systolic dysfunction noted during a December 2012 echocardiogram is at least as likely as not etiologically related to his active service; whether it is at least as likely as not that the Veteran's Grade I systolic dysfunction is proximately due to or the result of his service-connected disabilities; and whether it is at least as likely as not that the Veteran's Grade I systolic dysfunction is aggravated beyond its natural progression by his service-connected disabilities. See January 2021 Board Remand. The February 2021 VA examiner did not provide an opinion as to direct service connection as instructed. As such, additional opinion is warranted in order to comply with the terms of the Board's prior remand instructions. See Stegall v. West, 11 Vet. App. 268 (1998) (a remand by the Board confers on the appellant, as a matter of law, the right to compliance with the remand orders). Additionally, while the VA examiner opined that the Veteran's Grade I systolic dysfunction was less likely than not proximately due to or aggravated by his service-connected disabilities, the provided rationale is conclusory as it merely listed the medical evidence that was considered and reviewed. Thus, this rationale is inadequate. See Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007) ("[A] medical opinion must support its conclusion with an analysis that the Board can consider and weigh against contrary opinions"). Therefore, additional opinion is needed. The matters are REMANDED for the following action: 1. Obtain an addendum opinion from a physician with appropriate expertise as to whether the Veteran's Grade I systolic dysfunction noted during a December 2012 echocardiogram is at least as likely as not (50 percent or greater probability) etiologically related to his active service. Adequate rationale must be provided for the opinion proffered. (a.) If not, whether it is at least as likely as not that the Veteran's Grade I systolic dysfunction is proximately due to or the result of his service-connected disabilities. Adequate rationale must be provided for the opinion proffered. In rendering the requested rationale, the examiner must note that it is not required that the Grade I systolic dysfunction is shown to be "predominantly" due to or result of service-connected disabilities, but rather, whether there is any contributing degree of etiological relationship to a service-connected disability. (b.) If not, whether it is at least as likely as not that the Veteran's Grade I systolic dysfunction is aggravated beyond natural progression by his service-connected disabilities. Adequate rationale must be provided for the opinion proffered. In rendering the requested rationale, the examiner must note that it is not required that the Grade I systolic dysfunction is shown to be aggravated beyond natural progression "predominantly" by a service-connected disability, but rather, whether there is any contributing degree of aggravation beyond natural progression by a service-connected disability. 2. If the claim remains denied, issue a supplemental statement of the case. K. A. BANFIELD Veterans Law Judge Board of Veterans' Appeals Attorney for the Board G. N. Wilson, 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.