Citation Nr: 21030084 Decision Date: 05/17/21 Archive Date: 05/17/21 DOCKET NO. 10-39 085 DATE: May 17, 2021 REMANDED Service connection for a heart disability is remanded. Service connection for a kidney disability is remanded. Service connection for a liver disability is remanded. A compensable rating for service-connected tuberculosis is remanded. REASONS FOR REMAND The Veteran served on active duty from February 1953 to January 1955. These matters are before the Board of Veterans' Appeals (Board) on appeal from a May 2009 rating decision by the Department of Veterans Affairs (VA) Agency of Original Jurisdiction (AOJ). In August 2016, a Board hearing was held before the undersigned; a transcript is in the record. In February 2017 and September 2020, the Board remanded the Veteran's claims for further development. 1. Service connection for a heart disability is remanded. 2. Service connection for a kidney disability is remanded. 3. Service connection for a liver disability is remanded. The above three issues are closely related and are being remanded for the same reason, thus they will be addressed together for the purposes of this decision. Despite the additional and regrettable delay, and after further review of the July 2018 VA examinations obtained for the above conditions, the Board finds addendum medical opinions are required. The July 2018 VA examiner did not render complete opinions on the issue of aggravation of the Veteran's liver, kidney, and heart conditions by the Veteran's service-connected tuberculosis. The examiner's opinion references a lack of a causal connection, but the rationale provided does address the issue of aggravation. 4. A compensable rating for service-connected tuberculosis is remanded. This issue is inextricably intertwined with the Veteran's other remanded issues; accordingly, it must be remanded as well. The matters are REMANDED for the following action: 1. Please note that this Veteran's case has been advanced on the docket and, by law, ALL remanded claims must be processed expeditiously. 2. The AOJ should arrange for an addendum VA medical opinion with examination or telehealth interview of the Veteran only if deemed necessary by a medical professional, to determine the nature and likely cause of the Veteran's liver, kidney, and heart conditions. The examiner should review the claim file (including this remand) and note that this review was conducted. Based on review of the record, the examiner should provide an opinion with detailed rationale that responds to the following: (a.) For each HEART disability diagnosed, is it at least as likely as not (50% or greater probability) that the disability was either caused or aggravated by the Veteran's service-connected tuberculosis? Please explain why. The opinion must address whether the disability increased in severity beyond its natural progression (i.e., was aggravated). If aggravation is found, please identify to the extent possible the baseline level of disability prior to the aggravation. The examiner is requested to fully explain any causal or aggravation and opine to the extent possible the likely cause of the Veteran's condition. (b.) For each LIVER disability diagnosed, is it at least as likely as not (50% or greater probability) that the disability was either caused or aggravated by the Veteran's service-connected tuberculosis? Please explain why. The opinion must address whether the disability increased in severity beyond its natural progression (i.e., was aggravated). If aggravation is found, please identify to the extent possible the baseline level of disability prior to the aggravation. The examiner is requested to fully explain any causal or aggravation and opine to the extent possible the likely cause of the Veteran's condition. (c.) For each KIDNEY disability diagnosed, is it at least as likely as not (50% or greater probability) that the disability was either caused or aggravated by the Veteran's service-connected tuberculosis? Please explain why. The opinion must address whether the disability increased in severity beyond its natural progression (i.e., was aggravated). If aggravation is found, please identify to the extent possible the baseline level of disability prior to the aggravation. The examiner is requested to fully explain any causal or aggravation and opine to the extent possible the likely cause of the Veteran's condition. A detailed explanation (rationale) is required for all opinions provided. (By law, the Board is not permitted to rely on any conclusion that is not supported by a thorough explanation. Providing an opinion or conclusion without a thorough explanation will delay processing of the claim and may also result in a clarification being requested.) VICTORIA MOSHIASHWILI Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M. Williams, 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.