Citation Nr: 21030502 Decision Date: 05/19/21 Archive Date: 05/19/21 DOCKET NO. 16-25 277 DATE: May 19, 2021 REMANDED Entitlement to service connection for mitral valve disease, claimed as a heart condition, is remanded. Entitlement to service connection for hypertension is remanded. Entitlement to a total disability rating based upon individual unemployability (TDIU) is remanded. REASONS FOR REMAND The Veteran served on active duty with the United States Air Force from December 1975 to May 1994. This matter comes before the Board of Veterans' Appeals (Board) on appeal from April 2013 (heart condition) and June 2014 (hypertension) rating decisions issued by the Department of Veterans Affairs (VA) Regional Office (RO). In this regard, new and material evidence was received within one year of the April 2013 rating decision for the heart condition, and the Veteran appealed the June 2014 rating decision considering the same. 38 C.F.R. § 3.156(b). The Board notes that the claims were previously remanded in September 2018 and July 2020 in order to further develop the Veteran's claims. The Board notes that in February 2021, during the pendency of the previous remand, the RO granted the Veteran service connection for gastroesophageal reflux disease (initially claimed as a stomach condition) with an evaluation of 10 percent effective November 29, 2012. This represents a full grant of the claim, and thus this claim is no longer before the Board. 1. Entitlement to service connection for mitral valve disease, claimed as a heart condition, is remanded. 2. Entitlement to service connection for hypertension is remanded. In its September 2018 and July 2020 Board remands, the Board sought medical opinions on whether the Veteran's hypertension and mitral valve disease might be related to prolonged exposure to aircraft noise. Additionally, the Veteran submitted information regarding a study that indicated that exposure to aircraft noise over many years may increase risks for heart disease and stroke. Unfortunately, the opinions obtained on remand are still conclusory and offer an inadequate explanation for their findings or are not present at all. See Stegall v. West, 11 Vet. App. 268, 271 (1998) (holding that where the remand orders of the Board are not complied with, the Board errs as a matter of law when it fails to ensure compliance). The December 2020 VA examiner's opinions on the Veteran's hypertension and mitral valve disease indicates that such disabilities are not caused by exposure to g-force exposure. The examiner's rationale that they are unaware of any medical evidence that would support these claims and therefore are less likely related to service are too conclusory. Opinions must be accompanied by a reasonable rationale and thus the Board further finds that remand for additional explanation and/or clarification in support of the opinions is necessary. Barr v. Nicholson, 21 Vet. App. 303, 310-11 (2007). 3. Entitlement to a TDIU is remanded. In the September 2018 and July 2020 remands, the Veteran's claim for entitlement to a TDIU was remanded because the file did not have sufficient documentation about the Veteran's occupational history. Given this, the RO was directed to provide the VA Form 21-8940 (Application for Increased Compensation Based on Unemployability) to the Veteran, in addition to obtaining any other evidence relevant to the issue of entitlement to a TDIU. The RO properly attempted this development when it sent the Veteran a request for the requested information. The Veteran submitted a new VA Form 21-8940, however he failed to provide the needed employment information in response to this request. Given that the information is required to make a determination on entitlement to a TDIU, the Veteran's claim is again remanded to obtain information about his occupational history. The Veteran is notified, however, that although VA has a duty to assist the Veteran in substantiating his claims, that duty is not a one-way street and it is important that he make efforts to assist VA in gathering and presenting evidence relevant to his claim. Woods v. Gober, 14 Vet. App. 214, 224 (2000); see also Hurd v. West, 13 Vet. App. 449, 452 (2000). The Board further notes that as the additional development requested as to the other claims on appeal may impact the TDIU claim, any decision with respect to TDIU should be deferred pending the completion of this development. The Board acknowledges the Veteran's submission of his VA Form 21-8940 in August 2020 but emphasizes that it is important that the form is completed, in its entirety, to ensure that VA can properly adjudicate his claim. More specifically, the last five years of employment should be listed and the along with the requested information contained in those sections. The matters are REMANDED for the following actions: 1. Obtain any outstanding VA treatment records. 2. Obtain a completed VA Form 21-8940 (Application for Increased Compensation Based on Unemployability) from the Veteran, in addition to any other evidence relevant to the issue of entitlement to a TDIU. 3. Obtain an addendum opinion that adequately addresses the etiology of the Veteran's mitral valve disease and hypertension. The electronic claims file must be made available to the examiner for review in connection with the examination. All indicated tests should be conducted, and the reports of any such studies incorporated into the examination reports to be associated with the claims file. After reviewing the claims file, the examiner should address the following: (a.) Provide an opinion as to whether the Veteran's mitral valve disease and/or hypertension is at least as likely as not (a 50 percent or greater probability) etiologically related to service, to include exposure to G-forces during years of active service as an aircraft loadmaster and exposure to aircraft noise. The examiner must review and discuss the medical literature submitted by the Veteran. See documents dated April 16, 2015. (b.) A complete rationale must be provided for all opinions expressed. If unable to provide a medical opinion, provide a statement as to whether there is any additional evidence that could enable an opinion to be provided, or whether the inability to provide the opinion is based on the limits of medical knowledge. 4. Then, readjudicate the claims on appeal. Romina A. Casadei Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board J. J. Rogers, 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.