Citation Nr: 21032133 Decision Date: 05/25/21 Archive Date: 05/25/21 DOCKET NO. 14-43 428 DATE: May 25, 2021 REMANDED Entitlement to service connection for a cardiac and/or circulatory disability, to include thoracic aortic aneurysm (TAA), abdominal aortic aneurysm (AAA), heart block, and hypertensive disease, is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from June 1943 to December 1945. This matter comes before the Board of Veterans' Appeals (Board) on appeal from an October 2014 rating decision by an agency of original jurisdiction (AOJ) of the Department of Veterans Affairs (VA). In August 2018, the Veteran and his daughter testified at a videoconference hearing before the undersigned. In December 2018, the Board remanded this matter for additional development. In March 2020, the Board granted entitlement to service connection for a back disability and denied entitlement to service connection for a cardiac and/or circulatory disability. The Veteran appealed the March 2020 Board decision to the United States Court of Appeals for Veterans Claims (CAVC). In an November 2020, the CAVC granted a Joint Motion for Partial Remand (JMPR) submitted by the Veteran and the Secretary of Veterans Affairs (Parties), vacated the March 2020 Board decision insofar as it denied service connection for a cardiac and/or circulatory disability, and remanded that matter to the Board for compliance with the JMPR instructions. The Parties to the JMPR agreed that the Board erred when it determined that there had been substantial compliance with its prior remand directives, as the examiner only opined on two of the Veteran's four diagnosed cardiac and/or circulatory disabilities, and as the examiner did not reconcile the Veteran's in-service symptoms with his post-service diagnoses. Here, remand is necessary to obtain adequate medical opinions and comply with the terms of the JMPR. The Veteran's complete VA treatment records should also be secured. The matters are REMANDED for the following action: 1. Secure the Veteran's complete VA treatment records. 2. After completing #1, refer the claims file to the October 2019 examiner (or other examiner, if the October 2019 examiner is unavailable) for preparation of an addendum opinion. No further examination of the Veteran is necessary unless deemed otherwise by the Veteran. The examiner must opine as to whether it is at least as likely as not (a 50 percent or greater probability) that the Veteran's TAA: (a) had its onset during active duty or is otherwise related to the Veteran's service; or (b) initially manifested to a compensable degree as of December 1946. In addressing this question, the examiner should accept as true the Veteran's competent and credible report that he began to experience chest pain and fainting during service, and that his symptoms have continued from onset through the present. To ensure compliance with a Court Order, the examiner should explicitly reconcile the Veteran's conceded symptoms in service that persisted to the present with his current diagnosis of TAA. For example, were the Veteran's symptoms related to his TAA, or were they related to a different condition? A complete rationale must be provided for all opinions expressed. If a requested opinion cannot be provided without resorting to speculation, the examiner should so state and explain why this is the case. 3. After completing #1, refer the claims file to the October 2019 examiner (or other examiner, if the October 2019 examiner is unavailable) for preparation of an addendum opinion. No further examination of the Veteran is necessary unless deemed otherwise by the Veteran. The examiner must opine as to whether it is at least as likely as not (a 50 percent or greater probability) that the Veteran's AAA: (a) had its onset during active duty or is otherwise related to the Veteran's service; or (b) initially manifested to a compensable degree as of December 1946. In addressing this question, the examiner should accept as true the Veteran's competent and credible report that he began to experience chest pain and fainting during service, and that his symptoms have continued from onset through the present. To ensure compliance with a Court Order, the examiner should explicitly reconcile the Veteran's conceded symptoms in service with his current diagnosis of AAA. For example, were the Veteran's symptoms related to his AAA, or were they related to a different condition? A complete rationale must be provided for all opinions expressed. If a requested opinion cannot be provided without resorting to speculation, the examiner should so state and explain why this is the case. 4. After completing #1, refer the claims file to the October 2019 examiner (or other examiner, if the October 2019 examiner is unavailable) for preparation of an addendum opinion. No further examination of the Veteran is necessary unless deemed otherwise by the Veteran. The examiner must opine as to whether it is at least as likely as not (a 50 percent or greater probability) that the Veteran's heart block: (a) had its onset during active duty or is otherwise related to the Veteran's service; or (b) initially manifested to a compensable degree as of December 1946. In addressing this question, the examiner should accept as true the Veteran's competent and credible report that he began to experience chest pain and fainting during service, and that his symptoms have continued from onset through the present. To ensure compliance with a Court Order, the examiner should explicitly reconcile the Veteran's conceded symptoms in service with his current diagnosis of heart block. For example, were the Veteran's symptoms related to his heart block, or were they related to a different condition? A complete rationale must be provided for all opinions expressed. If a requested opinion cannot be provided without resorting to speculation, the examiner should so state and explain why this is the case. 5. After completing #1, refer the claims file to the October 2019 examiner (or other examiner, if the October 2019 examiner is unavailable) for preparation of an addendum opinion. No further examination of the Veteran is necessary unless deemed otherwise by the Veteran. The examiner must opine as to whether it is at least as likely as not (a 50 percent or greater probability) that the Veteran's hypertensive disease: (a) had its onset during active duty or is otherwise related to the Veteran's service; or (b) initially manifested to a compensable degree as of December 1946. In addressing this question, the examiner should accept as true the Veteran's competent and credible report that he began to experience chest pain and fainting during service, and that his symptoms have continued from onset through the present. To ensure compliance with a Court Order, the examiner should explicitly reconcile the Veteran's conceded symptoms in service with his current diagnosis of hypertensive disease. For example, were the Veteran's symptoms related to his hypertensive disease, or were they related to a different condition? A complete rationale must be provided for all opinions expressed. If a requested opinion cannot be provided without resorting to speculation, the examiner should so state and explain why this is the case. S. BUSH Veterans Law Judge Board of Veterans' Appeals Attorney for the Board D.M. Badaczewski, 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.