Citation Nr: 22015333 Decision Date: 03/17/22 Archive Date: 03/17/22 DOCKET NO. 14-24 245 DATE: March 17, 2022 REMANDED Service connection for a heart disability is remanded. REASONS FOR REMAND The Veteran served in the Army National Guard of North Carolina from March 1996 to March 2000. He performed his basic training from September 1996 to December 1996, and Defense Department Form 214 shows this was active duty for training (ACDUTRA). This matter comes before the Board of Veterans' Appeals (Board) on appeal from an August 2010 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). A Board decision in December 2020 denied the Veteran's claim of service connection for a heart disability. The Veteran thereafter appealed the Board's decision to the United States Court of Appeals for Veterans Claims (Court). In an Order dated in October 2021, the Court granted a Joint Motion for Partial Remand (JMPR) by the Veteran and VA General Counsel, to vacate the Board's decision and remand the case for readjudication in accordance with the JMPR. 1. Service connection for a heart disability is remanded. Unfortunatelly, additional remand is warranted to obtain an addendum medical opinion. The medical opinion that was questioned by the JMPR needs clarification in light of the evidence that the only period of ACDUTRA was between September 1996 and December 1996. Moreover, the VA examination report and medical opinion do not make it sufficiently clear as to whether the Veteran's AV block is a disability, rather than a medical finding. The matters are REMANDED for the following action: 1. Ask the Veteran to identify any private treatment he has received with regard to his heart disability claim since September 2018 and to complete a VA Form 21-4142 for those facilities. Make two requests for the authorized records unless it is clear after the first request that a second request would be futile. 2. Obtain any VA treatment records for the Veteran's heart disability claim for the period from 2010 to the present. 3. After the treatment records are updated, obtain an addendum opinion from a cardiologist regarding the following: (a.) Whether the atrioventricular block I degree diagnosed in November 2019 by the VA examiner is a disability that causes functional impairment, such as pain, dizziness, fatiguability, etc. Please note, the November 2019 VA examiner found a METs level of 1 to 3 based solely on his heart conditions. (b.) Whether the Veteran has had any heart diseases or disabilities since May 2010. Note the November 2019 VA examiner notes a history of cardiomyopathy, pericarditis, and mild tricuspid regurgitation. A July 2012 imaging report shows very slight hyperinflation, but otherwise no acute cardiopulmonary disease suggested. (c.) For each disability identified above, is it related to the chest pain for which the Veteran was treated in service and deemed to be bronchitis? The examiner is to consider whether the bronchitis was actually pericarditis as the Veteran claims and as the November 2019 VA examination report suggests ("11/14/96 EKG - first degree heart block (age 18) - (suggests cardiac involvement - possibly unrecognized pericarditis or myocarditis.)". (d.) If the examiner finds the Veteran's current heart block is a disability, is it related to the November 1996 electrocardiogram findings in service? The examiner is advised that the November 2019 VA examination report indicated that the November 1996 electrocardiogram showed first degree heart block. (Continued on the next page) The examiner is instructed that the only period of service to consider when rendering the above opinions is from September 1996 to December 1996. The examiner must provide all findings, along with a complete rationale for his or her opinion(s) in the examination report. A detailed rationale is particularly important where there a previous opinion conflicts with the examiner's opinion. If any of the above requested opinions cannot be made without resort to speculation, the examiner must state this and provide a rationale for such conclusion. D. Martz Ames Veterans Law Judge Board of Veterans' Appeals Attorney for the Board A. Rocktashel, 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.