Citation Nr: 22015504 Decision Date: 03/17/22 Archive Date: 03/17/22 DOCKET NO. 19-07 522 DATE: March 17, 2022 REMANDED The appeal regarding entitlement to service connection for heart disease, to include coronary artery disease, valvular heart disease, and congestive heart failure, is remanded. REASONS FOR REMAND The Veteran had active service from January 1973 to January 1979, with additional service in the National Guard. This matter comes before the Board of Veterans' Appeals (Board) from a February 2018 rating decision by the Agency of Original Jurisdiction (AOJ). In August 2019, the Board remanded the issue of entitlement to service connection for heart disease. It specified that the Veteran should be afforded a VA examination conducted by a cardiologist to determine the nature and etiology of his claimed heart disease, to include as due to various chemicals he was exposed to during service as a photographic specialist. On remand, a VA examination was conducted in November 2019. The examination report indicates that the physician who conducted the examination was a consultant in ambulatory care. A remand by the Board confers on an appellant, as a matter of law, the right to compliance with the terms of the remand order and imposes upon VA a concomitant duty to ensure compliance with those terms. See Stegall v. West, 11 Vet. App. 268, 271 (1998). Here, it is unclear whether the November 2019 VA examiner is a qualified cardiologist. Remand is necessary to ensure that the Veteran is examined by a cardiologist, as directed by the August 2019 remand. The matter is REMANDED for the following action: 1. Schedule the Veteran for an examination by a cardiologist, on a fee basis if necessary, to determine the nature and etiology of any diagnosed heart disease. The evidentiary record, including a copy of this remand, must be made available to and reviewed by the examiner. The examination report must include a notation that this record review took place. After the record review and examination of the Veteran, the examiner should identify all relevant diagnoses referable to the Veteran's heart. The examiner should provide an opinion regarding whether it is at least as likely as not that any such condition was incurred in or is otherwise related to active service, to include the various chemicals he was exposed to as a photographic specialist. See March 21, 2015 correspondence regarding photography chemicals. The examiner is advised that the Veteran is competent to report his symptoms and history. Such reports must be acknowledged and considered in formulating any opinion. If the examiner rejects the Veteran's reports, he or she must provide an explanation for such rejection. The examiner is not to improperly discount the Veteran's lay statements or mistakenly rely on an absence of medical evidence in the record to support his or her conclusions. The complete rationale for all opinions should be set forth, and a discussion of the facts and medical principles involved would be of considerable assistance to the Board. If an opinion cannot be provided without resorting to mere speculation, the examiner must provide a complete explanation for why an opinion cannot be rendered. In so doing, the examiner must explain whether the inability to provide a more definitive opinion is the result of a need for additional information, or that he or she has exhausted the limits of current medical knowledge in providing an answer to that particular question. 2. Then, readjudicate the Veteran's claim. If the decision remains adverse to the Veteran, he and his representative should be furnished a supplemental statement of the case (SSOC) and afforded an appropriate period within which to respond thereto. DONNIE R. HACHEY Veterans Law Judge Board of Veterans' Appeals Attorney for the Board J. Barone, 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.