Citation Nr: 22018705 Decision Date: 03/30/22 Archive Date: 03/30/22 DOCKET NO. 18-12 863 DATE: March 30, 2022 REMANDED Entitlement to service connection for cause of death is remanded. REASONS FOR REMAND The Veteran served on active duty from July 1968 to July 1970. He died in September 2016; the Appellant is his surviving spouse, so widow. In November 2021, in support of this claim, she testified at a hearing before the undersigned Veterans Law Judge of this Board. A transcript of the proceeding is of record. At the time of his death, the Veteran had established his entitlement to service connection for coronary artery disease (CAD), rated as 100-percent (so totally) disabling, and for posttraumatic stress disorder (PTSD), rated as 70-percent disabling. When he died, the Veteran was traveling abroad in Haiti. Although there is a U. S. Department of State Report of Death of a U.S. Citizen or U.S. Non-Citizen National Abroad form in the claims file, it lists the cause of death as "not provided by Local authorities". There is no death certificate in the claims file, and, according to the Appellant, one was not provided since the Veteran was traveling abroad when he passed and because she did not have money for that after getting his body back to the Continental United States from Haiti. Nevertheless, during her November 2021 hearing before this Board, the Appellant testified that she believes the Veteran died of a heart attack owing to his service-connected disabilities, especially his CAD. She explained that, prior to his death, his hands and feet were icy cold, that he had been sweating a lot, and that he had been given aspirin to put under his tongue whenever he experienced a worsening of his symptoms. In further support of her claim, she also submitted an affidavit from J.M. attesting that, prior to the Veteran's death, he was sweating a lot, touching his chest and neck, and unable to speak. See June 2017 Affidavit. Given this evidence, the Board finds that a VA medical opinion is needed to assist in deciding the appeal of this cause of death claim. In DeLaRosa v. Peake, 515 F.3d 1319, 1322 (Fed. Cir. 2008), the U. S. Court of Appeals for the Federal Circuit (Federal Circuit Court) indicated that, while 38 U.S.C. § 5103A(a) does not always require VA to assist a claimant in obtaining a medical nexus opinion for a Dependency and Indemnity Compensation (DIC) claim, so including for cause of death, it does require VA to assist a claimant in obtaining such whenever necessary to substantiate the DIC claim. See also Wood v. Peake, 520 F.3d 1345 (Fed. Cir. 2008) (holding that, in the context of a DIC claim, VA must also consider that 38 U.S.C. § 5103A(a) only excuses VA from making reasonable efforts to provide an opinion when no reasonable possibility exists that such assistance would aid in substantiating the claim). Furthermore, in November 2017, the Appellant submitted a VA Form 21-4142a, General Release for Medical Provider Information to the Department of Veterans Affairs (VA), identifying a private medical facility, Bronson Hospital, where the Veteran had been treated. A preliminary review of the claims file, however, reveals these records have not been obtained. Moreover, although the Appellant already has, as required, submitted a VA Form 21-4142 providing information for Bronson Hospital, this form expires a year after it is signed, so the authorization form currently of record is no longer valid. See VA Form 21-4142 (noting authorization and consent ends 12 months from date of signature). Accordingly, she must be notified that she must complete and sign a new release form to allow VA to request these confidential private medical records on her behalf. In addition, during his lifetime, the Veteran received treatment for his service-connected disabilities at the VA Medical Centers (VAMCs) in Battle Creek and Grand Rapids, Michigan. See November 2017 VA Form 21-4142a. But the only treatment records that have been obtained and associated with the claims file are those from the VAMC in Battle Creek, with the most recent ones dating approximately 15 months before his death. Therefore, these other records also must be obtained so that they, too, may be considered. Accordingly, this claim is REMANDED for the following action: 1. Obtain all outstanding VA treatment records from the Battle Creek VAMC (from June 2015 onwards) and from the Grand Rapids VAMC assuming these facilities are not one and the same. Follow proper VA procedures, and appropriately notify the Appellant and her representative if unable to obtain identified records. 38 C.F.R. § 3.159(c) and (e). Ensure that all VA treatment records obtained and associated with the claims file are complete. 2. Also ask the Appellant-widow to complete and submit another VA Form 21-4142, Authorization and Consent to Release Information to VA, for each private health care provider from whom she would like VA to obtain records relevant to this appeal, including, but not limited to, the health care provider (Bronson Hospital) she already listed on the VA Form 21-4142 submitted in November 2017. Inform her that the prior VA Form 21-4142 since has expired and, therefore, no longer can be used to obtain the records she identified as relevant, hence, the reason she needs to again complete and submit another VA Form 21-4142. Also ask that she submit any relevant records she has in her personal possession. 3. After obtaining all additional treatment or other records pertinent to this claim, obtain a medical opinion concerning the cause of the Veteran's death. A copy of this remand and all relevant medical and other records must be made available to the examiner for the pertinent history. The examiner must consider this history, including the Appellant's lay assertions and affidavit from J.M. A response is needed concerning the following: Is it at least as likely as not that the Veteran's service-connected CAD and/or PTSD caused or contributed substantially or materially to his death? In making this determination, the examiner should consider: (i) the September 2016 Report of Death of a U.S. Citizen or U.S. Non-Citizen National Abroad; (ii) the June 2017 Affidavit from J.M.; (iii) the September 2017 Statement from the Appellant-widow (M.S.); (iv) her October 2017 Notice of Disagreement (NOD); (v) her February 2018 Statement; and (vi) her November 2021 hearing testimony before the Board. It is essential the examiner provide rationale, regardless of whether responding favorably or conversely unfavorably preferably citing to findings or other evidence in the file supporting conclusions and/or accepted medical authority. KEITH W. ALLEN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Mukherjee, Cameron B. 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.