Ischemic heart disease decisions — 2014

The Veteran's service-connected disabilities are at least as likely as not of such severity as to prevent him from securing or following substantially gainful employment, thus meeting the criteria for TDIU.

The Veteran withdrew his appeal for service connection for coronary artery disease (CAD) and the Board dismissed this issue. The special monthly pension claim based on aid and attendance and housebound status was not granted.

The Veteran's hypertension was not incurred in or aggravated by active military service, and may not be presumed to have been incurred in service. The Veteran's currently diagnosed hypertension is not shown to be related to his service-connected diabetes mellitus, type II.,Since the initial grant of service connection, the Veteran's coronary artery disease has been manifested by a left ventricular ejection fraction ranging from 45 to 50 percent; and there has been no showing of chronic congestive heart failure or a workload of 3 metabolic equivalents (METs) resulting in dyspnea, fatigue, angina, or syncope. The Veteran's coronary artery disease is currently evaluated at 60%.

The Board has determined that the evidence is at least in equipoise as to whether the Veteran's hypertension is proximately due to his service-connected PTSD, and thus grants service connection for hypertension.

The Veteran's appeal is remanded due to the need for additional medical records and examination. The service connection claim is inextricably intertwined with the 1151 claim.

The Veteran's claim for an earlier effective date for the grant of service connection for ischemic heart disease was denied as there is no evidence of a prior formal or informal claim filed before September 30, 2004.

The Veteran's appeal is being remanded for additional development, including obtaining VA treatment records and scheduling a VA examination to assess the severity of his coronary artery disease.

The Veteran's appeal is being remanded for a new VA examination to assess his employability status due to service-connected disabilities, and for clarification on whether he desires a hearing.

The Veteran's claims for increased ratings for PTSD and CAD, as well as his claim for a TDIU, are being remanded due to the need for additional examinations and development of records.

The Veteran's claims for service connection for an acquired psychiatric disorder, including PTSD, and a heart disorder, including ischemic heart disease (IHD), are being remanded due to the need for additional development.

The Board has determined that there is no evidence of a claim for service connection for ischemic heart disease prior to July 22, 2009. As such, the effective date for the grant of service connection for ischemic heart disease remains at July 22, 2009.

The Veteran's appeal involves multiple issues related to effective dates for service connection and disability ratings. The Board has determined that additional development is needed, including obtaining results of VA January 2008 vascular studies and/or EKG study, reviewing all relevant evidence added since the April 2012 statement of the case, and issuing a supplemental statement of the case.

The Board has remanded the case due to inadequate examination reports and a need for an opinion on whether service-connected lumbar spine disabilities aggravate any heart disorders. The Veteran is scheduled for a Travel Board hearing at the local RO in Reno, Nevada.

The Board has remanded the Veteran's claim for additional development, including obtaining VA treatment records and any available letter from Dr. K.

The Veteran's claims for earlier effective dates, increased evaluations, and service connection were denied. The heart disability was granted an effective date of April 27, 2009, but the hearing loss and psychiatric disorder did not warrant compensable ratings. Service connection for hypertension and erectile dysfunction was also denied.

The Veteran's claim for an initial rating in excess of 10 percent for coronary artery disease is being remanded due to the need for a VA examination and additional development.

The Veteran's service-connected PTSD and other conditions have rendered him unable to secure or follow substantially gainful employment, warranting a TDIU effective October 15, 2008.

The Veteran's service-connected disabilities do not render him unemployable, as he has worked part-time and his education level, training, and earned income are unknown.

The Veteran is seeking service connection for a cardiovascular disorder. The Board has determined that additional development, including obtaining medical records and scheduling an examination, is necessary to properly adjudicate his claim.

The Veteran's claim for an earlier effective date for the grant of service connection for ischemic heart disease was denied as there is no pending claim prior to April 23, 2010.