Ischemic heart disease decisions — 2015

The Veteran's heart disability has been rated at 60 percent disabling from May 9, 2012 to September 25, 2012. From June 1, 2013, the rating is no higher than 10 percent.

The Veteran's heart disability is found to be due to an undiagnosed illness, and his irritable bowel syndrome (IBS) is rated at 30 percent.

The Veteran's diabetes mellitus and coronary artery disease are presumed to be due to herbicide exposure in Vietnam. Service connection is granted for these conditions. The Veteran does not have early onset peripheral neuropathy, so service connection cannot be established on a presumptive basis. However, the Board finds that there is no evidence of unremitting symptoms since separation from active duty and thus denies service connection for peripheral neuropathy.

The Board denied the Veteran's claims for an earlier effective date of service connection for ischemic heart disease and for increased ratings for PTSD and IHD, as well as TDIU prior to May 29, 2013.

The Veteran's appeal is being remanded for further development, including issuance of a statement of the case and referral to the Director, Compensation and Pension Service for extra-schedular consideration of TDIU.

The Veteran's service-connected disabilities did not render him unable to secure or follow a substantially gainful occupation prior to May 10, 2011.

The Board found that the Veteran's current heart conditions, including coronary artery disease and bypass grafting, are not service-connected due to lack of evidence linking these conditions to his active service.

The claim for service connection for hypertension has not been reopened due to the lack of new and material evidence, but the claim for a low back disorder was reopened.,The Veteran's low back disorder is considered direct service connection as there is no evidence showing it occurred in or was caused by service.

The Veteran is seeking service connection for ischemic heart disease, which he claims is related to his exposure to herbicides while serving in the Republic of Vietnam. The Board has ordered additional VA treatment records be obtained and reviewed as they may impact the claim.

The Veteran's TDIU was granted effective March 28, 2011 due to his service-connected heart disorder. The effective date is based on the date of unemployability determined by a VA examination.

The Veteran's appeal for a higher evaluation for paroxysmal atrial fibrillation was denied, and the claim for service connection for coronary artery disease to include as secondary to service-connected paroxysmal atrial fibrillation is pending.

The VA granted service connection for coronary artery disease associated with herbicide exposure, assigning a 10 percent disability rating and an effective date of October 15, 2004.

The Veteran's claim to reopen a previously denied heart condition was denied as the submitted evidence was not new and material.

The Board has reopened the claims for service connection for diabetes mellitus, peripheral neuropathy of the upper and lower extremities, and a heart condition based on new evidence. However, as there is no confirmed exposure to herbicides or other Agent Orange-like agents during service, and no in-service symptoms or diagnoses related to these conditions, the Board finds that service connection cannot be granted.

The Board has determined that a remand is necessary to obtain an adequate VA examination and medical opinion regarding the Veteran's claim for service connection for coronary artery disease, as secondary to PTSD and hypertension.

The Veteran's unauthorized medical expenses incurred on August 25, 2010 at John D. Archbold Memorial Hospital were approved due to the presence of a service-connected disability (ischemic heart disease) and the emergent nature of his abdominal pain.

The Veteran's heart disability is being remanded for further examination and opinion to determine its etiology, including whether it is related to service-connected diabetes mellitus and/or hypertension or herbicide exposure.

The Board found that the Veteran did not have exposure to herbicides in Vietnam, and thus could not establish service connection for his claimed conditions based on herbicide exposure. The Veteran's diabetes mellitus type II and ischemic heart disease were not shown during service or within one year of separation, and there is no evidence linking these conditions to active service.

The Board has remanded the case for further development regarding herbicide exposure allegations and a review of Defense Department records. The claim will be reconsidered based on any new evidence.