Ischemic heart disease decisions — 2017

The Veteran's service-connected heart disability and hypertension are found to be due to herbicide exposure in Korea, and the claims for service connection have been granted.

The Board has determined that there is new and material evidence to reopen the claims for service connection for diabetes mellitus and a heart disability, but denied these claims on the merits. The case is now remanded for further development.

The Veteran's service-connected hypertensive heart disease is rated at 60 percent disabling, effective March 14, 2011. The rating for diabetes mellitus type 2 remains at 20 percent. The right eye corneal scar continues to be rated at 30 percent. Service connection was granted for erectile dysfunction and skin disability, but not for prostate disability or obstructive sleep apnea.

The Board has determined that additional development is needed in order to make a determination on the Veteran's claims, including obtaining relevant medical records and service personnel records.

The Board has determined that the Veteran's erectile dysfunction had its onset during his military service and grants service connection for this condition. For coronary artery disease, the Board finds insufficient evidence to establish a direct relationship with service or secondary to service-connected peripheral vascular disease.

The Board has determined that additional development is needed to determine if the Veteran's coronary artery disease is related to his service, including exposure to herbicide agents. The case will be remanded for a VA examination and further consideration.

The Veteran's appeal was dismissed due to his death during the pendency of the appeal.

The Board has granted a 60 percent rating for the Veteran's service-connected cardiomyopathy with valvular heart disease, ventricular arrhythmia, congestive heart disease, angina, acute, subacute myocardial infarction, heart block and heart valve replacement. The claim for hyperreflexia of the left lower extremity due to cerebrovascular accident (stroke) has also been granted.

The Veteran's claims for increased ratings for coronary artery disease (CAD) and peripheral neuropathy of the bilateral lower extremities were denied. The CAD claim was denied as it did not meet the criteria for a rating in excess of 30 percent prior to June 13, 2007. The peripheral neuropathy claims were denied as they did not meet the criteria for an initial rating in excess of 20 percent prior to August 5, 2005 and thereafter.

The Veteran's initial ratings for coronary artery disease post CABG were denied prior to September 28, 2005 and from September 28, 2005 through January 18, 2011. Service connection for polycythemia vera was not established.

The Veteran's claim for service connection for periodontitis has been granted for treatment purposes. The Board finds that the Veteran meets the basic eligibility requirements of service connection.,For his hiatal hernia with GERD, the Veteran is entitled to a disability rating of 10 percent from November 23, 2007; 30 percent from April 19, 2011; and 60 percent from April 7, 2016.

The Board has determined that the Veteran's service connection claim for coronary artery disease, due to Agent Orange exposure, is granted as it meets the criteria for presumptive service connection.

The Veteran's type II diabetes mellitus and diabetic peripheral neuropathy are service-connected. His heart disability is not service-connected, but the Board has requested additional development to determine if it is related to his service-connected diabetes.

The Veteran's claims for increased ratings and TDIU were granted. The initial rating of 60 percent was assigned for coronary artery disease, effective May 1, 2007, with a subsequent increase to 100 percent effective June 10, 2013. Gout received an initial evaluation of 40 percent. Osteoarthritis and post-operative residuals of right shoulder surgery were each assigned an initial evaluation of 10 percent.

The Veteran's service-connected disabilities render him unable to secure or follow a substantially gainful occupation, and the Board has determined that he meets the criteria for a TDIU.

The Veteran's cause of death was listed as cardiomyopathy (including congestive cardiomyopathy), prostate cancer, and coronary artery disease. The Board found that these conditions were not linked to service and did not reach the level of equipoise in favor of service connection. Therefore, the claim for service connection for the cause of the Veteran's death is denied.

The Veteran's PTSD is currently rated at 70 percent, but the Board finds that a higher rating is not warranted. The Veteran also has other service-connected conditions (diabetes and coronary artery disease) which do not meet the criteria for TDIU due to his current employment.

The Veteran's service-connected coronary artery disease (CAD) has rendered him unable to secure and follow a substantially gainful occupation since January 1, 2011. Effective September 22, 2014, the Veteran is entitled to TDIU based on his CAD.

The Veteran's case is being remanded for a new video conference hearing due to his request, and the Board will consider service connection for heart disease secondary to exposure to Agent Orange.

The Veteran's coronary artery disease, status post-myocardial infarction, has manifested as a workload of greater than 7 METs but not greater than 10 METs resulting in dyspnea, fatigue, angina, dizziness, or syncope. However, there is no evidence showing a workload of 7 METs or less results in these symptoms at any time during the period of the claim.