Ischemic heart disease decisions — 2018

The Board has determined that the Veteran's diabetes mellitus type II and ischemic heart disease did not have onset during active service or within one year of service discharge, and are not otherwise related to active service. The Veteran served at a Thai air base but his duties were administrative in nature and he was not exposed to herbicides as shown by the evidence.

The Veteran's service-connected disabilities do not prevent him from obtaining or maintaining substantially gainful employment.

The Veteran's claims for service connection are denied as there is no credible evidence of Agent Orange exposure, and the conditions claimed are not shown to be related to his active military service or a service-connected disability.

The Veteran's claim for an increased rating for coronary artery disease with coronary spasm is denied as the evidence does not meet the criteria for a higher than 10 percent evaluation.

The Veteran's claim for a higher disability rating for coronary artery disease was granted, with the effective date being June 28, 2017. The case of entitlement to TDIU due to service-connected disabilities is also considered and granted.

The Veteran's service-connected coronary artery disease has been productive of left ventricular dysfunction with an ejection fraction (LVEF) of 49 percent throughout the appeal period, and his claim for a higher initial rating is granted beginning September 16, 2009.

The Veteran's death was caused by chronic liver disease and coronary artery atherosclerotic disease, presumed to be related to his military service. The Board has ordered additional development to determine the etiology of these conditions.

The Veteran's service-connected conditions did not preclude him from securing or following substantially gainful employment prior to March 24, 2013.

The Veteran's service-connected coronary artery disease is currently rated at 30 percent, which does not meet the criteria for an increased rating. The Board finds that a higher rating is not warranted as his disability does not result in one episode of acute congestive heart failure or more nearly approximate a workload greater than 5 METs resulting in dyspnea, fatigue, angina, dizziness, or syncope.

The Board denied the Veteran's claims of service connection for type 2 diabetes mellitus and ischemic heart disease, finding no evidence to support a nexus between these conditions and his military service.

The Veteran's coronary artery disease has not been shown to meet the criteria for a rating in excess of 30 percent, as it does not result in congestive heart failure or left ventricular dysfunction with an ejection fraction of less than 50%. The current evaluation of 30% is appropriate.

The Board has determined that additional development is necessary before a decision can be made regarding the Veteran's claims for service connection. This includes verifying his periods of active duty and Air National Guard service, obtaining SSA records, securing VA treatment records, and arranging for medical opinions to determine the etiology of various conditions.

The Veteran's heart disorder has been rated at 60 percent prior to July 2, 2013, and at 100 percent thereafter. The appeal is granted for the initial rating in excess of 60 percent prior to July 2, 2013.

The Board has determined that the Veteran was exposed to herbicide agents while stationed in Thailand, and therefore service connection for ischemic heart disease is granted based on this presumption.

The Veteran's diabetes mellitus, type II and ischemic heart disease (including coronary artery disease and hypertrophic cardiomyopathy) are presumed to have been incurred during his active service in Thailand due to herbicide exposure. The claim for hypertension is dismissed as the Veteran withdrew it.

The Veteran's service-connected disabilities, including diabetic neuropathy and PTSD, are found to preclude him from securing or following substantially gainful employment.

The Board has granted service connection for prostate cancer and diabetes mellitus, both presumed to be due to Agent Orange exposure. The heart disability, kidney disability, bladder disability, and anemia are also presumed to be related to the Veteran's service-connected conditions.

The Board denied the Veteran's claims for service connection for ischemic heart disease and Parkinson's disease, finding that there was no evidence of in-service exposure to herbicides or other conditions related to service.

The Veteran's appeal is being remanded for additional development, including obtaining a VA examination to address the etiology of his heart disability and erectile dysfunction.

The Board found that there was no evidence to support the Veteran's exposure to herbicides in Okinawa, Japan. As a result, service connection for ischemic heart disease due to military service could not be established.