Ischemic heart disease decisions — 2018

The Veteran's claim of service connection for diabetes mellitus, coronary artery disease, hypertension, and peripheral neuropathy of the bilateral lower extremities has been reopened. The claims are remanded due to insufficient evidence regarding herbicide exposure during active service.

The Board denied service connection for hypertension and heart disease, finding that the Veteran did not have these conditions during or within one year of his military service.

The Veteran's cause of death was atherosclerotic heart disease, which the Board found not related to service or any service-connected disability. The claim for service connection for the cause of death is denied.

The Veteran's initial claim for an increased disability rating for ischemic heart disease was denied. The Board found that the evidence did not support a finding of more than one episode of acute congestive heart failure, or left ventricular dysfunction with an ejection fraction of 30 to 50 percent since August 30, 2013. Prior to this date, there was no evidence supporting a workload of less than 7 METs resulting in dyspnea, fatigue, angina, dizziness, or syncope.

The Veteran's left knee brace is not service-connected, and he does not use it to treat any of his other service-connected disabilities. The Board finds no eligibility for a clothing allowance due to the left knee brace.,The Veteran uses a manual wheelchair primarily due to severe effects from multiple service-connected conditions including coronary artery disease, peripheral vascular diseases, diabetes, hypertension, and neuropathies. The VAMC's decision was incorrect in concluding that the use of the wheelchair is not related to his service-connected disabilities.

The Veteran's service-connected disabilities, including coronary artery disease, major depression, low back disability, cervical spine disability, and diabetes mellitus, rendered him unable to obtain or retain substantially gainful employment from March 24, 2010 to November 19, 2013. The Board granted a TDIU during this period.

The Veteran's type II diabetes mellitus is currently rated at 20 percent, but the Board has found that it does not meet or approximate the criteria for a higher rating. The Veteran’s ED is currently rated at 0 percent and the Board has found no evidence of external or internal deformity warranting a higher rating.,The Veteran's heart disease is currently rated at 60 percent, but the Board has found that his condition may have worsened since the last examination. He is also rated at 40 percent for each leg due to arteriosclerosis obliterans and claudication.

The Board has remanded the claims for service connection for various conditions, including a heart disorder, neck disorder, low back disorder, left hip disorder, left knee disorder, right broken foot, right foot cellulitis, TBI, and migraine headaches. The Veteran's military records indicate he was stationed at Camp LeJeune in 1982, which may be relevant to his heart disorder claim.

The Veteran's service connection claims for hearing loss, tinnitus, coronary artery disease (CAD/IHD), erectile dysfunction as secondary to CAD/IHD, and peripheral neuropathy of the bilateral lower extremities are remanded due to incomplete records and need for further medical evaluation.

The Board denied service connection for diabetes mellitus and coronary artery disease, finding no evidence of herbicide exposure during service. The Veteran's service was not in the Republic of Vietnam or its inland waterways.

The Veteran's appeal is remanded for a VA examination to assess the impact of his service-connected disabilities on his employability prior to February 14, 2017.

The Veteran's service connection claim for type II diabetes mellitus is granted based on presumed exposure to herbicides during his time stationed at U-Tapao Air Force Base in Thailand. The claim for ischemic heart disease remains pending as the evidence does not clearly indicate a diagnosis of this condition.

The Veteran's service-connected disabilities, including coronary artery disease with post-operative residuals of coronary artery bypass surgery, posttraumatic stress disorder, type II diabetes mellitus, left lower extremity peripheral neuropathy, right lower extremity peripheral neuropathy, left upper extremity peripheral neuropathy, and right upper extremity peripheral neuropathy, preclude him from securing or following substantially gainful employment. The Veteran's total disability rating based on individual unemployability is granted.

The Board denied service connection for cervical strain, left shoulder strain, left trapezius strain, degenerative disc disease (DDD), lumbar spine, generalized pain disorder, hypertension, hypertensive heart disease, gastro-esophageal reflux disease (GERD), acute sinusitis, and migraine headaches as the evidence did not support a nexus to service.,The Board found that there was no medical evidence showing a direct link between any of these conditions and military service.

The Veteran's service-connected coronary artery disease is rated at 10 percent, and the VA examiner found that his current workload limitations are due to a back disability rather than his heart condition. The case is being remanded for further evaluation.

The Board has remanded the claims for service connection due to herbicide exposure, as well as the claim for tinnitus. The Veteran's service records confirm his service in Thailand from March 1968 to February 1970 and his alleged exposure to herbicides during that time. However, there is no direct evidence of such exposure. The Board has requested further inquiry through the JSRRC to verify this claim. For hypertension, VA treatment records do not confirm a diagnosis of hypertension. The Veteran's tinnitus claim requires an addendum opinion from a VA audiologist to determine if it is related to service.

The Veteran's right ear hearing loss is granted as service-connected.,Service connection for a right ankle disorder and an acquired psychiatric disorder are denied.,Service connection for a respiratory disorder is denied.,Service connection for a heart disorder is denied.

The Board has decided to remand the case due to outstanding private treatment records and the need for an additional VA examination.

The Veteran's appeal is remanded due to the need for additional medical opinions regarding his right ear hearing loss. The initial rating for ischemic heart disease remains denied.

The Veteran's service-connected disabilities have rendered him unable to secure and follow a substantially gainful occupation since June 2, 2017.