Ischemic heart disease decisions — 2018

The Veteran's PTSD is rated at 70% from July 3, 2013 to August 29, 2016. The rating for ischemic heart disease remains at 30%. The Veteran's headaches and diabetes are not service-connected.

The Veteran's coronary artery disease was characterized by left ventricular dysfunction with an ejection fraction of 39 percent or greater, and a workload greater than 3 METs but not greater than 5 METs, resulting in dyspnea, dizziness, and fatigue. The evidence did not meet the criteria for a higher rating.

The Veteran's claims for service connection have been remanded due to the need for additional medical opinions regarding the nature and etiology of various conditions, including bilateral knee disability, heart disability, inflammatory joint disability (gout), left shoulder disability, bilateral hip disability, and skin disability. The issues are related to direct service connection rather than presumptive exposure.

The Veteran's left ear hearing loss and erectile dysfunction are granted service connection. The cervical spine disorder, ischemic heart disease, esophageal disorder, goiter, pituitary gland disorder, and PTSD claims are denied.

The Veteran's appeal is remanded due to the need for additional VA examinations and the identification of new claims. The initial compensable rating for service-connected spot on right lung due to asbestos exposure requires further evaluation, and other issues related to heart disorder, posttraumatic stress disorder, stomach disorder, spine and knee problems, and COPD are also raised.

The Veteran's ischemic heart disease was rated at 100% effective April 13, 2016. The decision is based on the severity of his condition as determined by a June 2015 VA examination and an April 13, 2016 DBQ from Dr. J.M.

The Board has decided that additional development is needed for the Veteran's claims of service connection for a heart disability and hypertension due to exposure to herbicides. The VA examiner will need to review the Veteran's STRs, current treatment records, and provide an opinion on whether these conditions are related to his military service.

The Veteran's service-connected PTSD, coronary artery disease, and left knee disability render him unable to secure and follow a substantially gainful occupation.

The Veteran's unauthorized medical expenses incurred at a private hospital from December 29, 2015 to December 31, 2015 are denied because VA facilities were feasibly available and he should have been transferred to a VA facility after receiving emergency care in Ottumwa, Iowa.

The Veteran's heart condition does not meet the criteria for a higher rating as it does not result in symptoms of congestive heart failure, left ventricular dysfunction with an ejection fraction less than 50%, or require more than 5 METs during exertion.

The Veteran's ischemic heart disease is granted as service connected due to presumed exposure to herbicides during his Vietnam service.

The Board has remanded the claims for hypertension, heart disability (coronary artery disease), and kidney disease due to insufficient evidence regarding their etiology. The Veteran's reports of ongoing symptomatology following service are considered in conjunction with his reported diagnosis.

The Veteran's service connection for coronary artery disease is granted due to in-service herbicide exposure. The cause of death, metastatic esophageal cancer with contributing causes of coronary artery disease and hypertension, is also granted.

The Board has decided to remand the claim for service connection for ischemic heart disease as a result of exposure to herbicide agents due to insufficient development. The case must be referred to the United States Army and Joint Services Records Research Center (JSRRC) to verify if the Veteran was exposed to herbicide agents or other hazardous/toxic chemicals at Fort Gordon during his period of service.

The Board denied service connection for various conditions, including a back disorder, bilateral knee disorder, respiratory disorder, heart disorder, and bilateral lower extremity nerve disorder. The decision also remanded the issue of service connection for hypertension.

The Board has remanded the case due to the need for a supplemental opinion regarding whether the Veteran's sleep apnea is at least as likely as not related to service-connected disabilities, including his hypertension and psychiatric conditions.

The Veteran's initial claim for an increased rating for aortic aneurysm was denied as the current noncompensable rating adequately compensates his symptoms of dyspnea, fatigue, angina (chest pain), and dizziness. The Veteran is already receiving a 60 percent rating for his valvular heart disease.

The Board dismissed all reopened claims due to the death of the appellant.

The Veteran's initial rating for service-connected coronary artery disease is being remanded due to the need for a new VA examination. The TDIU claim is also being remanded as it is inextricably intertwined with the CAD rating claim.

The Board has decided to remand the Veteran's claims of service connection for joint pain, muscle pain, hypertension secondary to PTSD, chronic fatigue syndrome, heart condition (claimed as cardiovascular symptoms), and headaches. The reasons include the need for additional medical opinions regarding the nature and etiology of these conditions.