Ischemic heart disease decisions — 2019

The Board has determined that the Veteran's TBI residuals do not meet the criteria for service connection due to insufficient evidence of significant cranial or neurological pathology consistent with a TBI.

The Board has restored a 60% disability rating for the Veteran's coronary artery disease, pericarditis, and status post coronary artery bypass graft effective November 1, 2015. The evidence did not show improvement in his condition that would warrant reducing the rating.

The Veteran's prostate cancer is granted service connection due to herbicide exposure. The heart disability claim has been withdrawn by the appellant. TDIU remains pending and needs further action.

The Board denied the Veteran's claims of service connection for right foot cellulitis and heart disorder, finding that new and material evidence had not been submitted to reopen these previously denied claims.

The Board denied service connection for a heart disability and an initial compensable rating for bilateral hearing loss, finding that the Veteran's current disabilities were not related to his active service.

The Veteran's service connection claims for CAD, DM, lung cancer residuals, RLE and LLE neuropathy, and OSA have been granted.,Service connection is also granted for prostate disorder and residuals of skin cancer, but additional evidence is needed to determine their relationship with the Veteran's in-service exposure.

The Board dismissed the appeals concerning whether new and material evidence had been received to reopen claims of entitlement to service connection for obstructive sleep apnea, arthritis, bilateral upper neuropathy, bilateral lower neuropathy, diabetes mellitus, and heart disease. The appellant's claims were denied as there was no evidence of exposure to toxic chemicals while at Fort McClellan, Alabama.

The Veteran's claims for service connection for an acquired psychiatric disability to include PTSD, diabetes mellitus, and a heart condition have been denied as there is no direct evidence of these conditions during or within one year after service. The exposure basis was not established due to lack of herbicide exposure in the Republic of Vietnam.

The Veteran's claim for a higher rating for his right knee disability was denied. The claims for service connection for diabetes mellitus, ischemic heart disease, and left knee disorder were granted based on herbicide exposure in Thailand. The acquired psychiatric disability claim is denied.

The Board has remanded the Veteran's claims for service connection for heart disease and bilateral hearing loss due to inadequate medical opinions. The TDIU claim is also being remanded as it is intertwined with the other claims.

The Veteran's diabetes mellitus type II, coronary artery disease status-post myocardial infarction, and non-Hodgkin's lymphoma with multiple myeloma are all presumed to be due to herbicide exposure in Vietnam.

The Veteran's initial claim for an increased rating for ischemic heart disease was denied prior to April 12, 2012.,From April 12, 2012 to September 23, 2013, the Veteran’s disability was rated at 60 percent due to a workload of greater than 5 METs resulting in fatigue and left ventricular dysfunction with an ejection fraction of 60-65 percent.,From September 24, 2013 to November 28, 2018, the Veteran’s disability was rated at 30 percent due to a workload of greater than 10 METs and evidence of cardiac hypertrophy or dilation.,The Veteran's claim for an increased rating from November 29, 2018 is pending and requires further action.

The Veteran's appeal was withdrawn for certain issues, but his claim of service connection for an acquired psychiatric disorder (including PTSD) has been reopened and granted. His TDIU claim is also granted.

The Board has determined that the VA examinations and medical opinions are inadequate for decisional purposes, and thus remanding the cases for further development.

The Veteran's claim for an initial rating in excess of 10 percent for service-connected left lower extremity tarsal tunnel syndrome is being remanded due to the need for a new VA examination.,The Veteran's claim for service connection for diabetes mellitus type II (diabetes) is being remanded as there is insufficient evidence to determine its onset during service.,The Veteran's claim for service connection for a heart disorder is being remanded as there is insufficient evidence to determine its onset during service.,The Veteran's claim for residuals of stroke is being remanded due to the inextricability with her other claims, including service connection for a heart disorder and sarcoidosis.,The Veteran's claim for service connection for migraine headaches is being remanded as there is insufficient evidence to determine its onset during service.,The Veteran's claim for right lower extremity disability, to include as secondary to service-connected LLE tarsal tunnel syndrome, is being remanded due to the need for a new VA examination and opinion on etiology.,The Veteran's claim for sinusitis is being remanded as there is insufficient evidence to determine its onset during service.,The Veteran's claim for sarcoidosis is being remanded due to the inextricability with her other claims, including service connection for a heart disorder and sarcoidosis.,The Veteran's claim for left hand carpal tunnel syndrome (CTS) is being remanded as there is insufficient evidence to determine its onset during service.,The Veteran's claim for left shoulder rotator cuff (RTC) tendonitis is being remanded due to the need for a new VA examination and opinion on etiology.

The Veteran's claims for increased ratings and service connection were denied. The appeal is remanded for further action on the issue of service connection for diabetic retinopathy.

The Board has remanded the cases for further development to determine if the Veteran was exposed to herbicide agents during his service in Guam, which could potentially establish a link between his claimed conditions and his military service.

The Board has remanded the claims for service connection for a heart disability and bilateral tinnitus due to insufficient evidence regarding whether the disabilities preexisted service or are related to service. A VA examination is needed to determine if the Veteran's current heart murmur clearly and unmistakably preexisted service, and if so, whether it was caused or aggravated by service. For tinnitus, a VA examination is also needed to determine if it is at least as likely as not related to her period of active duty, including exposure to gunfire on the rifle range during basic training.

The Board has restored service connection for arteriosclerotic heart disease, effective November 1, 2019. The original grant of service connection was on a presumptive basis due to Agent Orange exposure in Vietnam.

The Board has remanded the case due to uncertainty about whether the Veteran has ischemic heart disease, which would be service-connected under presumptive provisions for herbicide exposure. The case will need further examination and medical opinion.