Ischemic heart disease decisions — 2020

The Veteran's claims for increased evaluation of TBI and service connection for cervical strain, PTSD, and arteriosclerotic heart disease have been withdrawn by his representative.

The Board denied an initial rating in excess of 10 percent for coronary artery disease (CAD) as the Veteran's condition did not meet the criteria for a higher rating based on METs level or left ventricular dysfunction.

The Veteran's heart disorder, diagnosed as mitral valve regurgitation, is granted service connection. The right and left foot disabilities are denied service connection.

The Veteran's ischemic heart disease is granted service connection based on presumed exposure to herbicide agents during his active military service in Thailand.

The Veteran's service-connected disabilities have made it impossible for him to secure or follow a substantially gainful occupation since February 18, 2010.

The Veteran's service-connected multiple myeloma caused or aggravated his disability manifested by clostridium difficile. The cause of the Veteran's death is not related to active service, but he had other disabilities that were not related to service.

The Veteran's appeal is remanded due to the need for a new examination of his service-connected ischemic heart disease (IHD) as nearly six years have passed since the last evaluation.

The Board has granted a total disability rating based on individual unemployability (TDIU) effective June 27, 2014. The case is remanded for further action regarding service connection for diabetes mellitus, type II.

The Board denied service connection for ischemic heart disease as the evidence did not establish herbicide exposure during service and there was no other basis to grant the claim.

The Board has ordered a VA examination to determine if the Veteran's heart disability, other than ischemic heart disease, is related to his presumed herbicide exposure. The current opinion from the November 2019 VA examiner was inadequate and requires further clarification.

The Board has remanded the case for additional development, including obtaining missing medical records and providing an addendum opinion on the etiology of the Veteran's death.

The Veteran's initial and higher ratings for CAD are remanded due to insufficient evidence regarding the severity of his condition from July 6, 2011 to August 20, 2013.,The Veteran's rating for CAD from August 20, 2013 to January 5, 2020 is remanded as the Board did not explain why an interview-based METs test was used instead of a diagnostic exercise test in his VA examination.,The Veteran's claim for service connection for GERD is remanded due to insufficient evidence regarding whether his condition is related to his military service or secondary to his PTSD.,The Veteran's claim for service connection for a skin disability (presumptive due to Agent Orange exposure) is remanded as the VA examiner did not address whether it was caused by his diabetes mellitus.,The Veteran's TDIU prior to January 24, 2014 is raised and remanded.

The Veteran's claim for an earlier effective date of November 12, 2013 for service connection of heart disease was denied as the May 2, 2014 rating decision became final and no new and material evidence was submitted within a year. The earliest possible effective date is assigned based on receipt of the application to reopen on May 18, 2015.

The Veteran's claim for an initial rating in excess of 10 percent for hypertension is denied as the evidence does not show that his diastolic pressure has been predominantly 110 mm/Hg or more, or systolic pressure has been predominantly 200 mm/Hg or more at any point during the appeal period.

The Board has granted service connection for a skin disorder, hypertension, peripheral vascular disease, and heart disorders (including heart murmur and valvular heart disease). Service connection for vasculitis is remanded.

The Veteran's service-connected PTSD is found to be the primary cause of his hypertension, heart disorder (Long QT Syndrome), and obstructive sleep apnea. The Board grants these claims as secondary to PTSD.

The Board has granted service connection for ischemic heart disease and Parkinson's disease, both presumed to be caused by exposure to herbicide agents during the Veteran's service aboard the USS Shangri-La. The appeal regarding TDIU is remanded as it may be affected by these grants.

The Board has remanded the claim of service connection for stroke, as claimed secondary to postoperative coronary artery disease, due to its inextricability with the pending claim of service connection for postoperative coronary artery disease. The AOJ should not readjudicate the Veteran's claim until all development pertaining to the postoperative coronary artery disease has been completed.

The Veteran's appeals for a compensable rating for bilateral hearing loss and service connection for a heart disability, to include as due to herbicide exposure, are being remanded due to the failure of the Veteran to show for scheduled VA examinations.

The Veteran's claims for service connection for ischemic heart disease and diabetes mellitus type II have been granted. The claim for hypertension has been remanded, and the claim for erectile dysfunction also needs further development.