Ischemic heart disease decisions — 2020

The Board has dismissed the Veteran's appeals on service connection claims for COPD, a right wrist condition, bilateral ankle condition, heart condition, and cervical and thoracic spine disability due to his withdrawal of these claims.

The Veteran's heart conditions, including atrial fibrillation and cardiomegaly, are being remanded due to insufficient evidence addressing the relationship between his service-connected sleep apnea. The bilateral knee disorder and right foot disorder claims are also being remanded for additional review of the medical records.,reasoning_summary_for_decision_summary_1_and_2_and_3_combined_with_service_connection_theory_and_exposure_basis_and_is_pact_act_and_rating_assigned_and_effective_date_and_decision_summary,confidence_level_for_reasoning_summary_for_decision_summary_1_and_2_and_3_combined_with_service_connection_theory_and_exposure_basis_and_is_pact_act_and_rating_assigned_and_effective_date_and_decision_summary

The Veteran's claim for a TDIU prior to May 12, 2014 was denied as he did not meet the criteria for a rating in excess of 10 percent for his IHD prior to that date. As of May 12, 2014, he met both thresholds required for a TDIU (a single service-connected disability ratable at 60% or more, or two or more disabilities with one rated at 40% or more and the combined rating at 70% or more). However, the Board found that his heart condition alone did not render him unemployable during this period.

The Board has granted an effective date of January 11, 2008 for the award of service connection for ischemic heart disease due to herbicide exposure.

The Veteran's coronary artery disease was not manifested by more than one episode of acute congestive heart failure in the past year, a workload of greater than three metabolic equivalents (METs) but not greater than five METs, nor a left ventricular ejection fraction of less than 50 percent. Therefore, the claim for a rating in excess of 30 percent was denied.

The Veteran's claims for service connection for diabetes mellitus, type II and coronary artery disease are granted. The appeal regarding a chronic kidney condition is dismissed.

The Veteran's death was not caused by a service-connected disability, and his surviving spouse is denied DIC benefits under both the cause of death and 38 U.S.C. § 1318 criteria.

The Board has granted the Veteran's claim for payment or reimbursement of unauthorized medical expenses incurred at Enloe Medical Center from April 7, 2006 to April 10, 2006. The decision is based on the fact that a VA facility was not feasibly available and the Veteran could not have been safely discharged or transferred to a VA facility.

The Veteran's claims for earlier effective dates pertaining to the awards of service connection for PTSD and ischemic heart disease are dismissed.

The Veteran's service-connected disabilities, including coronary artery disease, diabetes mellitus, and peripheral neuropathy, have rendered him unable to secure and maintain substantially gainful employment.

The Veteran's claim for a higher rating for ischemic heart disease was denied as the severity level of his condition did not meet the criteria for a total (100%) rating.,Service connection for an acquired psychiatric disorder prior to May 15, 2017, was denied because there is no evidence showing that the Veteran expressed belief in entitlement or filed an informal claim before this date. The effective date of service connection has been granted from May 2017.,The Veteran's claim for hypertension was remanded as the medical records did not meet the regulatory definition of hypertension.

The Veteran's bilateral hearing loss is related to his military service and he has been granted service connection.,His residuals of prostatic adenocarcinoma are not rated as compensable, but the issue remains remanded for further development.,The Veteran's heart condition (claimed as ischemic heart disease) does not qualify under the generally accepted medical definition of ischemic heart disease.

The Board has remanded the case for further development, including scheduling a VA examination to assess the combined impact of the Veteran's service-connected disabilities on his employability prior to June 1, 2012. The TDIU claim is also being remanded due to incomplete adjudication.

The Veteran's claims for service connection are remanded due to uncertainty regarding his exposure to herbicide agents during service. The Board requests further development to determine if he served within the territorial sea of Vietnam, which would grant presumptive service connection.

The Board has denied the Veteran's claims for increased ratings for ischemic heart disease, diabetes mellitus, type II, right and left lower extremity peripheral neuropathy, and TDIU. The cases are being remanded to schedule the Veteran for VA examinations to evaluate his current levels of impairment from these conditions.

The Board has remanded the cases of ischemic heart disease and hypertension for further development, including obtaining medical records and scheduling VA examinations to determine the nature and etiology of these conditions.

The Board has decided the case is remanded due to insufficient evidence regarding whether the Veteran's current heart disability, including hypertension and ischemic heart disease, is related to his service exposure to herbicides. The VA will obtain updated medical records and provide a new opinion from a cardiologist.

The Board has remanded the cases for further development and an opinion regarding whether the Veteran's CAD and diabetes are related to his service-connected peripheral arterial disease.

The Veteran's diabetes mellitus type II and ischemic heart disease are granted service connection. The Board finds the Veteran's exposure to herbicide agents at Korat Air Force Base in Thailand, which is not covered by the Vietnam Era presumption, credible. However, there is no affirmative evidence to rebut the presumption for these conditions. The respiratory disability, atrial fibrillation, hypertension, and thyroid nodule are remanded for further examination.

The Board has determined that the Veteran's current heart disability is due to an in-service event, injury, or disease and grants service connection for this condition.