Ischemic heart disease decisions — 2023

The Veteran's appeal for increased ratings for left knee disability and service connection for heart disorder was denied. The decision upheld the existing rating of 10 percent for left knee lateral instability, effective April 12, 2022.

The Board has remanded the case due to insufficient compliance with previous remand instructions regarding the etiology of the Veteran's heart disability and obesity.

The Veteran's claim for an increased rating for PTSD prior to June 21, 2019 was denied due to the evidence not showing occupational and social impairment with reduced reliability and productivity.,The Veteran's appeal for an increased rating for coronary artery disease was dismissed as he withdrew his appeal.

The Veteran's service connection claim for coronary artery disease (CAD) is granted due to exposure to herbicide agents during his military service in Thailand. The Board finds that the evidence shows a current diagnosis of CAD and exposure to herbicides, leading to presumptive service connection.

The Board has determined that the Veteran's current heart condition, diagnosed as coronary artery disease with two stents placed in 2014, atherosclerotic cardiovascular disease, supraventricular arrhythmia, and heart valve replacement, is related to service. The decision grants service connection for this condition.

The Board has remanded the Veteran's claims of service connection for atrial fibrillation and erectile dysfunction due to potential exposure to herbicide agents in Vietnam. The decision also denied earlier effective dates for service connection.

The Board has remanded the claims for compensation under 38 U.S.C. §1151 due to the need for additional medical records and Social Security Administration (SSA) documents.

The Board has denied service connection for Erectile Dysfunction, Diabetes Mellitus Type II, and Coronary Arteriosclerosis (coronary artery disease) due to lack of evidence showing a current disability or a relationship to service. The case is being remanded for further development.

The Veteran's claim for service connection for obstructive sleep apnea as secondary to coronary artery disease and/or hypertension is remanded due to the inadequacy of the March 2023 VA examiner's opinion. The Veteran also submitted evidence suggesting a possible association between hypertension and OSA, which was not adequately addressed by the examiner.

The Veteran's petition to reopen his claim for service connection for ischemic heart disease is granted, and the case is remanded for further action regarding diabetes mellitus type II. The Veteran contends that his conditions are related to herbicide exposure in Korea.

The Board has remanded the cases for further examination and opinion regarding service connection, as well as determining whether additional evidence is needed to establish a relationship between current conditions and service.

The Veteran's diabetes mellitus, CAD, and hypertension are granted service connection based on the PACT Act presumption of exposure to herbicide agents.

The Veteran's appeals for various conditions and issues have been withdrawn or remanded. The right knee disability claim has been reopened, but service connection is not granted. Sleep apnea secondary to PTSD is granted. Bilateral hearing loss requires a VA examination. A higher evaluation for PTSD is required. Headaches need an addendum opinion. Chronic rhinosinusitis needs a VA examination and etiological opinion. Right knee condition also requires a VA examination.

The Board has remanded the claims of service connection for heart disability, diabetes mellitus type II, hypertension, and sleep apnea due to lack of documented treatment during service and inconclusive medical opinions.

The Veteran's service-connected autoimmune disorder to include rheumatoid arthritis has resulted in the need for aid and attendance of another, as evidenced by his inability to perform daily activities independently due to joint pain, swelling, and weakness. He requires assistance with bathing, grooming, and keeping himself clean and presentable.

The Veteran's service-connected disabilities, including lower back disability, radiculopathies, and hearing loss, have rendered him unable to maintain substantially gainful employment since July 28, 2022. The Board has granted TDIU based on the combined effect of these conditions.

The Board has determined that the claims must be remanded to obtain missing private treatment records and to provide a new VA examination for each of the service-connected conditions. The Veteran's STRs do not contain specific references to these conditions, but he reported experiencing symptoms since service.

The Veteran was granted special monthly compensation (SMC) at the aid and attendance level for his nonservice-connected left lower and upper extremities, as well as service-connected right upper and lower extremities. The appellant is also entitled to SMC based on two separate awards of SMC (l).

The Veteran's heart disability, specifically ischemic heart disease (IHD) and coronary artery disease (CAD), is currently rated at 30 percent. The Board found that the evidence did not meet the criteria for a higher rating as it did not show more than one episode of acute congestive heart failure in the past year or left ventricular dysfunction with an ejection fraction of 30 to 50 percent.

The Board has decided to remand the case due to an inadequate VA opinion regarding whether the Veteran's service-connected obstructive sleep apnea aggravated his heart conditions, specifically coronary artery disease. The claim will be returned for further development.