Citation Nr: 0003400 Decision Date: 02/10/00 Archive Date: 02/15/00 DOCKET NO. 94-20 365 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Newark, New Jersey THE ISSUE Entitlement to service connection for hypertension and heart disease, claimed as secondary to the veteran's service- connected bronchial asthma. REPRESENTATION Appellant represented by: The American Legion WITNESS AT HEARING ON APPEAL Appellant ATTORNEY FOR THE BOARD Peter C. Lenart, Associate Counsel INTRODUCTION The veteran served in the military from August 1969 to October 1970. In June 1993, the Department of Veterans Affairs (VA) Regional Office (RO) in Newark, New Jersey, denied the veteran's claim for hypertension and a heart condition, secondary to the veteran's service-connected asthma. The veteran timely appealed this issue to the Board of Veterans' Appeals (Board). The veteran testified before a hearing officer at the RO ( RO hearing) on October 19, 1993. His appeal is now before the Board for resolution. REMAND The veteran is service connected for asthma and he is currently assigned a 100 percent evaluation. In support of his secondary service connection claim, the veteran submitted a September 1993 medical statement from a private physician that attributed his hypertension and his heart trouble to his service-connected asthma condition. In April 1998, the veteran underwent a VA examination to address the question of whether it was as likely as not that his asthma caused his heart disease and hypertension. The examiner noted that she had reviewed the veteran's claims file. The examiner diagnosed the veteran with hypertension, in addition to controlled diabetes and asthma. The examiner concluded her examination report with the following comment on etiology: "Asthma does not cause hypertension or heart disease." As the veteran's claims folder contains contradictory medical evidence addressing the etiology of the veteran's hypertension and heart disease, an additional examination must be conducted before the Board is able to address the issue on appeal. While the Board notes that the VA examination is more thorough than the medical statement submitted by the veteran, neither report gives any support or rationale for the opinion given. Accordingly, this claim is hereby REMANDED to the RO for the following action: 1. The RO should schedule the veteran for an cardiovascular examination to obtain a medical opinion concerning the nature and etiology of his hypertension and heart disease. The entire claims folder, containing all evidence pertinent to her appeal, and a complete copy of this REMAND, must be provided to, and be reviewed by, the examiner. After examining the veteran (to include all appropriate tests and studies) and a comprehensive review of his claims file, the examiner should offer a written opinion as to whether the veteran's currently diagnosed hypertension and heart disease are the result of his service-connected bronchial asthma. The examiner must provide the complete rationale underlying any conclusions drawn or opinions expressed, citing, where necessary, to specific evidence in the record, in a typewritten report. 2. The RO should review the examination report for compliance with the directives of this REMAND. If deficient in any manner, it should be returned, along with the claims file, for immediate corrective action. 3. Upon completion of the above development, and after undertaking and completing any additional development deemed warranted by the record, the RO should readjudicate the veteran's claim for service connection for hypertension and a heart condition, claimed as secondary to her service-connected bronchial asthma. The RO must provide adequate reasons and bases for its decision, citing to all governing legal authority and precedent, and addressing all issues and concerns that were noted in this REMAND. 4. If the benefits sought by the veteran are not granted to his satisfaction, he and his representative must be furnished a supplemental statement of the case (SSOC) and given an opportunity to submit written or other argument in response thereto, before the case is returned to the Board for further appellate consideration. The appellant has the right to submit additional evidence and argument on the matter or matters the Board has remanded to the regional office. Kutscherousky v. West, 12 Vet. App. 369 (1999). This claim must be afforded expeditious treatment by the RO. The law requires that all claims that are remanded by the Board of Veterans' Appeals or by the United States Court of Appeals for Veterans Claims for additional development or other appropriate action must be handled in an expeditious manner. See The Veterans' Benefits Improvements Act of 1994, Pub. L. No. 103-446, § 302, 108 Stat. 4645, 4658 (1994), 38 U.S.C.A. § 5101 (West Supp. 1999) (Historical and Statutory Notes). In addition, VBA's Adjudication Procedure Manual, M21-1, Part IV, directs the ROs to provide expeditious handling of all cases that have been remanded by the Board and the Court. See M21-1, Part IV, paras. 8.44- 8.45 and 38.02-38.03. (CONTINUED ON NEXT PAGE) LAWRENCE M. SULLIVAN Member, Board of Veterans' Appeals Under 38 U.S.C.A. § 7252 (West 1991 & Supp. 1999), only a decision of the Board of Veterans' Appeals is appealable to the United States Court of Appeals for Veterans Claims. This remand is in the nature of a preliminary order and does not constitute a decision of the Board on the merits of your appeal. 38 C.F.R. § 20.1100(b) (1999).