BVA9507837 DOCKET NO. 93-00 166 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in Muskogee, Oklahoma THE ISSUE Entitlement to service connection for a heart disorder. REPRESENTATION Appellant represented by: The American Legion WITNESSES AT HEARING ON APPEAL Appellant and Celeste [Redacted] ATTORNEY FOR THE BOARD T. S. Kelly, Associate Counsel INTRODUCTION The veteran had active military service from August 1944 to December 1944. CONTENTIONS OF APPELLANT ON APPEAL The veteran contends that after being in service for approximately three weeks he was hospitalized at Fort Warren, Wyoming, for blood poisoning due to a boil on his wrist, at which time a heart murmur was detected. The veteran maintains that his present heart disorder is related to his period of service. DECISION OF THE BOARD The Board, in accordance with the provisions of 38 U.S.C.A. § 7104 (West 1991), has reviewed and considered all of the evidence and material of record in the veteran's claims file. Based on its review of the relevant evidence in this matter, and for the following reasons and bases, it is the decision of the Board that the preponderance of the evidence is against the claim of entitlement to service connection for a heart disorder. FINDINGS OF FACT 1. All relevant evidence necessary for an equitable disposition of the veteran's claim has been obtained insofar as possible. 2. A heart disorder, including arteriosclerotic heart disease, is first shown many years after service and is unrelated to service. CONCLUSION OF LAW A heart disorder was not incurred in or aggravated by service nor may arteriosclerotic heart disease be presumed to have been incurred in service. 38 U.S.C.A. §§ 1101, 1110, 1112, 1113, 5107 (West 1991); 38 C.F.R. §§ 3.303(d), 3.307, 3.309 (1994). REASONS AND BASES FOR FINDINGS AND CONCLUSION The Board finds that the veteran has submitted a well-grounded claim within the meaning of 38 U.S.C.A. § 5107(a) (West 1991). That is, he has presented a claim which is plausible and capable of substantiation. As the veteran has submitted evidence of a well-grounded claim, the Department of Veterans Affairs (VA) has a duty to assist the appellant. It appears that the veteran's service medical records may have been involved in the 1973 fire at the National Personnel Records Center. The United States Court of Veterans Appeals (Court) has held that the VA must place an increased emphasis on the duty to assist in cases where service medical records are not available. Dixon v. Derwinski, 3 Vet.App. 261 (1992). As a result of this, the veteran was requested to fill out a NA Form 13055, which could have possibly allowed the NPRC to obtain this information from other sources. While the veteran returned this form in February 1992, it did not contain the necessary information to perform the additional search. A response received from the NPRC in May 1992, indicated that it was unable to make a search of the veteran's unit records without a complete assigned unit at the time of treatment. In September 1994, the Board remanded this matter to the RO to allow the veteran the opportunity to fill out another NA Form 13055, with the necessary information. In November 1994, the RO sent a letter to the veteran requesting that he fill out the enclosed NA Form 13055 with the necessary information and return it to the RO within 60 days. The RO, in March 1995, sent a letter to the veteran indicating that it was returning the file to the Board for further appellate review. The United States Court of Veterans Appeals has held that the duty to assist is not a one-way street. As the veteran was requested to provide additional essential information in November 1994, which would have allowed for further development, and he did not respond, the duty to assist has been satisfied. 38 U.S.C.A. § 5107 (West 1991). Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by wartime service. 38 U.S.C.A. § 1110 (West 1991). In addition, where a veteran served ninety (90) days or more during a period of war and arteriosclerotic heart disease becomes manifest to a degree of 10 percent within one year from date of termination of such service, such disease shall be presumed to have been incurred in service, even though there is no evidence of such disease during the period of service. This presumption is rebuttable by affirmative evidence to the contrary. 38 U.S.C.A. §§ 1101, 1112, 1113 (West 1991); 38 C.F.R. §§ 3.307, 3.309 (1994). A review of the file reveals that the only service medical record available for review demonstrates that the veteran was treated for an acute furuncle on the ulnar border of the left hand in September 1944. In a December 1991 application for nonservice- connected pension, the veteran reported having had a stroke and problems with his heart beginning in 1991. The veteran was hospitalized at the Baptist Medial Center on October 8, 1991, with pre-infarction angina. The veteran indicated that he had been having chest pains throughout the day. The veteran reported that he had had chest pains off and on for a couple of months prior to this incident. An October 11, 1991, report noted that the veteran had had an eight month history of coronary artery disease prior to his admission on October 9, 1991. While hospitalized, the veteran underwent emergency coronary angioplasty. An occlusion of the coronary arteries occurred following the angioplasty and the veteran underwent coronary artery bypass grafting. He also experienced myocardial infarction. Although the initial surgery was noted to have gone well, the veteran experienced two episodes of pericardial tamponade which required re-exploratory surgery. Past medical history reported during the veteran's hospitalization noted that he had previously never been hospitalized. A history of arteriosclerotic cardiovascular disease and hypertension, with some question of a heart murmur, was also noted. A work history of heavy construction for twenty years, with retirement for non-health reasons, and intermittent employment as a janitor was also reported. At the time of his October 30, 1991, discharge, diagnoses of coronary artery disease, acute myocardial infarction, cardiogenic shock, coagulopathy, atrial fibrillation and a right cerebrovascular accident with left hemiparesis were rendered. A letter received from the veteran's private physician, S. P. Shetty, M.D., in December 1991 indicated that the veteran had undergone coronary artery bypass surgery. He further indicated that the veteran was found to have had arteriosclerotic heart disease with a myocardial infarction at that time. Dr. Shetty also indicated that the veteran's condition had been exacerbated by the reexploratiory surgery. He further noted that the veteran had recently suffered a cerebrovascular accident and left hemiparesis. In a March 1992 letter, the veteran indicated that he had been inducted into the Army in August 1944 and discharged 3 months and 22 days later due to a heart problem. The veteran further reported that his heart problem began in service and that he had been put on limited duty assignment during that time. A March 1992 VA examination indicated that the veteran thought he was in good health until November 1991, when he was hospitalized with an acute myocardial infarction. The examiner indicated that the veteran had apparently had a number of complications. Diagnoses of coronary artery disease with myocardial infarction, angioplasty, a 3 vessel coronary bypass graft, resolved pericardial effusion, and a cerebrovascular accident with residual left spastic hemiparesis were rendered at that time. At the veteran's September 1992 personal hearing, the veteran's representative indicated that it was the veteran's contention that he had passed the induction examination with no defects noted and had been accepted for active service. He further indicated that after serving for approximately three weeks, the veteran was hospitalized at Fort Warren, Wyoming, for blood poisoning due to a boil on his left wrist, at which time a heart murmur was detected. The veteran's representative further indicated that the veteran was released from the hospital, placed on light duty, and transferred to Camp Chaffe in Arkansas for discharge. He further noted that the veteran was basing his claim for service connection on the fact that he was presumed sound at the time of his induction into service and did not develop a heart condition until after he began serving on active duty. Transcript page 3 (T. 3). The veteran testified that prior to his entrance into service he was farming and had had no problems with his heart. The veteran further indicated that he had not undergone physicals for either highschool sports or employment reasons prior to his entrance into service. He further testified that he was not aware of any heart problems prior to his entrance into service. (T. 3). The veteran further indicated that a heart condition was not detected until he had entered the service. He also testified that quite a few years after service he woke up in the night with hurting in his chest and then it just disappeared. He further reported that he did not see a doctor at that time. (T. 4). The veteran further indicated that his heart problem in service was a murmur. (T. 7). Upon further questioning from the hearing officer, the veteran indicated that the chest pains that he previously spoke of had occurred in 1958 or 1959. (T. 9). He further indicated that the first time he saw a doctor for a chest problem was in July or August 1991. (T. 10). He also testified that between the time of his discharge from service and the time that he went to the Shawnee Medical Center in October 1991, he was not seen for a heart problem. (T. 10). Numerous letters were also received from various individuals who knew the veteran prior to his entrance into service which indicated that the veteran did not have a heart problem prior to his entrance into service. A letter from Cecil [Redacted] indicated that the veteran had told him that he had been discharged from service due to a heart condition. Overall, the evidence reflects that the first objective finding of a heart disorder did not occur until the veteran was hospitalized in October 1991. The veteran has testified that he did not notice any heart pain until 1958 or 1959. The veteran's service medical records, while consisting of only one page, do not make reference to a murmur or heart disorder. While the veteran has testified as to his belief that his present heart disorder began in service and is related to a murmur diagnosed at that time, the first objective medical finding of a heart disorder is not until 1991. At that time, it was recorded that there was a question of a heart murmur in the veteran's history. The veteran is not qualified to render an opinion as to the etiology of his current heart disorder. Espiritu v. Derwinski, 2 Vet.App. 492 (1992). Likewise, the individuals who wrote the numerous letters on behalf of the veteran are not qualified to render an opinion as to the etiology of the veteran's current heart disorder. Furthermore, the veteran's present heart disorder, including arteriosclerotic heart disease, has not been medically attributed to any murmur, and the veteran is not competent to make such a connection. Grottveit v. Brown, 5 Vet.App. 91 (1993). The report that the veteran was separated from service because of a heart disorder is not supported by the service separation documents which do not so show. While the Board is sympathetic to the testimony of the veteran, the absence of a finding of a heart murmur or disorder on the report of the hospitalization for the boil on the wrist in service, the passage of over 13 years before any chest pain, as reported by the veteran at his September 1992 personal hearing, and the passage of over 45 years before any objective medical finding of a heart disorder, including arteriosclerotic heart disease, coupled with the fact that the medical evidence of record does not show or suggest a relationship between the current heart disease and the alleged murmur in service, demonstrates that the preponderance of the evidence is against a claim for service connection for a heart disorder, including arteriosclerotic heart disease. The preponderance of the evidence shows that the veteran's current heart disorder, heart disease, was not manifest until many years after separation from service and is unrelated to service. ORDER Service connection for a heart disorder is denied. WILLIAM J. REDDY Member, Board of Veterans' Appeals The Board of Veterans' Appeals Administrative Procedures Improvement Act, Pub. L. No. 103-271, § 6, 108 Stat. 740, ___ (1994), permits a proceeding instituted before the Board to be assigned to an individual member of the Board for a determination. This proceeding has been assigned to an individual member of the Board. NOTICE OF APPELLATE RIGHTS: Under 38 U.S.C.A. § 7266 (West 1991), a decision of the Board of Veterans' Appeals granting less than the complete benefit, or benefits, sought on appeal is appealable to the United States Court of Veterans Appeals within 120 days from the date of mailing of notice of the decision, provided that a Notice of Disagreement concerning an issue which was before the Board was filed with the agency of original jurisdiction on or after November 18, 1988. Veterans' Judicial Review Act, Pub. L. No. 100-687, § 402 (1988). The date which appears on the face of this decision constitutes the date of mailing and the copy of this decision which you have received is your notice of the action taken on your appeal by the Board of Veterans' Appeals.