BVA9504477 DOCKET NO. 93-09 697 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in Buffalo, New York THE ISSUE Entitlement to service connection for the cause of the veteran's death. REPRESENTATION Appellant represented by: New York Division of Veterans' Affairs ATTORNEY FOR THE BOARD James A. Pritchett, Associate Counsel INTRODUCTION The veteran served on active duty from August 1943 to June 1946, and died on December [redacted] 1990. This appeal arises from a July 1991 decision by the Buffalo, New York, Department of Veterans Affairs (VA) Regional Office (RO) that denied service connection for the cause of the veteran's death. CONTENTIONS OF APPELLANT ON APPEAL It is contended that the veteran incurred lower leg wounds with artery and vein damage during active duty. It is asserted that the wounds were ongoing problems which required several surgeries. It is further contended that the cumulative effect of the damaged arteries and veins and corrective surgeries weakened the veteran's cardiovascular system and caused his death by myocardial infarction. DECISION OF THE BOARD The Board of Veterans' Appeals (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 record supports the appellant's claim for service connection for the cause of the veteran's death. FINDINGS OF FACT 1. All relevant evidence necessary for an equitable disposition of the veteran's appeal has been obtained by the RO. 2. The cause of the veteran's death in December 1990 at age 64 was an acute myocardial infarction due to coronary artery disease. 3. Residuals of multiple shell fragment wounds sustained by the veteran during service were debilitating and rendered the veteran less capable of resisting the effects of coronary artery disease. CONCLUSION OF LAW Disability incurred in service contributed substantially or materially to the cause of the veteran's death. 38 U.S.C.A. §§ 1310, 5107 (West 1991); 38 C.F.R. § 3.312 (1993). REASONS AND BASES FOR FINDINGS AND CONCLUSION The appellant's claim is "well grounded" within the meaning of 38 U.S.C.A. § 5107. That is, she has presented a claim which is plausible, and all relevant facts have been properly developed. No further assistance to the appellant is required to comply with the duty to assist the appellant mandated by 38 U.S.C.A. § 5107. The veteran died in December 1990 at age 64. The official death certificate indicates that the underlying cause of death was coronary artery disease. It has not been contended nor does the record establish that coronary artery disease had its onset during service or developed secondary to the residuals of the inservice wounds. The veteran's service medical records are unavailable, as they apparently were destroyed in the fire at the National Personnel Records Center in 1973. Hospital admission data cards compiled by the Office of Surgeon General indicate that the veteran was wounded and treated for a fractured humerus, a penetrating leg wound and unspecified nerve paralysis. The available records indicate that the veteran was hospitalized in January 1945 and discharged in June 1946. The records further indicate that the veteran sustained multiple shell fragment wounds of both buttocks and thighs, left leg and left arm, and was separated from active service for medical disability. The RO has noted that the veteran's claims folder has been lost. However, a computer print-out dated in February 1991 indicates that the veteran apparently was receiving $821 per month in VA compensation benefits at the time of his death in December 1990. An entry on the printout indicates that an 80 percent evaluation had been assigned for many years. A hospital discharge summary dated in January 1988 states that the veteran incurred multiple shrapnel wounds at age 18 and had had chronic venous insufficiency and stasis edema since then. The summary states that at age 25 the veteran developed small ulcers on his right leg which were treated with vein stripping and venous ligation. Further, a letter from Carl E. Brendenberg, M.D., dated in March 1988, reveals that the veteran had been plagued by causalgia of the left foot and leg secondary to fragment wounds sustained in World War II, as well as bilateral post venous stasis problems with dermatitis and recurrent ulceration and edema. A letter dated in May 1991, from Arthur S. Levy, M.D., states that as a result of his combat wounds the veteran had lifelong complications involving both the arterial and venous circulation of each leg. In his mid forties the veteran had a major myocardial infarction and at age 54 underwent a coronary artery bypass. The letter states that in 1987 and 1988 the veteran required several major surgical procedures, including lower limb arterial and venous grafts in order to preserve the integrity of his limbs. In 1989 the veteran had a right hip replacement to repair his totally degenerated hip joint. The letter states that the hip had degenerated because the veteran developed an abnormal gait because of his combat wounds. Dr. Levy states that there was no doubt at all that the surgeries in 1987 through 1989 resulted from the late consequences of the veteran's combat injuries. He further states that the surgeries were required because of the veteran's compromised cardiovascular system and that the veteran might have lived longer if those surgeries had not been required as late consequences of the veteran's war wounds. Letters dated in July 1992 by a VA physician and in August 1992 by the Chief, Cardiology Section, Buffalo VA Medical Center, express opinions to the effect that the veteran's fatal myocardial infarction was not related to the orthopedic surgeries performed during the years immediately prior to his death. The above evidence shows that in World War II the veteran sustained multiple shell fragment wounds, some affecting the lower extremties, which resulted in significant residual disability and had an adverse effect on his health for the remainder of his life. Although VA physicians have concluded that the veteran's death in December 1990 was not related to orthopedic surgeries reportedly performed for complications associated with the inservice shell fragment wounds, the statement by Dr. Levy and the medical history noted at the time of the veteran's recent hospitalizations suggest that it was at least as likely as not that the shell fragment residuals were debilitating and left him less capable of resisting the effects of the fatal coronary artery disease. Accordingly, resolving the benefit of the doubt in his favor, service connection for the cause of the veteran's death is warranted. 38 U.S.C.A. §§ 1310, 5107; 38 C.F.R. § 3.312. ORDER Entitlement to service connection for the caused of the veteran's death is granted. WAYNE M. BRAEUER 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.