CORONARY ARTERY DISEASE

Summary

The Veteran, a Veteran who served from October 1967 to June 1970, including service in the Republic of Vietnam, appeals the January 2018 rating decision concerning service connection for coronary artery disease and an implanted cardiac pacemaker. The claim originated from an August 21, 2017, VA form 21-526EZ. The Board notes the Veteran's service in Vietnam, which triggers a presumption of herbicide exposure under 38 U.S.C. § 1116 and 38 C.F.R. § 3.307(a)(6). Coronary artery disease is a chronic disease presumptively linked to herbicide exposure under 38 C.F.R. §§ 3.307(a)(6) and 3.309(e), requiring only manifestation to a 10% compensable degree at any time after service. A January 2022 VA examination report noted the diagnosis of coronary artery disease and the implanted pacemaker. The AOJ had previously granted service connection favorably, finding the condition related to service based on presumed herbicide exposure. The Board reviewed the case to ensure the correct effective date, as the current appeal began after the AOJ's grant. Ultimately, the Board concluded that service connection for coronary artery disease, including the implanted pacemaker, is warranted on a presumptive basis due to the established herbicide exposure.

Rationale

Veteran served in Vietnam, triggering herbicide exposure presumption.; Coronary artery disease is presumptively linked to herbicide exposure.; VA examination noted diagnosis and pacemaker; AOJ previously granted favorably.

Full Decision Text

Citation Nr: 26003870
Decision Date: 03/26/26	Archive Date: 03/26/26

DOCKET NO. 18-28 620A
DATE: March 26, 2026

ORDER

Entitlement to service connection for coronary artery disease, to include implanted cardiac pacemaker, based on an August 21, 2017 claim, is granted.

FINDING OF FACT

1. The Veteran served in the Republic of Vietnam and is presumed to have been exposed to herbicides.

2. The Veteran's coronary artery disease was diagnosed following cardiac catheterization in a May 24, 2016 VA treatment record.

CONCLUSION OF LAW

The criteria for service connection for coronary artery disease, to include implanted cardiac pacemaker, have been met.  38 U.S.C. §§ 1110, 1112, 1113, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309.

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran served on active duty from October 1967 to June 1970, to include service in the Republic of Vietnam from March 1969 to June 1970.  The Board thanks the Veteran for his service to our country.

This matter comes before the Board of Veterans' Appeals (Board) on appeal of a January 2018 rating decision of the Agency of Original Jurisdiction (AOJ).  The Veteran presented testimony during a hearing before the undersigned Veterans Law Judge in March 2026.  

Entitlement to service connection for coronary artery disease, to include implanted cardiac pacemaker

Entitlement to service connection for coronary artery disease is warranted.

This matter arises from a VA form 21-526EZ received on August 21, 2017.

Service connection may be granted for disability due to disease or injury incurred in or aggravated by active military service.  38 U.S.C. § 1110; 38 C.F.R. §§ 3.303, 3.304.  Service connection may also be granted for any disease diagnosed after discharge when all the evidence, including that pertinent to service, establishes that the disease was incurred in service.  38 C.F.R. § 3.303.  To substantiate a claim of service connection, there must be evidence of: (1) a current disability; (2) a disease, injury, or event in service; and (3) a nexus or causal relationship between the claimed disability and the disease, injury, or event in service.  Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004).

For Veterans with 90 days or more of active service during a war period or after December 31, 1946, certain chronic diseases, to include cardiovascular-renal disease, including hypertension, may be presumed to have been incurred in service if they manifest to a compensable degree within a certain timeframe from service.  38 U.S.C. §§ 1112, 1113, 1137; 38 C.F.R. §§ 3.307, 3.309.  Furthermore, certain chronic diseases, such as cardiovascular-renal disease, including hypertension, will be presumed related to service, absent an intercurrent cause, if they were shown as chronic in service; or, if they manifested to a compensable degree within a presumptive period following separation from service; or, if they were noted in service (or within an applicable presumptive period) with continuity of symptomatology since service that is attributable to the chronic disease.  38 U.S.C. §§ 1101, 1112, 1113, 1137; 38 C.F.R. §§ 3.303, 3.307, 3.309.  Walker v. Shinseki, 708 F.3d 1331, 1338 (Fed. Cir. 2013).

A Veteran who served in the Republic of Vietnam between January 9, 1962, and May 7, 1975, is presumed to have been exposed to certain herbicide agents (e.g., Agent Orange) during such service, absent affirmative evidence to the contrary.  38 U.S.C. § 1116 (f); 38 C.F.R. § 3.307 (a)(6)(iii).  Certain diseases will be considered to have been incurred in service, even if there is no record of the disease during service, if that disease is associated with exposure to "herbicide agents" used in support of military operations in the Republic of Vietnam during the Vietnam era.  38 U.S.C. § 1116 (a)(1);
 between January 9, 1962, and May 7, 1975, is presumed to have been exposed to certain herbicide agents (e.g., Agent Orange) during such service, absent affirmative evidence to the contrary.  38 U.S.C. § 1116 (f); 38 C.F.R. § 3.307 (a)(6)(iii).  Certain diseases will be considered to have been incurred in service, even if there is no record of the disease during service, if that disease is associated with exposure to "herbicide agents" used in support of military operations in the Republic of Vietnam during the Vietnam era.  38 U.S.C. § 1116 (a)(1); 38 C.F.R. § 3.307 (a)(6), 3.309 (e).  Coronary artery disease (as an ischemic heart disease) is listed among the diseases presumptively linked to exposure to certain herbicide agents under 38 C.F.R. §§ 3.307(a)(6), 3.309(e).  They need only manifest to a degree of at least 10 percent at any time after service.  38 C.F.R. § 3.307(a)(6)(ii).

In a January 2022 VA examination report, during the period on appeal, the examiner noted a diagnosis of coronary artery disease, which was found in 2016, and implanted cardiac pacemaker.  In a February 2022 rating decision, the AOJ granted service connection for the Veteran's coronary artery disease, to include implanted cardiac pacemaker, favorably finding that the disability is related to service based on the Veteran's presumed herbicide exposure.  See also Veteran's DD 214 (confirming overseas service in Vietnam).  The Board is bound by this favorable finding.

However, as the grant of the claim in connection with this appeal may result in a more favorable effective date, given the current appeal began with a date of claim in August 2017, prior to the effective date currently assigned, September 30, 2021, for the Veteran's coronary artery disease disability, it is not moot.  See Green v. McDonough, 37 Vet. App. 127, 136-48 (2024); see also Warren v. McDonald, 28 Vet. App. 214, 221 (2016) (holding that a subsequent AOJ decision cannot divest the Board of jurisdiction over the prior appeal; therefore, an AOJ grant of service connection cannot finally decide the claim of service connection already on appeal to the Board).

Therefore, the Board concludes that service connection for coronary artery disease, to include implanted cardiac pacemaker, is warranted on a presumptive basis under 38 C.F.R. §§ 3.307(a)(6) and 3.309(e).  38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Lynch v. McDonough, 21 F.4th 776, 781-82 (Fed. Cir. 2021). 

 

M. C. GRAHAM

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	D. Makarenko, Associate Counsel

The Board's decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.