VALVULAR HEART DISEASE (INCLUDING RHEUMATIC HEART DISEASE)

Summary

The Veteran, an Army Veteran who served from June 1983 to September 1992, appeals the denial of service connection for a heart disability. The Veteran had previously been granted service connection for PTSD. The Agency of Original Jurisdiction denied the heart claim in August 2021, finding no in-service event or current diagnosis. In June 2025, the Veteran submitted a private medical opinion from M.M., DNP, CNP, who diagnosed several valvular and heart conditions and opined that the heart disorder was at least as likely as not secondary to the Veteran's service-connected PTSD. This opinion cited supporting medical literature. The Board found this private opinion probative, noting it was from a medical professional who reviewed the Veteran's record and provided clinical evaluations. Crucially, there were no contrary opinions in the record. Resolving all reasonable doubt in the Veteran's favor, the Board found service connection for the heart disorder warranted, to include as secondary to PTSD. The Board granted service connection for the heart disability.

Rationale

Private opinion found heart disorder secondary to PTSD; No contrary opinions of record; Doubt resolved in Veteran's favor

Full Decision Text

Citation Nr: A26038301
Decision Date: 04/23/26	Archive Date: 04/23/26

DOCKET NO. 211103-195337
DATE: April 23, 2026

ORDER

Entitlement to service connection for a heart disability is granted.

FINDING OF FACT

Resolving all reasonable doubt in the Veteran's favor, his heart disability is etiologically related to his posttraumatic stress disorder (PTSD).

CONCLUSION OF LAW

The criteria for entitlement to service connection for a heart disability, to include as secondary to PTSD, have been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.310.

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran served on active duty in the United States Army from June 1983 to September 1992.

The Veteran filed his claim of service connection for a heart disability in May 2021. In an August 2021 rating decision, the Agency of Original Jurisdiction (AOJ) denied the claim. 

In the November 2021 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Hearing docket. On May 9, 2025, the Veteran withdrew the hearing request. Therefore, the Board may only consider the evidence of record at the time of the August 2021 AOJ decision on appeal, as well as any evidence submitted by the Veteran or his representative within 90 days following receipt of the withdrawal of the hearing request. 38 C.F.R. § 20.302(b). If evidence was submitted either (1) during the period after the AOJ issued the decision on appeal and prior to receipt of the withdrawal, or (2) more than 90 days following receipt of the withdrawal, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.302(b), 20.801. 

If the Veteran would like VA to consider any evidence that was submitted that the Board could not consider, the Veteran may file a Supplemental Claim (VA Form 20-0995) and submit or identify this evidence. 38 C.F.R. § 3.2501. If the evidence is new and relevant, VA will issue another decision on the claim, considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision. 

Entitlement to service connection for a heart disability.

Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. § 3.303, 3.304. The three-element test for service connection requires evidence of: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004).

Service connection may be established on a secondary basis for a disability which is shown to be proximately due to or the result of a service-connected disability. 38 C.F.R. § 3.310 (a). Establishing service connection on a secondary basis requires evidence sufficient to show (1) that a current disability exists and (2) that the current disability was either caused by or aggravated by a service-connected disability. 38 C.F.R. § 3.310 (a); Allen v. Brown, 7 Vet. App. 439 (1995).

Turning to the record, in the August 2021 rating decision, the AOJ denied the claim, finding that the evidence did not show an event, disease or injury in service or a current diagnosed disability.

In June 2025, the Veteran submitted a private opinion from M.M., DNP, CNP.  Ms. M. noted that the Veteran had diagnoses of valvular disease, cardiomyopathy, chest pain, right atrial enlargement, dilative cardiomegaly, mitral, tricuspid, aortic, and pulmonary valve conditions. She also opined that it is as least as likely as not that the Veteran's heart disorder is secondary to his service-connected PTSD. In support of the opinion, she cited multiple medical studies that showed a causal relationship between PTSD and heart disease.

Based on a review of the record and with doubt resolved in the Veteran's favor, the Board finds that service connection for a heart disorder is warranted. The Veteran has been diagnosed
 Veteran submitted a private opinion from M.M., DNP, CNP.  Ms. M. noted that the Veteran had diagnoses of valvular disease, cardiomyopathy, chest pain, right atrial enlargement, dilative cardiomegaly, mitral, tricuspid, aortic, and pulmonary valve conditions. She also opined that it is as least as likely as not that the Veteran's heart disorder is secondary to his service-connected PTSD. In support of the opinion, she cited multiple medical studies that showed a causal relationship between PTSD and heart disease.

Based on a review of the record and with doubt resolved in the Veteran's favor, the Board finds that service connection for a heart disorder is warranted. The Veteran has been diagnosed with various heart diseases. The Veteran is in receipt of service connection for PTSD. The June 2025 private examiner opined that the Veteran's heart disorder was secondary to his PTSD and provided multiple medical articles supports a causal relationship between heart disease and PTSD. 

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The Board finds the June 2025 opinion probative as it was written by a medical professional who reviewed the Veteran's medical record and provided clinical evaluations of the claimed condition. Importantly, there are no contrary opinions of record regarding whether the Veteran's claimed heart disability is related to his service-connected PTSD. Therefore, the Board finds that service connection for a heart disorder, to include as secondary to PTSD, is warranted. See Lynch v. McDonough, 21 F.4th 776, 781 (Fed. Cir. 2021) (en banc).

 

 

D. C. JOHNSON

Acting Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	Shana Z. Siesser, 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.