Entitlement to service connection for the cause of the Veteran's death is remanded.

Citation Nr: 26001410 Decision Date: 01/30/26 Archive Date: 01/30/26 DOCKET NO. 13-25 088 DATE: January 30, 2026 REMANDED Entitlement to service connection for the cause of the Veteran's death is remanded. REASONS FOR REMAND The Veteran served on active duty for training from March 1962 to June 1962 and on active duty from January 1966 to December 1967. Regrettably, the Veteran died in December 2011. The appellant is his surviving spouse. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a December 2012 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO). In March 2014, the appellant requested a Board hearing, which was scheduled for May 2023. The appellant did not appear for the hearing and claimed that she did not receive notice of the hearing date. See June 2023 Informal Hearing Presentation. Her representative requested that the hearing be rescheduled. Id. In June 2023, the Board denied the motion for a new hearing date, finding that it was untimely and lacked a showing of good cause. See 38 C.F.R. § 20.603(d). The Board most recently remanded the claim in June 2024 to provide the appellant with an opportunity to obtain any outstanding treatment records, to obtain the Veteran's autopsy report, to associate the Veteran's service personnel records with the record and to translate the Veteran's death certificate into English. In July 2024, September 2024 and January 2025 letters, VA requested that the appellant complete an authorization to obtain the Veteran's private treatment records. The appellant did not respond to the letters. The Veteran's military personnel records were associated with the claim file in July 2024 and February 2025. The Veteran's death certificate was translated into English in January 2025. In May 2025 correspondence, the private treatment provider that completed the Veteran's autopsy report notified VA that the report could be obtained for a fee. It does not appear that the appellant was notified of the availability of the report for a fee. As the autopsy report is not associated with the claim file, further remand is required as explained below. Stegall v. West, 11 Vet. App. 268, 270-71 (1998). The Board acknowledges that in May 2024 VA received from the appellant's representative an Informal Hearing Presentation which contained hyperlinks to content that is not otherwise part of the record on appeal; however, that content was not accessed nor considered as part of the record before the Board. See Bowey v. West, 11 Vet. App. 106, 108-09 (1998) (holding that the mere reference to non VA documents is insufficient to incorporate them into the record). Entitlement to service connection for the cause of the Veteran's death is remanded. The appellant seeks entitlement to service connection for the cause of the Veteran's death. See July 2012 Application for Dependency and Indemnity Compensation, Death Pension and Accrued Benefits by a Surviving Spouse or Child (VA Form 21-534). Specifically, the appellant, through her representative, contends that the Veteran, in the performance of his military duties as a tracked vehicle mechanic, would have been exposed to toxic agents that are known to contribute to Parkinson's disease and diabetes mellitus. See January 2026 Informal Hearing Presentation. Further, she asserts that the Veteran's service treatment records show that he complained of low back pain, that he had fall issues due to his Parkinson's disease and it is at least as likely as not that his toxic exposures in military service contributed to his Parkinson's disease and his Parkinson's disease contributed to his fall that led to his death. Id. As discussed above, further development to obtain the Veteran's autopsy report is necessary before the Board can adjudicate the claim. The December 2012 death certificate received by VA in January 2025 lists the immediate cause of the Veteran's death as complications of trauma to the spine with other significant conditions that contributed to death of Parkinson's disease and diabetes mellitus. An October 1967 service treatment record notes the Veteran's complaint of back pain and an impression of a light muscle strain of the lower back. An October 1966 military personnel record associated with the claim file in February 2025 notes that the Veteran was assigned to the heavy equipment maintenance company. A February 2024 VA memorandum states that the Veteran was not exposed to toxic exposure risk activity. However, the Board finds that a new toxic exposure risk activity memorandum should be completed based on the updated military personnel records. In a cause of death claim, VA must make reasonable efforts to assist a claimant in obtaining a medical opinion when such opinion is "necessary to substantiate the claimant's claim for a benefit." DeLaRosa v. Peake, 515 F.3d 1319, 1322 (Fed. Cir. 2008). Here, the record does not reflect that a medical opinion concerning whether the Veteran's complications of trauma to the spine with other significant conditions that contributed to death of Parkinson's disease and diabetes mellitus is directly related to service was obtained. Given the Veteran's lower back complaint dating back to service, the Board finds that a remand is necessary to obtain such opinion. The matter is REMANDED for the following actions: 1. Obtain and associate with the claim file a copy of the Veteran's autopsy report through the Instituto de Ciencias Forenses. See May 5, 2025 letter. If an authorization form is needed from the appellant to request such report, the appellant should be asked to provide one. The appellant should be notified and provided an opportunity to pay the fee to obtain the autopsy report. If the autopsy report cannot be obtained, it should be so noted for the record (with the scope of the search described in detail), and the appellant and her representative should be so notified. 2. Obtain an updated toxic exposure risk activity memorandum with consideration of the Veteran's duties with the heavy equipment maintenance company. 3. Upon completing the above development, obtain an etiology opinion from an appropriate examiner to determine the nature and etiology of the Veteran's claimed complications of trauma to the spine with other significant conditions that contributed to death of Parkinson's disease and diabetes mellitus as it relates to the cause of his death. The record, to include a copy of this Remand, should be made available to the examiner. The examiner is asked to furnish an opinion with respect to the following questions: (A) Is it at least as likely as not (likelihood is at least approximately balanced or nearly equal, if not higher) that the Veteran's complications of trauma to the spine with other significant conditions that contributed to death of Parkinson's disease and diabetes mellitus had its onset during his active service or is otherwise etiologically related to such service? The examiner should address an October 1967 service treatment record noting the Veteran's complaint of back pain and an impression of a light muscle strain of the lower back. (B) If the Veteran was toxic exposed during service, is it at least as likely as not (likelihood is at least approximately balanced or nearly equal, if not higher) that the Veteran's complications of trauma to the spine with other significant conditions that contributed to death of Parkinson's disease and diabetes mellitus is related to his toxic exposures? The examiner must consider (i) total potential exposure through all applicable military deployments; and (ii) synergistic, combined effect of all toxic exposure risk activities. The examiner should address the appellant's contention that the Veteran had fall issues due to his Parkinson's disease and it is at least as likely as not that his toxic exposures in military service contributed to his Parkinson's disease and his Parkinson's disease contributed to his fall that led to his death. A rationale should be provided for all opinions offered. (Continued on the next page) ? The medical opinion must support the conclusions reached with an analysis that is adequate to consider and weigh against other evidence of record; medical opinions must contain not only clear conclusions with supporting data, but also a reasoned medical explanation connecting the two. If an opinion cannot be expressed without resorting to speculation, ensure that the clinician so indicates and discusses why an opinion is not possible, to include whether there is additional evidence that could enable an opinion to be provided, or whether the inability to provide the opinion is based on the limits of medical knowledge. KRISTY L. ZADORA Veterans Law Judge Board of Veterans' Appeals Attorney for the Board A. Kuhn, 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.