Citation Nr: 0814618 Decision Date: 05/02/08 Archive Date: 05/12/08 DOCKET NO. 06-32 671 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in Newark, New Jersey THE ISSUE Entitlement to service connection for hypertension. REPRESENTATION Veteran represented by: The American Legion WITNESS AT HEARING ON APPEAL Veteran ATTORNEY FOR THE BOARD Jennifer R. White, Law Clerk INTRODUCTION The veteran served on active duty from February 1962 to March 1966, October 1966 to August 1974 and November 1985 to December 1993 with additional time in the Army Reserve. The veteran retired after twenty years of active service. This matter comes to the Board of Veterans' Appeals (Board) on appeal from a May 2005 decision by the Department of Veterans Affairs (VA) Regional Office (RO) in Newark, New Jersey. In January 2008, the veteran testified at a hearing before the undersigned Veterans Law Judge. A transcript of this hearing is of record. FINDINGS OF FACT The veteran's hypertension was originally diagnosed and treated in service. CONCLUSION OF LAW Hypertension was incurred in service. 38 U.S.C.A. § 1131 (West 2002). REASONS AND BASES FOR FINDINGS AND CONCLUSION On November 9, 2000, the Veterans Claims Assistance Act of 2000 (VCAA), (codified at 38 U.S.C.A. §§ 5100, 5102, 5103, 5103A, 5107) became law. Regulations implementing the VCAA provisions have since been published. 38 C.F.R. §§ 3.102, 3.156(a), 3.159, 3.326(a). The Board has considered this legislation with regard to the matter on appeal. Given the favorable action taken hereinbelow, no further assistance in developing the facts pertinent to this limited matter is required at this time. Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C.A. §§ 1110, 1131; 38 C.F.R. § 3.303(a). For the showing of chronic disease in service, there is required a combination of manifestations sufficient to identify the disease entity and sufficient observation to establish chronicity at the time. If chronicity in service is not established, a showing of continuity of symptoms after discharge is required to support the claim. 38 C.F.R. § 3.303(b). Service connection may also be granted for any disease diagnosed after discharge when all of the evidence establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). Also, certain chronic diseases, including hypertension, may be presumed to have been incurred during service if manifested to a compensable degree within one year of separation from active military service. 38 U.S.C.A. §§ 1112, 1113, 1137; 38 C.F.R. §§ 3.307, 3.309. The veteran's service treatment records reveal that the veteran was treated while on active service for hypertension. In the veteran's report of medical history at the time of his discharge in August 1974, the medical officer indicated that he had elevated blood pressure in 1966 which was subsequently treated with medication. The veteran's service treatment records indicate, in a November 1967 treatment note, that the veteran was known to have high blood pressure in 1965. This same treatment note indicates that the veteran was suffering from bouts of dizziness and his blood pressure was recorded at 172/100. An additional treatment note from November 1967 indicates the veteran's blood pressure was 170/120. There are additional indications of hypertension noted during the veteran's final period of active duty from November 1985 to December 1993. The veteran's blood pressure reading on his discharge examination in October 1993 was 160/80. On an April 1993 treatment note, the veteran was diagnosed with borderline elevated blood pressure and in a subsequent note that same month elevated blood pressure was noted. He was referred to a physician for treatment of his hypertension. During this last period of active duty, the veteran's service treatment records indicate high blood pressure readings during 1985, 1989, and 1991 with consistently high readings during 1992 and 1993. Additionally, private treatment records from 1998 through 2004 indicate the veteran had high blood pressure readings noted. A VA medical examination conducted in March 2004 indicates that the veteran had been diagnosed with hypertension four years before and that he was on medication for such condition. The veteran also submitted a statement from his private physician indicating that the veteran was diagnosed with hypertension in August 2000 with a blood pressure of 181/90 and had been on medication since that time. It is the defined and consistently applied policy of VA to administer the law under a broad interpretation, consistent, however, with the facts shown in every case. When, after careful consideration of all procurable and assembled data, a reasonable doubt arises regarding service origin, the degree of disability, or any other point, such doubt will be resolved in favor of the claimant. By reasonable doubt is meant one which exists because of an approximate balance of positive and negative evidence which does not satisfactorily prove or disprove the claim. It is a substantial doubt and one within the range of probability as distinguished from pure speculation or remote possibility. 38 C.F.R. § 3.102 (2007). In Alemany v. Brown, 9 Vet. App. 518 (1996), the U.S. Court of Appeals for Veterans Claims (Court) noted that in light of the benefit of the doubt provisions of 38 U.S.C.A. § 5107(b), an accurate determination of etiology is not a condition precedent to granting service connection; nor is "definite etiology" or "obvious etiology." Further, in Gilbert v. Derwinski, 1 Vet. App. 49 (1990), the Court stated that "a veteran need only demonstrate that there is an 'approximate balance of positive and negative evidence' in order to prevail." In Gilbert the Court specifically stated that entitlement need not be established beyond a reasonable doubt, by clear and convincing evidence, or by a fair preponderance of the evidence. Under the benefit of the doubt doctrine established by Congress, when the evidence is in relative equipoise, the law dictates that the veteran prevails. Given the fact that the veteran was diagnosed with hypertension in service and manifested symptoms of such for many years afterward resulting in a current diagnosis of hypertension, this is an appropriate case in which to invoke VA's doctrine of reasonable doubt. 38 U.S.C.A. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). Thus, after resolving all reasonable doubt in favor of the veteran, the Board finds that he is entitled to a grant of service connection for his hypertension. ORDER Entitlement to service connection for hypertension is granted. ____________________________________________ CHERYL L. MASON Veterans Law Judge, Board of Veterans' Appeals Department of Veterans Affairs