Citation Nr: 1322010	
Decision Date: 07/10/13    Archive Date: 07/18/13

DOCKET NO.  09-48 124	)	DATE
	)
	)

On appeal from the
Department of Veterans Affairs Regional Office in North Little Rock, Arkansas


THE ISSUE

Entitlement to service connection for hypertension, to include as due to exposure to herbicide agents and secondary to diabetes mellitus, type II.


REPRESENTATION

Appellant represented by:	Disabled American Veterans


ATTORNEY FOR THE BOARD

Scott Shoreman, Counsel


INTRODUCTION

The Veteran had active service from February 1971 to January 1973.

This matter comes before the Board of Veterans' Appeals (Board) from a July 2007 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in North Little Rock, Arkansas.

The appeal is REMANDED to the RO via the Appeals Management Center (AMC), in Washington, DC.  VA will notify the appellant if further action is required.


REMAND

The Veteran had a VA examination in October 2009.  The examination report indicates that he was initially diagnosed with hypertension in 2002 but that he stopped his medications due to diet modification.  In June 2006 he again had hypertension, and he presently took amlodipine, hydrochlorothiazide and lisinopril.  His blood pressure on three consecutive days leading up to the examination was 145/92, 131/94, and 118/71.  The examiner diagnosed the Veteran with essential hypertension and felt that since the Veteran was initially diagnosed with hypertension in 2002 and was diagnosed with diabetes in 2006, they were not related.  

The Board finds that this opinion is inadequate, because the examiner did not clearly address whether the Veteran's hypertension was aggravated by the diabetes mellitus, type II.  An addendum to the opinion provided should be sought.  

VA treatment records to October 2009 have been associated with the claims file.  The RO should attempt to obtain all relevant VA treatment records dated from October 2009 to the present, while the claim is in remand status.  Bell v. Derwinski, 2 Vet. App. 611 (1992).

Accordingly, the case is REMANDED for the following action:

1.  Obtain copies of VA treatment records from October 2009 to the present.  

2.  Obtain an addendum to the VA examination report from October 2009.  The Veteran's claims folder should be provided to the reviewer prior to completion of the opinion.  The reviewer should provide an opinion as to whether it is at least as likely as not (50 percent probability or more) that the Veteran's hypertension was aggravated by his service-connected diabetes mellitus, type II.  Aggravation is defined for these purposes as a worsening of the underlying condition versus a temporary flare-up of symptoms.  

The reviewer should provide a detailed rationale for any opinion expressed.  If an opinion cannot be rendered without resorting to speculation, the reviewer should state why that is so, to include a recitation of any missing facts necessary to render a non-speculative opinion.

3.  Then readjudicate the appeal.  If the benefit sought on appeal is not granted in full, issue the Veteran and his representative a supplemental statement of the case and provide the Veteran an opportunity to respond.

The appellant has the right to submit additional evidence and argument on the matter the Board has remanded.  Kutscherousky v. West, 12 Vet. App. 369 (1999).

This claim must be afforded expeditious treatment.  The law requires that all claims that are remanded by the Board of Veterans' Appeals or by the United States Court of Appeals for Veterans Claims for additional development or other appropriate 





action must be handled in an expeditious manner.  See 38 U.S.C.A. §§ 5109B, 7112 (West Supp. 2012).



_________________________________________________
MICHAEL E. KILCOYNE
Veterans Law Judge, Board of Veterans' Appeals

Under 38 U.S.C.A. § 7252 (West 2002), only a decision of the Board of Veterans' Appeals is appealable to the United States Court of Appeals for Veterans Claims.  This remand is in the nature of a preliminary order and does not constitute a decision of the Board on the merits of your appeal.  38 C.F.R. § 20.1100(b) (2012).