Citation Nr: 18141338 Decision Date: 10/11/18 Archive Date: 10/10/18 DOCKET NO. 16-27 479 DATE: October 11, 2018 ORDER Entitlement to service connection for hypertension is denied. REMANDED Entitlement to service connection for sleep apnea is remanded. FINDING OF FACT The Veteran’s hypertension did not manifest to a compensable degree within the applicable presumptive period; continuity of symptomatology is not established; and the disability is not otherwise etiologically related to an in-service injury, event, or disease. CONCLUSION OF LAW The criteria for service connection for hypertension have not been met. 38 U.S.C. §§ 1110, 1112, 1113, 1131, 1137, 5107(b) (2012); 38 C.F.R. §§ 3.102, 3.303(a)-(b), (d), 3.307, 3.309(a) (2017). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from October 1962 to October 1966. These matters come before the Board of Veterans’ Appeals (Board) on appeal from an October 2014 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO). 1. Entitlement to service connection for hypertension A veteran is entitled to VA disability compensation if the evidence demonstrates that a current disability resulted from an injury or disease incurred in, or aggravated by active military service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303(a). To establish a right to compensation for a present disability, a veteran must show: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service. Davidson v. Shinseki, 581 F.3d 1313, 1315-16 (Fed. Cir. 2009); Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Service connection may be granted for any disease that is initially diagnosed after service when all of the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). Service connection may also be granted on a presumptive basis for certain chronic diseases, including hypertension, if such diseases are shown to be manifest to a degree of 10 percent or more within 1 year after separation from active service. See 38 U.S.C. §§ 1101(3), 1112(a)(1), 1137; 38 C.F.R. §§ 3.307(a), 3.309(a). Determinations regarding service connection are based on a review of all of the evidence of record, including pertinent medical and lay evidence. 38 U.S.C. § 1154(a); 38 C.F.R. § 3.303(a). Under certain circumstances, lay evidence may be sufficient to establish a medical diagnosis or nexus. See Davidson v. Shinseki, 581 F.3d 1313, 1316 (Fed. Cir. 2009); see also Layno v. Brown, 6 Vet. App. 465, 469 (1994). When considering evidence and determining its probative value, VA considers both the competency and the credibility of the witness. See Layno, 6 Vet. App. at 469. The Veteran asserts that he has hypertension that is related to active service. Having carefully reviewed the evidence of record, the Board finds that the preponderance of the evidence is against service connection for hypertension. The Veteran has a current diagnosis of hypertension. See April 2016 CAPRI records. The record does not reflect that his hypertension first manifested during service or within one year of his separation from service. Service treatment records reflect no in-service diagnoses or treatment for hypertension. Blood pressure readings and heart and vascular examinations conducted during service were normal. On separation from service the Veteran did not indicate that he experienced high blood pressure or cardiovascular issues. The blood pressure reading during the Veteran’s September 1966 separation examination was 128/76. In addition, the evidence does not show, nor does the Veteran otherwise allege, that he continuously manifested symptoms of hypertension after his discharge from service. Post-service treatment records first document a history of hypertension in 1995, 29 years after his discharge from service. See April 2016 CAPRI, pg. 221. To the extent that the Veteran asserts that he has hypertension that is related to service, the Board notes he is competent to report incidents and symptoms in service and symptoms since then. He is not, however, competent to render an opinion as to the cause or etiology of the current diagnosis because he does not have the requisite medical knowledge or training, and because this matter is beyond the ability of a lay person to observe. The grant of service connection requires competent evidence to establish a diagnosis and, as in this case, relate the diagnosis to the Veteran’s service. While the record demonstrates current diagnosis of hypertension, it does not contain reliable evidence which relates this claimed disability to any incident of service. For these reasons, the Board concludes that the claim of entitlement to service connection for hypertension must be denied, as the preponderance of the evidence is against the claim. The doctrine of reasonable doubt is not applicable in the instant appeal. 38 U.S.C. § 5107; 38 C.F.R. § 3.102. REASONS FOR REMAND 1. Entitlement to service connection for sleep apnea is remanded. The Veteran contends that his sleep apnea began in service, but that he did not seek treatment at that time. See May 2016 Form 9. The Board notes that the Veteran has not been afforded a VA examination and a VA medical opinion has not been obtained. In light of the Veteran’s contentions that he suffered from sleep apnea in service and his current diagnosis of sleep apnea, the Board finds that the Veteran should be afforded a VA examination to obtain an opinion regarding the nature and etiology of the Veteran’s sleep apnea. In a July 2017 IHP, the Veteran’s representative specifically asked for a VA examination/opinion to determine if the Veteran’s sleep apnea began in service. The matter is REMANDED for the following action: 1. Schedule the Veteran for a VA examination to determine the nature and etiology of the Veteran’s sleep apnea. The claims file must be reviewed by the examiner. The examiner should provide the following opinion: Whether it is at least as likely as not (50 percent greater probability) that the Veteran’s sleep apnea had its onset in, or is otherwise related to his active military service. 2. After the above development has been completed, readjudicate the claim. If the benefit sought remains denied, provide the Veteran a supplemental statement of the case, and return the case to the Board. DONNIE R. HACHEY Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD K. Brandt