Citation Nr: 18141353 Decision Date: 10/10/18 Archive Date: 10/10/18 DOCKET NO. 15-26 415 DATE: October 10, 2018 ORDER The motion for Clear and Unmistakable Error (CUE) within the April 2015 Board decision that denied service connection for depressive disorder, to include as secondary to service-connected headaches, is denied. The motion for CUE within the in the April 2015 Board decision that denied service connection for hypertension, to include as secondary to service-connected headaches, to include as secondary to depressive disorder, is denied. FINDINGS OF FACT 1. In denying entitlement to service connection for depressive disorder, the April 2015 Board decision was consistent with and reasonably supported by the evidence then of record and the existing legal authority, and it did not contain undebatable error that would have manifestly changed the outcome. 2. In denying entitlement to service connection for hypertension, the April 2015 Board decision was consistent with and reasonably supported by the evidence then of record and the existing legal authority, and it did not contain undebatable error that would have manifestly changed the outcome. CONCLUSIONS OF LAW 1. The April 2015 Board decision, which denied entitlement to service connection for depressive disorder, to include as secondary to headaches, did not contain clear and unmistakable error. 38 U.S.C. § 7111 (2012); 38 C.F.R. §§ 3.2600, 20.1400-11 (2018). 2. The April 2015 Board decision, which denied entitlement to service connection for hypertension, to include as secondary to headaches, did not contain clear and unmistakable error. 38 U.S.C. § 7111 (2012); 38 C.F.R. §§ 3.2600, 20.1400-11 (2018). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The moving party is a Veteran who served in the U.S. Air Force from July 1967 to August 1971, and from January to March 1991. He had additional Reserve service for a total of 28 years. These matters are before the Board of Veterans’ Appeals (Board) on a motion challenging the Board’s April 2015 decision that denied claims of entitlement to service connection for depressive disorder and hypertension, and regarding both, to include as secondary to service-connected headaches. The Veterans Law Judge and attorney who prepared this CUE decision are not the Veterans Law Judge and attorney who prepared the April 2015 decision that is being challenged. The issue of whether there was clear and unmistakable error (CUE) in the January 1973 rating decision denying entitlement to service connection for vertigo and epilepsy was raised in July and September 2015 statements. However, the Board will not refer this issue for adjudication because, effective on March 24, 2015, VA amended its rules as to what constitutes a claim for benefits; veterans are now required to file all claims on a specific claim form prescribed by the Secretary, which is available online or at the local RO. If the Veteran wishes to file a claim of CUE in the 1973 rating decision, he is encouraged to do so using the prescribed form either in person or online (https://www.ebenefits.va.gov/ebenefits/). Cue Under 38 U.S.C. § 7111 A final decision issued by the Board is subject to revision on the grounds of CUE. 38 U.S.C. § 7111 (a); 38 C.F.R. § 20.1400. The Court has promulgated a three-pronged test used to determine whether CUE was in any prior decision: (1) it must be determined whether either the correct facts, as they were known at the time, were not before the adjudicator (that is, more than a simple disagreement as to how the facts were weighed and evaluated) or the statutory or regulatory provisions extant at that time were incorrectly applied; (2) the error must be “undebatable” and of the sort “which, had it not been made, would have manifestly changed the outcome at the time it was made”; and (3) a determination that there was CUE must be based on the record and the law that existed at the time of the prior adjudication in question. See Damrel v. Brown, 6 Vet. App. 242, 245 (1994), citing Russell v. Principi, 3 Vet. App. 310, 313-14 (1992) (en banc). CUE is defined as a very specific and rare kind of error. “It is the kind of error, of fact or law, that when called to the attention of later reviewers compels the conclusion, to which reasonable minds could not differ, that the result would have been manifestly different but for the error. Thus, even where the premise of error is accepted, if it is not absolutely clear that a different result would have ensued, the error complained of cannot be, ipso facto, clear and unmistakable.” See Fugo v. Brown, 6 Vet. App. 40, 43-44 (1993). As applied to claims for CUE in prior Board decisions, in particular, the governing standard is essentially identical. See 38 C.F.R. § 20.1403 (a)-(c). The implementing regulations further designate that examples of situations that are not CUE in a Board decision as (1) a new medical diagnosis that “corrects” an earlier diagnosis considered in a Board decision; (2) the Secretary’s failure to fulfill the duty to assist, or; (3) a disagreement as to how the facts were weighed or evaluated. 38 C.F.R. § 20.1403 (d). CUE does not include the otherwise correct application of a statute or regulation where, subsequent to the Board decision challenged, there has been a change in the interpretation of the statute or regulation. 38 C.F.R. § 20.1403 (e). The “benefit of the doubt” rule of 38 38 U.S.C. § 5107 (b) does not apply to a Board decision on a motion to revise a Board decision due to CUE. 38 C.F.R. § 20.1411 (a). The Board has original jurisdiction to determine whether CUE exists in a prior final Board decision. 38 C.F.R. § 20.1400. A motion alleging CUE in a prior Board decision must set forth clearly and specifically the alleged CUE, or errors of fact or law in the Board decision, the legal or factual basis for such allegations, and why the result would have been different but for the alleged error. 38 C.F.R. § 20.1404 (b). Non-specific allegations of failure to follow regulations or failure to give due process, or any other general, non-specific allegations of error, are insufficient to satisfy the requirement of the pleading requirements, and must be dismissed without prejudice. Id. Here, the moving party and his representative have set forth specific allegations, some with greater detail than others, which allow for a decision. The Board has reviewed all the evidence in the Veteran's claims file. Although the Board has an obligation to provide adequate reasons and bases supporting this decision, there is no requirement that the evidence submitted by the Veteran or obtained on his behalf be discussed in detail. Rather, the Board's analysis below will focus specifically on what evidence is needed to substantiate the claim and what the evidence in the claims file shows, or fails to show, with respect to the claim. See Gonzales v. West, 218 F.3d 1378, 1380-81 (Fed. Cir. 2000) and Timberlake v. Gober, 14 Vet. App. 122, 128-30 (2000). The moving party’s claims file contains almost 700 documents, of which a large portion are statements from the moving party. The Board additionally notes that the moving party worked for VA as a compensation and pension adjudicator and as a supervisor for approximately 30 years, and has a working knowledge of the VA claims and appeals process. He has also been represented throughout his claims process. The pertinent laws and regulations at the time of this decision were similar, if not essentially the same, as they are now. Specifically, service connection may be granted for disability arising from disease or injury incurred in or aggravated by active service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303 (a). Service connection may be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303 (d). As a general matter, service connection for a disability requires evidence of: (1) the existence of a current disability; (2) the existence of the disease or injury in service, and; (3) a relationship or nexus between the current disability and any injury or disease during service. Shedden v. Principi, 381 F.3d 1163 (Fed. Cir. 2004); see also Hickson v. West, 12 Vet. App. 247, 253 (1999), citing Caluza v. Brown, 7 Vet. App. 498, 506 (1995), aff’d, 78 F.3d 604 (Fed. Cir. 1996). 1. Whether there was Clear and Unmistakable Error (CUE) present in the April 2015 Board decision that denied service connection for depressive disorder, to include as secondary to service-connected headaches In a July 2015 claim, and in additional statements, the moving party has provided the following arguments related to CUE in the April 2015 Board decision which denied entitlement to service connection for depressive disorder: a) he stated the Board erred in not immediately granting service connection for depressive disorder after the 2006 VA examination; b) he argued the Board went on “fishing expeditions” to obtain negative medical opinions; c) he stated it was CUE that he was “not given the benefit of reasonable doubt that is supposed to be automatically considered;” d) he stated he was entitlement to service connection for seizures; e) he stated it was CUE he was not granted depression as a result of it being linked to his active duty temporal lobe seizures; f) and he argued it was CUE that the Board ignored recent medical evidence that he had depressive disorder under the DSM-IV and DSM-V (the moving party was noted to have diagnoses of depressive disorder and depression in the April 2015 Board decision). In September 2015, the Veteran’s representative made the following arguments as related to his CUE claim: a) argued that because there were VAMC records for another veteran in the claims file in 2013 that the “state of the record [was] clearly [] indefensible” and that “none of the doctors, nurses, psychiatrist, raters, and attorneys who say that they reviewed the file since May 1, 2013 apparently actually did;” b) argued there was CUE because it was “not hard to find, for the reasonably diligent and competent layperson…that migraines worsen, and possibly cause, depression;” (The brief included links to google searches and online articles which were not provided prior to the April 2015 Board decision) c) argued that the April 2015 Board decision did not include reasons and bases to discount the Veteran’s own statements and contemporaneous writings as evidence of depression; and d) argued the Veteran had not been properly worked up for a seizure disorder. Initially, regarding the arguments pertaining to a seizure disorder, the Board notes that the moving party was not service-connected for a seizure disorder and did not have a claim pending for a seizure disorder at the time of the April 2015 Board decision; therefore, arguments of CUE in not addressing how his depression was related to a seizure disorder, or of not addressing the unclaimed entitlement to service connection for a seizure disorder, are not valid arguments for CUE in the April 2015 decision. There is no law that requires the Board to address claims which have not been raised. To the allegation that the April 2015 Board decision contained CUE by merely existing as a decision when there were records from another veteran misfiled in the claims file, the Board notes that there was no misapplication of facts on the part of the Board in the April 2015 decision. It is quite easy to ignore misfiled documents when reviewing a case, and the moving party and his representative have not cited any documents the Board relied upon in the April 2015 decision that were incorrectly attributed to the moving party. A review of the evidence cited in the April 2015 Board decision is consistent with the moving party’s service treatment records, VA treatment records, lay statements, and VA examination reports. Additionally, a review of the medical examinations relied upon by the Board in the April 2015 decision included citations to records belonging to the moving party, and did not include any citations to records of another (incorrect) veteran. As to the argument that the Board went on “fishing expeditions” to obtain negative opinions, the Court of Appeals for Veterans Claims (Court) has cautioned VA against seeking an additional medical opinion where favorable evidence in the record is unrefuted, and indicated that it would not be permissible to undertake further development in this circumstance if the sole purpose was to obtain evidence against an appellant’s claim. See Mariano v. Principi, 17 Vet. App. 305, 312 (2003). But see also Douglas v. Shinseki, 23 Vet. App. 19 (2009) (distinguishing Mariano and contrarily holding that VA may undertake the development of additional evidence if it is necessary to render an informed decision on the claim). This argument, however, is not an argument of CUE in the April 2015 decision, as the April 2015 decision denied the moving party’s claim. Prior Board decisions remanded the claim for additional examinations. Additionally, the remands (which are not the focus of this CUE claim) were necessary to render an informed decision as the 2006 examination that the moving party alleges warranted an “immediate grant” of service connection diagnosed depressive disorder and discussed the moving party’s allegation of PTSD, but did not provide a positive nexus opinion. The 2006 examiner wrote that his depressive disorder “may have been present in previous years, it certainly appears to have been exacerbated by the death of his mother in March of 2005.” An additional 2006 headache examination diagnosed headaches secondary to depression, but contained information about “witnessing” the crash of a B-52 that was in direct contrast to the psychiatric examination a month prior where he stated he did not witness the crash, but heard about it over the radio. Additionally, in February 2006, the Veteran provided a statement after the 2006 diagnosis of depressive disorder denying having depression for many years. Thus, although the remands for examinations were not a part of the April 2015 Board decision, the record does not demonstrate that the remands for additional examinations were unjustified or “illegal.” Regarding the moving party’s argument that he was not afforded the benefit-of-the-doubt, and his representative’s argument that the April 2015 Board decision did not provide reasons and bases to discount the Veteran’s own statements and contemporaneous writings, the Board finds no error. Notably, the April 2015 Board decision did address the moving party’s lay allegations, and found that he did not have the requisite knowledge to provide persuasive statements regarding his depressive disorder. The September 2015 brief by the moving party’s representative did not allege how the April 2015 Board decision’s finding that the lay statements were not persuasive was an error of fact or law (e.g. if the moving party has medical training). The April 2015 decision additionally pointed out discrepancies in the moving party’s statements and psychiatric testing which showed “some” exaggeration. Simply claiming CUE on the basis that the previous adjudication had improperly weighed and evaluated the evidence can never satisfy the stringent definition of CUE. Fugo v. Brown, 6 Vet. App. 40, 43-44 (1993), aff’d on reconsideration, 6 Vet. App. 162, 163 (1994). Similarly, the Court has rejected as being too broad general and unspecified allegations of error based on the failure to follow regulations, failure to give due process, failure to accord benefit of the doubt, failure of duty to assist, and any other general, non-specific claim of “error.” See id. Whether the Board properly applied VA’s benefit-of-the-doubt doctrine in deciding the claims in April 2015, including regarding secondary service connection, involves how the Board weighed the evidence of record. For sake of clarity, as stated, this same doctrine cannot apply now to the question of whether CUE existed. See again, 38 C.F.R. § 20.1411 (a). As to whether the same doctrine, under 38 U.S.C. § 5107 (b) was originally misapplied, the Board now examines, but does not find to have occurred. In sum, the preponderance of the evidence was clearly and definitively against recovery, precluding application of the reasonable doubt doctrine, and rendering challenge to this a contention only as to the proper weighing of the evidence which cannot amount to CUE. To this effect, under applicable law, when there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the Secretary shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107 (b). In evaluating the probative weight of a medical opinion, VA will generally take into account factors such as the objective examination of the veteran, the knowledge and skill in analyzing the data, including that comprised in medical history, and the medical conclusion the physician reaches. See Guerrieri v. Brown, 4 Vet. App. 467, 470-71 (1993). See also, Bloom v. West, 12 Vet. App. 185, 187 (1999); Hernandez-Toyens v. West, 11 Vet. App. 379, 382 (1998). See also Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007) (in addition to clearly considering direct service connection, a medical opinion must support its conclusion with an analysis that may be considered and weighed against contrary opinions). Review of the claims file often contributes to thoroughness. See Prejean v. West, 13 Vet. App. 444, 448-9 (2000); Boggs v. West, 11 Vet. App. 334, 340 (1998). But see Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 300 (2008) (an opining physician’s review of the claims folder is not the determinative factor is assigning probative value, particularly where a physician otherwise had information as to the most relevant case facts). In view of the above, error in application of the VA’s reasonable doctrine cannot be ascertained in the April 2015 Board decision. Essentially, there was no approximate balance of positive and negative evidence to warrant such, this occasioned in part by the fact that there were no opinions in this case that were directly favorable. The moving party has frequently referred to the PTSD examination from January 2006 as providing a favorable opinion linking his depressive disorder to service. This is not the case. The examination included that psychological testing pointed to “a number of personality characteristics.” He scored below threshold for a diagnosis of PTSD, and was noted to have a score “somewhat exaggerated” regarding intrusive symptoms and symptoms of avoidance. The examiner found that the Veteran did not meet Criterion A (experiencing trauma) for a diagnosis of PTSD. He diagnosed depressive disorder, and stated “though it may have been present in previous years, it certainly appears to have been exacerbated by the death of his mother in 2005.” As this opinion was not adequate to provide service connection for depressive disorder, additional opinions were sought. A February 2006 opinion stated his service-connected headaches were due to depression; however, the April 2015 Board decision noted that his headaches began in service in 1968 and that the Veteran denied all psychiatric symptoms in service through 1991. A May 2013 VA examination found that the Veteran did not meet the criteria for a diagnosed mental health disorder due in large part to the Veteran’s “grossly inconsistent…self-report” during psychological testing. The April 2015 Board decision noted that the Veteran’s test results during the May 2013 examination included a score that would have required psychiatric hospitalization due to the inability to care for oneself, whereas the Veteran lived alone and was not under psychiatric or therapeutic treatment at the time. A 2014 examination included the diagnosis of depression, but again provided a negative nexus opinion to his service and a negative nexus opinion to his service-connected headaches. The Veteran provided numerous statements attesting to his developing depression in service, but also statements that he was not depressed and had not been depressed for a long time when he was seeking service connection for PTSD. The April 2015 Board decision noted the Veteran’s statements of his ongoing depression since service, his poetry, and a letter from his wife. The April 2015 Board decision noted that the Veteran did not have the requisite knowledge to self-diagnose depression or to attribute his depression to his headaches, and that the more probative evidence of record were the negative medical opinions, the contemporaneous service medical records denying symptoms, and the notations that the Veteran did not credibly represent himself during examinations. All medical nexus opinions before the Board in April 2015 were negative. A failure to properly apply section 5107(b) regarding VA’s benefit-of-the-doubt doctrine, overall, cannot be ascertained, and whereas there was some positive evidence favoring the claim (mostly the Veteran’s statements), there was not an approximate balance (relative equipoise), at minimum, to an extent that meets the stringent CUE standard. Apart from issue of any error under 38 U.S.C. § 5107 (b), there is no valid CUE claim that can be further pled based entirely on how the evidence in a Board decision was weighed. The moving party has also argued that there was aggravation of depression by service-connected headaches. The moving party’s representative’s brief included cites to internet searches and articles that were not of record at the time of the April 2015 Board decision, and are therefore inapplicable to a claim based on CUE as these were not “facts” before the Board at that time. Service connection may also be granted for a disability that is proximately due to, or the result of, a service-connected disease or injury. 38 C.F.R. § 3.310 (a) (adding that “[w]hen service connection is thus established for a secondary condition; the secondary condition shall be considered a part of the original condition”). Additionally, service connection may be established by the degree of disability resulting from aggravation of a nonservice-connected disability by a service-connected disability. See 38 C.F.R. § 3.310 (b); see also Allen v. Brown, 7 Vet. App. 439, 448 (1995). Further, effective October 10, 2006, 38 C.F.R. § 3.310 was amended to codify the Court’s holding in Allen, requiring that a baseline level of severity of the nonservice-connected disease or injury must be established by medical evidence created before the onset of aggravation. Thus, the Veteran’s argument for aggravation of depression by his headaches is not shown by the record, as his headaches were initially medically recorded in 1968, and he denied psychiatric symptoms in service and was not diagnosed with a psychiatric disorder until 2006. Additionally, the record contained, and the April 2015 Board decision cited, negative secondary service-connection medical opinions. Lastly, in August 2016, the moving party submitted a statement from a Dr. L.B.H., psychologist, that was written in July 2016. The letter was regarding a June 2016 psychological evaluation. Notably, the Veteran reported “seeing a B-52 explode” and witnessing the death of two people he trained with. This statement is in direct contrast to his 2006 statement that he heard about the accident on the radio. Dr. L.B.H. diagnosed major depression, and that the moving party’s need for “treatment is directly related to the above mentioned traumatic events of his Vietnam War combat experience.” Importantly, this July 2016 examination report was not available at the time of the April 2015 Board decision. As such, it was not a “fact” upon which a CUE allegation could be made, and it cannot be used to argue for application of the benefit-of-the-doubt in the April 2015 Board decision. This report is inapplicable to the CUE claim. For these reasons, the CUE challenge to the Board’s April 2015 decision denying entitlement to service connection for depressive disorder must be denied. 2. Whether there was Clear and Unmistakable Error (CUE) present in the April 2015 Board decision that denied service connection for hypertension, to include as secondary to service-connected headaches, to include as secondary to depressive disorder In a July 2015 claim, the moving party did not provide any arguments related to CUE in the April 2015 Board decision which denied entitlement to service connection for hypertension. In the September 2015 appellate brief, the moving party’s representative argued: a) because there were documents for another Veteran in the moving party’s claims file, the “state of the record [was] clearly [] indefensible” and that “none of the doctors, nurses, psychiatrist, raters, and attorneys who say that they reviewed the file since May 1, 2013 apparently actually did;” b) that the medical opinion regarding NSAIDS and hypertension looked only at causation, and not aggravation; and c) that the examiner who provided the hypertension opinion was the “nurse who examined the veteran’s ears in 2010 and got most of his name wrong.” He argued that the Board failed to state the “reasons and bases for finding her credible.” As stated above, the allegation that the April 2015 Board decision contained CUE by merely existing as a decision when there were records from another veteran misfiled in the claims file, is not an allegation of error in fact or law. It is quite easy to ignore misfiled documents when reviewing a case, and the moving party and his representative have not cited any documents the Board relied upon in the April 2015 decision that were incorrectly attributed to the moving party. A review of the evidence cited in the April 2015 Board decision is consistent with the moving party’s service treatment records, VA treatment records, lay statements, and VA examination reports. A November 2005 VA examination included a negative nexus opinion between the moving party’s hypertension and his service-connected headaches. In March 2010, an addendum opinion based on review of the record noted he was diagnosed with hypertension in 2004, and the examiner opined that his hypertension was less likely than not secondary to his service-connected headaches. He had “risk factors for hypertension of obesity, remote alcohol abuse, marital/personal stress, and a stressful job.” The examiner also provided the opinion that his hypertension was not secondary to his headache medications, as “Elavil does not elevate blood pressure” and he was not taking Motrin excessively or even daily for his headaches per his July 2004 neurologist note, which was quoted as his taking 800 mg of Motrin for any aura or when pain starts, with headaches up to five days a week. The examiner also noted his 2005 laboratory findings showed normal renal function. “Hypertension in 95 % of cases is essential and has not known cause. The episodic use of NSAIDS was less likely than not the cause of his hypertension.” The September 2015 brief is correct, the record does not include an opinion which directly relates to whether the moving party’s headaches or headache medication aggravated his hypertension. Aggravation is also not addressed in the April 2015 Board examination. Therefore, the Board must analyze whether this error manifestly changed the outcome of the claim based on the evidence before the Board in April 2015. Service connection may also be granted for a disability that is proximately due to, or the result of, a service-connected disease or injury. 38 C.F.R. § 3.310 (a). Additionally, service connection may be established by the degree of disability resulting from aggravation of a nonservice-connected disability by a service-connected disability. See 38 C.F.R. § 3.310 (b); see also Allen v. Brown, 7 Vet. App. 439, 448 (1995). Further, effective October 10, 2006, 38 C.F.R. § 3.310 was amended to codify the Court’s holding in Allen, requiring that a baseline level of severity of the nonservice-connected disease or injury must be established by medical evidence created before the onset of aggravation. Here, the moving party complained of headaches as early as 1968, and began use of over-the-counter medication at some point prior to 1998 (as he had increased headaches with use of Motrin in 1998, according to the 2005 VA examination). The 2005 examination noted he had used Elavil in the past, but that he had stopped because he did not like how it made him feel. The moving party was diagnosed with hypertension in 2004. Aggravation of hypertension by his service-connected headaches would have required a baseline finding related to his hypertension prior to aggravation from his headaches. The moving party had service-connected headaches for approximately 30 years prior to developing hypertension. Although not addressed by the Board in April 2015, there was not possibility of establishing a baseline severity of hypertension prior to aggravation by headaches because his headaches pre-dated his hypertension by decades. Aggravation of hypertension by medications taken for his service-connected headaches would have required medical evidence of his baseline hypertension prior to aggravation from these medications. The moving party had recently stopped taking Elavil around the time he was diagnosed with hypertension, so there would be no baseline severity of hypertension prior to Elavil use. The moving party used over-the-counter medications from at least 1998, but likely as early as the late 1960s, for treatment of his headaches. Again, there would be no record of a baseline severity of his hypertension prior to his use of over-the-counter medication. His increased use of Motrin in 1998 was still six years before his diagnosis of hypertension. And by February 2011, the moving party reported to VA treatment providers that he used Motrin “occasionally; not daily” for treatment of his headaches. As the facts before the Board at the time of the April 2015 decision showed that a baseline severity of hypertension could not be established to argue for aggravation by his service-connected headaches or headache medication, the decision does not compel the conclusion, to which reasonable minds could not differ, that the result would have been manifestly different but for the error. Lastly, the representative argues that the Board erred in the April 2015 decision by not discussing the “credibility” of the April 2010 “nurse.” The Board notes that the April 2010 hypertension opinion was provided by a nurse practitioner, and was additionally acknowledged by an internist. In adjudicating claims, the Board must assess the competence and credibility of lay affiants. See Buchanan v. Nicholson, 451 F.3d 1331 (Fed. Cir. 2006) (addressing lay evidence as potentially competent to support presence of disability even where not corroborated by contemporaneous medical evidence). Washington v. Nicholson, 19 Vet. App. 362, 368-69 (2005). The Board does not address the “credibility” of a medical provider, but weighs medical opinions to determine whether the preponderance of the evidence is for or against a claim. Here, the April 2010 medical opinion was provided by a nurse practitioner, who cited correct evidence in the file (date of hypertension onset, use of medications, renal function, etc.), and provided a rationale for her opinion that his hypertension was less likely than not caused by his service-connected headaches and headache medication. The April 2015 Board decision included the nurse practitioner’s opinion, citations, and rationale. Although the April 2015 Board decision included assessment of the competency of the moving party’s statements relating his hypertension to his headaches and headache medication (and found that he was not competent to provide such an opinion), it did not address the “credibility” of the April 2010 nurse practitioner. Generally, the Board would address the competency of an objective medical opinion, or weigh the value of an objective medical opinion, but does not address the “credibility” of such. The Board does not find error of fact or law in accepting the medical opinion of a medical professional, which included a rationale and citations to correct information in the medical record. The representative’s contention that she was the same person who “examined his ears in 2010 and got most of his name wrong” do not specify an error in the April 2015 decision. An April 2010 audio examination was completed by an audiologist, and not the nurse practitioner who provided the negative hypertension opinion. Additionally, the hypertension opinion provided by the nurse practitioner was based on evidence review and did not involve interview of the Veteran whereby she may have mispronounced his name. His name is correctly captioned on the header of both the April 2010 audiologist’s opinion and the April 2010 nurse practitioner’s opinion. Although both women, they are separate people with very different names. For these reasons, the Board finds that its error in its April 2015 decision (not addressing secondary aggravation) does not compel the conclusion, to which reasonable minds could not differ, that the result would have been manifestly different but for the error, and his motion for CUE is therefore denied. KRISTI L. GUNN Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD M.H. Stubbs, Counsel