Citation Nr: 18142032
Decision Date: 10/12/18	Archive Date: 10/12/18

DOCKET NO. 16-28 463
DATE:	October 12, 2018
REMANDED
Entitlement to service connection for hypertension, including as due to service-connected diabetes mellitus, is remanded.
REASONS FOR REMAND
The Veteran had active service from June 1969 to June 1971, including in combat in the Republic of Vietnam from December 1969 to March 1970.
A review of the record evidence shows that, following VA hypertension Disability Benefits Questionnaire (DBQ) in August 2012, the VA examiner opined that it was less likely than not that the Veteran’s service-connected diabetes mellitus caused his current hypertension.  This VA examiner subsequently opined in a September 2012 addendum to the August 2012 VA hypertension DBQ that it was less likely than not that the Veteran’s service-connected diabetes mellitus aggravated (permanently worsened) his current hypertension.  See 38 C.F.R. § 3.310 (2017).  Unfortunately, although the August and September 2012 opinions concerning secondary service connection are sufficient for VA adjudication purposes, the August 2012 VA clinician was not asked to provide and did not provide an opinion as to whether the Veteran’s hypertension is related directly to active service.  See 38 C.F.R. §§ 3.303, 3.304 (2017).  Thus, the Board finds that, on remand, the August 2012 VA hypertension DBQ should be returned to the VA examiner who completed it or another appropriate clinician for an addendum opinion addressing whether the Veteran’s hypertension is related directly to active service.
The matter is REMANDED for the following action:
1.  Send the August 2012 VA hypertension DBQ to the VA clinician who completed it or another appropriate clinician for an addendum opinion.  In the addendum opinion, the August 2012 VA clinician or another appropriate clinician should opine whether it is at least as likely as not (i.e., a 50 percent or greater probability) that the Veteran’s hypertension is related directly to active service or any incident of service.  A rationale also should be provided for any opinions expressed.  If any requested opinion cannot be provided without resorting to mere speculation, then the August 2012 VA clinician or another appropriate clinician should explain why.  
The August 2012 VA clinician or another appropriate clinician is advised that the absence of contemporaneous records showing complaints of or treatment for hypertension, alone, is insufficient rationale for a medical nexus opinion.
2.  Readjudicate the appeal.
 
R. FEINBERG
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	Michael T. Osborne, Counsel