Citation Nr: 18150217 Decision Date: 11/14/18 Archive Date: 11/14/18 DOCKET NO. 14-32 846 DATE: November 14, 2018 ORDER New and material evidence having been received to reopen a claim of entitlement to service connection for hypertension (also known as high blood pressure), the claim is reopened. Entitlement to service connection for hypertension, to include as due to Agent Orange exposure, and secondary to service-connected coronary artery disease (CAD) is granted. FINDINGS OF FACT 1. An October 2007 rating decision denied the Veteran’s service connection claim for hypertension, to include as secondary to posttraumatic stress disorder (PTSD). The Veteran did not file an appeal, and therefore, the rating decision became final. 2. Since the October 2007 rating decision, new and material evidence has been received that relates to unestablished facts that are necessary to substantiate the claim, and it is reopened. 3. Resolving all doubt in the Veteran’s favor, the Veteran’s current hypertension diagnosis has been related to his active military service. CONCLUSIONS OF LAW 1. The October 2007 rating decision which denied the Veteran’s claim for entitlement to service connection for hypertension is final. 38 U.S.C. §§ 7104, 7105(c); 38 C.F.R. §§ 3.104, 20.302, 20.1103. 2. New and material evidence has since been received, and the claim for entitlement to service connection for hypertension, is reopened. 38 U.S.C. §§ 1110, 5107(b), 5108; 38 C.F.R. §§ 3.156, 20.1103. 3. The criteria for service connection for hypertension have been met. 38 U.S.C. §§ 1110, 1131, 5103, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.303. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran was on active service in the United States Navy from May 1965 to March 1969. His last duty assignment in 1969 was service in Qui Nhon, in the Republic of Vietnam. During the pendency of the appeal, the Veteran’s claims on appeal included a claim for service connection for posttraumatic stress disorder (PTSD). However, the Board notes that in a May 2017 rating decision, the Regional Office (RO) granted entitlement to service connection for an acquired psychiatric disorder diagnosed as other specified trauma disorder. The Veteran has also not objected to this change in the identification of his claimed psychiatric disability. The Board therefore finds that this decision has resulted in a full grant of the benefits sought, and there is no longer an issue in controversy with respect to this matter. The Veteran requested a videoconference hearing in August 2017, but failed to appear, and did not request for it to be rescheduled. New and material evidence has been submitted sufficient to reopen the claim for service connection for hypertension. The RO denied the Veteran’s original service connection claim for hypertension, secondary to PTSD in October 2004, on the basis the Veteran did not then have a current diagnosis of hypertension. The Veteran subsequently provided new medical records showing he had such a diagnosis, so the claim was reopened, but was denied in an October 2007 rating decision, as no evidence relating his hypertension diagnosis to his military service was found. The Veteran then refiled the claim in December 2009, seeking presumptive connection, citing exposure to Agent Orange, and also claiming as secondary to coronary artery disease (CAD). Since then, the Veteran has provided new and additional information, through his representative, which includes VA examinations, and now requests his claim to be adjudicated based on hypertensive vascular disease, secondary or aggravated by his now service-connected CAD. See, September 2018 Informal Hearing Presentation. The updated records also include an August 2010 VA examination, where the examiner opined that the Veteran’s hypertension diagnosis is directly related to his Agent Orange exposure. Reopening a claim for service connection which has been previously and finally disallowed, requires that new and material evidence be presented or secured since the last final disallowance of the claim. 38 U.S.C. § 5108; Evans v. Brown, 9 Vet. App. 273, 285 (1996); Graves v. Brown, 8 Vet. App. 522, 524 (1996). “New evidence” means existing evidence not previously submitted to the VA. “Material evidence” means existing evidence that, by itself or when considered with previous evidence of record, relates to an unestablished fact necessary to substantiate the claim. New and material evidence can be neither cumulative nor redundant of the evidence of record at the time of the last prior final denial of the claim sought to be reopened and must raise a reasonable possibility of substantiating the claim. 38 C.F.R. § 3.156(a). Upon review, the Board finds that the above-referenced evidence is both new and material evidence sufficient to reopen the Veteran’s claim. The evidence is new in that it was not of record at the time of the last final rating decision, and the evidence is “material” because it relates to an unestablished fact necessary to substantiate the underlying service connection claim. As a result, the Board also finds that the evidence raises a reasonable possibility of substantiating the Veteran’s claim. 38 C.F.R. § 3.156 (a). As the credibility of new evidence is generally presumed, the Veteran’s claim of entitlement to service connection for hypertension is reopened. Justus v. Principi, 3 Vet. App. 510, 512-513 (1992). The Service Connection Claims for Hypertension The Veteran contends that his hypertension is due to his exposure to Agent Orange, and is secondary to his service-connected CAD. Service connection is warranted where the evidence of record establishes that a particular injury or disease resulting in disability was incurred in the line of duty in the active military service or, if pre-existing such service, was aggravated thereby. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. If a condition noted during service is not shown to be chronic, then generally a showing of continuity of symptomatology after service is required for service connection if the disability is one that is listed in 38 C.F.R. § 3.309(a). 38 C.F.R. § 3.303(b); Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). Service connection may also be granted on the basis of a post-service initial diagnosis of a disease, where the physician relates the current condition to the period of service. 38 C.F.R. § 3.303(d). Other specifically enumerated disorders will be presumed to have been incurred in service if they manifested to a compensable degree within the first year following separation from active duty. 38 C.F.R. §§ 3.309. Service connection may also be granted for certain specified diseases on a presumptive basis if a veteran was exposed to Agent Orange during active service. 38 U.S.C. § 1116; 38 C.F.R. §§ 3.307(a)(b), 3.309(e). A Veteran is presumed exposed to Agent Orange if he or she had active military, naval, or air service, in the Republic of Vietnam from January 9, 1962 through May 7, 1975, "unless there is affirmative evidence to establish that the veteran was not exposed to any such agent during that service." 38 U.S.C. § 1116(f); 38 C.F.R. § 3.307 (a)(6)(iii). Moreover, the availability of presumptive service connection for a disability based on exposure to herbicides, however, does not preclude a veteran from establishing service connection with proof of direct causation. Stefl v. Nicholson, 21 Vet. App. 120 (2007); Combee v. Brown, 34 F.3d 1039 (Fed. Cir. 1994). The record reflects that the Veteran has a current diagnosis of hypertension. See, July 2013 and October 2010 VA examinations. The VA has also acknowledged that the Veteran had in-country service in the Republic of Vietnam during this presumptive period. See, March 2011 rating decision. As to nexus, the VA examiner opined that the Veteran’s hypertension is at least as likely as not related to exposures to toxins (Agent Orange) in Vietnam, and cited recent studies that show vascular damage to blood vessels from Agent Orange, which could lead to hypertension. See, August 2010 VA examination. Although hypertension is not a presumptive disease condition related to Agent Orange exposure, the VA examiner cites medical evidence in his August 2010 examination, that finds hypertension is directly related to the Veteran’s in-service exposure to toxins and supports such a relationship in the Veteran’s specific case. The Board finds the VA examiner’s rationale to be sufficiently thorough and persuasive, and has therefore assigned this opinion high probative value. As a layperson, the Veteran is competent to report on matters observed or within his personal knowledge, and thus is competent to relate his occupational duties. Layno v. Brown, 6 Vet. App. 465, 470 (1994). The Veteran has also submitted numerous lay statements regarding his exposure to Agent Orange while serving in Vietnam, which the Board also finds to be pertinent and credible evidence. See, May 2017 rating decision. See, May 2010 VA Form 21-3101. See, Veteran’s August 2016 correspondence. Accordingly, based on all of the foregoing, and resolving reasonable doubt in favor of the Veteran, the Board finds that service connection for hypertension is warranted. Michael J. Skaltsounis Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD J.B. King, Associate Counsel