Citation Nr: 18151010
Decision Date: 11/16/18	Archive Date: 11/16/18

DOCKET NO. 16-41 513
DATE:	November 16, 2018
REMANDED
Entitlement to service connection for hypertension is remanded.
REASONS FOR REMAND
The Veteran served on active duty from May 1969 to May 1970.
This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a December 2013 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO) in Waco, Texas.
1. Entitlement to service connection for hypertension is remanded.
The Veteran seeks service connection for hypertension, which he asserts is the result of his service-connected anxiety and depression and/or chronic pain the result of his various service-connected disabilities.  
In this case, the Veteran was afforded an examination in February 2013.  Unfortunately, the Board finds that the opinion given after that examination is inadequate for two reasons.  First, the complete claims file and medical record were not available to the examiner prior to her rendering her opinion.  Further, while she did address causation by his service-connected anxiety and depression, she did not discuss aggravation.  Neither did she fully address causation or aggravation by his reported chronic pain.  
After that examination was rendered, the Veteran submitted evidence in the form of internet articles indicating at least some possible link between hypertension and anxiety which have yet to be fully considered.
Considering the above, the Board finds that a remand is necessary so that an addendum opinion may be obtained which addresses all theories of service connection on appeal.
The matter is REMANDED for the following action:
1. Invite the Veteran to submit any additional evidence on support of his claim.	
2. Obtain an addendum opinion from an appropriate clinician regarding whether the Veteran’s hypertension is at least as likely as not related to either his service-connected psychiatric disabilities and/or his chronic pain due to his various service-connected disabilities.  Specifically, the examiner should address the following questions:
•	Is it at least as likely as not that the Veteran’s hypertension is proximately due to or the result of his service-connected psychiatric disabilities, particularly his anxiety and depression?
•	Is it at least as likely as not that the Veteran’s hypertension has been aggravated (implying a permanent worsening) by his service-connected psychiatric disabilities, particularly his anxiety and depression?
•	Is it at least as likely as not that the Veteran’s hypertension is proximately due to or the result of his chronic pain due to his various service-connected physical disabilities?
•	Is it at least as likely as not that the Veteran’s hypertension has been aggravated (implying a permanent worsening) by his chronic pain due to his various service-connected physical disabilities?
 
B.T. KNOPE
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	Pryce, Meredith