Citation Nr: 18156292
Decision Date: 12/11/18	Archive Date: 12/07/18

DOCKET NO. 10-29 299
DATE:	December 11, 2018
REMANDED
Entitlement to service connection for hypertension, to include as secondary to type II diabetes mellitus with erectile dysfunction, is remanded.
Entitlement to a total disability rating based on unemployability due to service-connected disabilities (TDIU), prior to March 18, 2013, is remanded.
REASONS FOR REMAND
The Veteran served on active duty service from February 1971 to February 1973.  These matters come before the Board of Veterans’ Appeals (Board) on appeal from a September 2009 rating decision.
In June 2017, the Board remanded the claims for further development.
1. Entitlement to service connection for hypertension, to include as secondary to type II diabetes mellitus with erectile dysfunction, is remanded
The Veteran has documented service in Vietnam and exposure to herbicides is conceded.  
Although hypertension is not a condition for which presumptive service connection may be granted once exposure to herbicide agents is established, there is a recent update from the National Academy of Sciences’ regarding veterans and herbicide exposure.  The update concluded that there was “sufficient” evidence of an association between hypertension and exposure to herbicide agents.  Accordingly, a remand is required for further opinion.
2. Entitlement to a TDIU prior to March 18, 2013, is remanded.
The issue of entitlement to TDIU prior to March 18, 2013, is inextricably intertwined with the service connection for hypertension issue being remanded, and adjudication of this matter will be deferred until further development of the service connection for hypertension issue is completed.
The matters are REMANDED for the following action:
1. Obtain an addendum opinion regarding the etiology of the Veteran’s hypertension from a VA examiner.  The entire claims folder must be made available to and reviewed by the examiner.  If an examination is necessary, it shall be provided.  An explanation for all opinions must be provided.  The examiner should address the following:
Whether it is at least as likely as not that the Veteran’s hypertension was due to or otherwise etiologically related to the Veteran’s service, to include as due to exposure to herbicide agents.
The examiner must address the evidence of record from the National Academy of Sciences regarding “sufficient” correlation between herbicide agents and hypertension.  The examiner must discuss whether he/she finds the National Academy of Sciences update to be persuasive and weigh the relative risks presented by the Veteran’s exposure to herbicides and other relevant factors.
2. When the development requested has been completed, the case should be reviewed by the AOJ on the basis of additional evidence.  If the benefits sought remain denied, the Veteran and his representative should be provided with a Supplemental Statement of the Case and given an appropriate period of time to respond.

 
M. Donohue
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	J. Henriquez, Counsel