Citation Nr: 18157215
Decision Date: 12/12/18	Archive Date: 12/11/18

DOCKET NO. 16-57 441
DATE:	December 12, 2018
REMANDED
Entitlement to service connection for hypertension is remanded.
Entitlement to service connection for erectile dysfunction, to include as secondary to hypertension is remanded.
REASONS FOR REMAND
The Veteran had active service from July 1990 to July 1994 and from April 1995 to January 1998.  The Veteran served in Operation Desert Storm from February 1991 to July 1991.
This matter comes before the Board of Veterans’ Appeals (Board) on appeal from December 2013 and April 2014 rating decisions by the Department of Veterans Affairs (VA) Regional Office (RO) in Atlanta, Georgia.
1. Entitlement to service connection for hypertension is remanded.
The Veteran seeks service connection for hypertension.  The Veteran contends that his blood pressure was evaluated at various times through his military career and after service.
VA treatment records show a current diagnosis of hypertension. Service and post- service treatment records show blood pressure that appears to have been elevated, at least intermittently.  The Veteran has not been afforded a VA examination; on remand one should be provided.  
2. Entitlement to service connection for erectile dysfunction, to include as secondary to hypertension is remanded.
The Veteran contends that his erectile dysfunction is related to his hypertension disability. Accordingly, the claims are inextricably intertwined. See 38 C.F.R. § 3.310; see also Harris v. Derwinski, 1 Vet. App. 180 (1991). Adjudication of the claim of service connection for an erectile dysfunction disability is deferred.
The matters are REMANDED for the following action:
1. Obtain and associate with the claims file any outstanding VA treatment records.
2. Schedule the Veteran for a VA examination to determine the nature and etiology of his hypertension.  The examiner must review the entire claims file, to include a copy of this Remand, in conjunction with authoring the opinion.
The examiner is asked to provide responses to the following:
a)	Is it at least as likely as not (a 50 percent or greater probability) that the Veteran’s hypertension was incurred in, or is otherwise related to, active service?
b)	Is it at least as likely as not that the Veteran’s hypertension initially manifested within a year of service discharge?
c) Is it at least as likely as not the Veteran’s erectile dysfunction was proximately caused or aggravated by his hypertension?
The examiner should note that this question requires two separate opinions: one for proximate causation and a second for aggravation. The term “aggravation” means a permanent worsening of a disability beyond its natural progression. If aggravation is found, then, to the extent possible, the examiner should attempt to establish a baseline level of severity of the erectile dysfunction prior to its aggravation by hypertension.
A rationale must be provided for each opinion.  In doing so, the examiner should consider the Veteran’s assertion that his blood pressure was elevated during and since service.

 
D. JOHNSON
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	D. Lauritzen, Associate Counsel