Citation Nr: 18157305 Decision Date: 12/12/18 Archive Date: 12/12/18 DOCKET NO. 16-61 534 DATE: December 12, 2018 ORDER Entitlement to service connection for hypertension is denied. FINDING OF FACT The Veteran’s current hypertension did not have its onset during service, within one year of separation, nor is there evidence of continuity of symptomatology. CONCLUSION OF LAW The criteria for service connection for hypertension have not been met. 38 U.S.C. §§ 1110, 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.303(b), 3.304, 3.307, 3.309. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty with the U.S. Army from November 1983 to December 1997. 1. Entitlement to service connection for hypertension Generally, to prove service connection, there must be competent, credible evidence of (1) a current disability, (2) in-service incurrence or aggravation of an injury or disease, and (3) a nexus, or link, between the current disability and the in-service disease or injury. See, e.g., Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009). In deciding whether service connection is warranted for a disability, VA is responsible for determining whether the evidence supports the claim or is in relative equipoise, with the veteran prevailing in either event, or whether a preponderance of the evidence is against the claim, in which case the claim is denied. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49, 53-56 (1990). Certain listed chronic diseases, such as hypertension, may be presumed to have been incurred during service if the disease becomes manifest to a compensable degree within one year of separation from qualifying military service. 38 U.S.C. §§ 1101, 1112; Fountain v. McDonald, 27 Vet. App. 258 (2015); 38 C.F.R. §§ 3.307(a)(3), 3.309(a). An alternative method of establishing incurrence or aggravation and a nexus to service is through a demonstration of continuity of symptomatology. 38 C.F.R. § 3.303(b). Continuity of symptomatology may be established if a claimant can demonstrate that a condition was noted during service; (2) there is a post-service continuity of the same symptomatology; and (3) a nexus between the present disability and the post-service symptomatology. The theory of continuity of symptomatology can be used only in cases involving those diseases explicitly recognized as chronic under 38 C.F.R. § 3.309(a). Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). For VA purposes, hypertension or isolated systolic hypertension must be confirmed by readings taken two or more times on at least three different days. The term hypertension means the diastolic blood pressure is predominantly 90 or greater, and isolated systolic hypertension means that the systolic blood pressure is predominantly 160 or greater with a diastolic blood pressure of less than 90mm. 38 C.F.R. § 4.104, Diagnostic Code 7101, Note 1. The January 2013 VA examination report indicates a diagnosis of hypertension. As such, the medical evidence of record shows a current diagnosis, so the question before the Board is whether such disability is related to service. In statements submitted in support of his claim, the Veteran reported that he experienced various bouts of high blood pressure while he was in service. He stated that this condition was not treated with medication, but fluctuated up and down. Service treatment records do not show an actual diagnosis of hypertension during service; rather, there were several episodes of elevated blood pressure with an unknown etiology. Specifically, treatment notes show blood pressure readings ranging from 140/80 and 160/90 in October 1985, 168/108 in March 1986, 180/100 in May 1986, 140/80 in October 1987, 140/80 in June 1988, 144/92 in April 1989, 148/90 in January 1995, and 144/90 in February 1996. In November 1987, his blood pressure ranged from 158/114 to 160/86; treatment notes indicated his blood pressure had been raised for over a week and there was no stated etiology. On his December 1997 separation exam, the examiner noted that his blood pressure had been “within normal limits” for over seven years. During the January 2013 VA examination, the Veteran reported an onset of hypertension in the 1980s and he was not placed on medication for his condition until 2005. Ultimately, the examiner opined that the Veteran’s current hypertension was not caused by or related to episodes of high blood pressure during service. Specifically, the examiner noted that: “while STRS note sporadic readings of high blood pressure there is no objective evidence of sustained hypertension requiring treatment during AD or within close proximity to separation from service. A diagnosis of HTN cannot be made on isolated elevations of blood pressure readings. A diagnosis of HTN is made on elevated b/p readings consistently over time, and this Vet did not have any objective evidence of this type of trend while on active duty. Veteran’s BP was normal (126/76) on separation exam.” Based on the foregoing, the Board finds that the available evidence does not support a finding that the Veteran’s current hypertension is related to service. The Veteran did not receive a diagnosis of hypertension of during service or within one year of separating. At separation the examiner found his blood pressure to be stabilized and within normal limits for several years. The Veteran reported he was not placed on medication for hypertension until 2005, approximately eight years after his separation. Therefore, the evidence does not support direct or presumptive service connection, as there was no diagnosis during or within one year of service and no evidence of continued symptoms. The January 2013 VA opinion is of high probative value as the examiner conducted an in-person exam and a thorough review of the Veteran’s claims file. Further, the opinion was accompanied by a complete rationale, and is consistent with the evidence of record. The Board takes note of the Veteran’s statements made in support of his claim; he is competent to report blood pressure readings conducted during service. However, he has not been shown to possess the skill to provide a diagnosis or an opinion as to etiology. Therefore, his statements are not considered credible as to whether his condition is service related. (Continued on the next page)   There is no doubt to be resolved and therefore, service connection is not warranted. See 38 C.F.R. § 3.309(a). H.M. WALKER Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD A. Price, Associate Counsel