Citation Nr: 18157935
Decision Date: 12/14/18	Archive Date: 12/13/18

DOCKET NO. 15-26 470
DATE:	December 14, 2018
REMANDED
Entitlement to service connection for hypertension as secondary to posttraumatic stress disorder (PTSD) is remanded.
REASONS FOR REMAND
The Veteran served on active duty from February 1963 to March 1973. He received the Vietnam Service Medal and the Purple Heart Medal with two Bronze Stars among other medals and awards. This appeal comes before the Board of Veterans’ Appeals (Board) from a March 2014 rating decision of the VA Regional Office (RO) in Boston, Massachusetts.
The Board has reviewed the evidence presently in the record and observes that there are VA outpatient treatment records indicating that the Veteran may have a hypertension diagnosis. For instance, notes in September, October, and December 2009, indicate that the Veteran’s blood pressure was “usually adequately controlled” by medication. December 2009 and December 2016 medication reconciliation notes confirm that the Veteran was taking blood pressure control medication. In correspondence from the Veteran’s representative in November 2018, the Veteran asserts that his hypertension is secondary to his service-connected PTSD, a theory of service connection that the record reflects has not been addressed. The Veteran has not been afforded a VA examination to determine the nature and etiology of his hypertension. That should be addressed on remand.
The matter is REMANDED for the following action:
1. Afford the Veteran a VA medical examination to ascertain the current nature and etiology of the Veteran’s hypertension. The claims file must be reviewed by the examiner. The examiner is asked to provide an opinion as to whether it is at least as likely as not (a 50 percent or greater probability) that the Veteran’s hypertension had onset during or was caused by his active service, or, in the alternative, whether it is at least as likely as not (50 percent or greater probability) that his hypertension was caused or aggravated (worsened beyond natural progression) by any service-connected disabilities (as listed in a March 2014 rating decision), specifically to include PTSD. If aggravation is found, the examiner should specify the baseline level of severity of the hypertension before the chronic worsening and the level of severity of the hypertension after the chronic worsening. All opinions must be supported by a rationale.
 
A. C. MACKENZIE
Veterans Law Judge
Board of Veterans’ Appeals
ATTORNEY FOR THE BOARD	B. Banks, Associate Counsel