Citation Nr: 18158242 Decision Date: 12/14/18 Archive Date: 12/14/18 DOCKET NO. 17-01 175 DATE: December 14, 2018 ORDER Service connection for hypertension is denied. FINDING OF FACT Hypertension was not shown in service or for many years thereafter and is not related to service. CONCLUSION OF LAW The criteria for entitlement to service connection for hypertension are not met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from November 2003 to May 2008. This matter comes before the Board of Veterans’ Appeal (Board) on appeal from a May 2015 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Winston-Salem, North Carolina. The Veteran’s Contentions The Veteran contends that he is entitled to service connection for hypertension because his service treatment records show hypertension or pre-hypertension during service, thereby demonstrating the in-service onset of hypertension. Service Connection Generally, service connection will be granted if the evidence demonstrates that a current disability resulted from a disease or injury incurred in active military service. 38 U.S.C. § 1131; 38 C.F.R. § 3.303(a). Establishing service connection requires evidence of a current disability, an in-service incurrence, disease or injury and a causal relationship between the current disability and the in-service incurrence, disease or injury. Saunders v. Wilkie, 886 F.3d 1356, 1361 (Fed. Cir. 2018). Additionally, hypertension is classified as a “chronic disease” under 38 C.F.R. § 3.309 (a). Presumptive service connection for chronic diseases must be considered on three bases: chronicity during service, continuity of symptomatology since service, and manifestations within one year of the appellant’s separation from service. 38 C.F.R. § 3.303 (b); Walker v. Shinseki, 708 F.3d 1331, 1338 (Fed. Cir. 2013). Where a veteran served continuously for 90 days or more during a period of war, or during peacetime service after December 31, 1946, and hypertension became manifest to a degree of 10 percent within one year from the date of termination of such service, it shall be presumed to have been incurred in service, even though there is no evidence of such disease during the period of service. This presumption is rebuttable by affirmative evidence to the contrary. 38 U.S.C. §§ 1101, 1112, 1113, 1137; 38 C.F.R. §§ 3.307, 3.309. Evidence of continuity of symptomatology from the time of service until the present is required where the chronicity of a chronic condition manifested during service either has not been established or might reasonably be questioned. 38 C.F.R. § 3.303(b); see also Walker v. Shinseki, 708 F.3d 1331, 1340 (Fed. Cir. 2013) (holding that only conditions listed as chronic diseases in 38 C.F.R. § 3.309(a) may be considered for service connection under 38 C.F.R. § 3.303(b)). Regulations also provide that service connection may be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disability was incurred in service. 38 C.F.R. § 3.303(d). When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, VA shall resolve reasonable doubt in favor of the claimant. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49 (1990). To deny a claim on its merits, the evidence must preponderate against the claim. Alemany v. Brown, 9 Vet. App. 518 (1996). Entitlement to service connection for hypertension For VA rating purposes, the term “hypertension” means that diastolic blood pressure is predominately 90 mm. or greater. The term “isolated systolic hypertension” means that the systolic blood pressure is predominantly 160 mm. or greater with a diastolic blood pressure of less than 90 mm. 38 C.F.R. § 4.104, Diagnostic Code 7101, Note 1. Here, the Veteran’s service treatment records do not document elevated blood pressure readings indicative of a clinical onset of hypertension during service. Post-service private treatment records document a diagnosis of hypertension, as defined by VA, in 2014, six years after the Veteran’s discharge from active service. In effort to determine whether the elevated blood pressure readings in service represented the clinical onset of hypertension, the Veteran was afforded a VA examination in October 2016. After reviewing the relevant evidence, the examiner opined that it was less likely than not that the Veteran’s hypertension was incurred in or caused by the elevated blood pressure shown during service. The examiner reasoned that while review of the service treatment records revealed multiple elevated readings of blood pressure, those readings did not meet the VA disability criteria for hypertension. The Board finds the October 2016 VA opinion is highly probative because the examiner considered the Veteran’s relevant history, provided a sufficiently detailed description of the condition, provided analysis to support his opinion concerning the nature and etiology of the condition, and considered the Veteran’s lay assertions. See Stefl v. Nicholson, 21 Vet. App. 120, 123-124 (2007). The VA examiner’s opinion regarding the Veteran’s elevated blood pressure readings during service is also validated by the evidence of record. To the extent that the Veteran has stated that he has hypertension attributable to service, the Board finds that he is competent to report on his symptoms and that of which he has personal knowledge, but he is not competent to provide an opinion as to the diagnosis or etiology of hypertension because such a question is not answerable by the application of knowledge within the realm of a lay person. See Layno v. Brown, 6 Vet. App. 465, 470 (1994); see also Jandreau v. Nicholson, 492 F.3d 1372, 1377 (Fed. Cir. 2007). Accordingly, the Veteran’s opinion as to the diagnosis or etiology of his hypertension is not competent medical evidence. The Board finds the opinion of the VA examiner to be more probative. In short, the preponderance of the evidence indicates that the Veteran does not have hypertension which had its onset in service, or within one year of his discharge from active service, or which is otherwise related to a period of active service. Accordingly, service connection for hypertension is denied. The benefit-of-the- doubt doctrine is inapplicable. See 38 U.S.C. § 5107(b); Ortiz v. Principi, 274 F.3d 1361, 1364 (Fed. Cir. 2001); Gilbert v. Derwinski, 1 Vet. App. 49, 55-56 (1990). (CONTINUED ON NEXT PAGE) S. C. KREMBS Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD M. Snyder, Associate Counsel