Citation Nr: 18159152 Decision Date: 12/18/18 Archive Date: 12/18/18 DOCKET NO. 15-37 911 DATE: December 18, 2018 ORDER Service connection for hypertension is granted. FINDING OF FACT The evidence is in equipoise as to whether the Veteran’s hypertension is related to service or to service-connected diabetes mellitus. CONCLUSION OF LAW The criteria for service connection for hypertension have been met. 38 U.S.C. §§ 1101, 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from July 1963 to March 1978. This matter is before the Board following his appeal of an August 2013 rating decision. The Board previously remanded this matter in September 2016. In February 2018, the Board obtained an opinion from the Veterans Health Administration (VHA). In response to the opinion, the Veteran submitted additional argument in an October 2018 statement, and expressly requested that his appeal be remanded to the Agency of Original Jurisdiction (AOJ) for consideration of that argument. Nevertheless, as discussed below, the Board is granting the Veteran’s claim; as such, the Board finds no prejudice to the Veteran by proceeding with his appeal at this time. Service Connection for Hypertension The Veteran contends that his hypertension is related to service or to service-connected disability. Specifically, he contends that hypertension was caused by his herbicide exposure while serving in Vietnam, or, alternatively, was caused or aggravated by his service-connected diabetes mellitus. At the outset, the Board finds that a current diagnosis of hypertension is confirmed by the evidence of record. More specifically, private treatment records show that the Veteran was diagnosed with hypertension and started on medication for the same in February 2010. Subsequent VA examination reports dated in April 2013 and January 2017 also document a diagnosis of hypertension. Additionally, the Veteran’s presumed herbicide exposure in-service has been conceded, and service connection for diabetes mellitus has been established. Thus, the remaining question is whether the Veteran’s hypertension is related to his herbicide exposure in service, or diabetes mellitus. Here, the most probative evidence is a February 2018 VHA opinion that it is at least as likely as not that the Veteran’s hypertension is aggravated by his diabetes mellitus. In offering the opinion, the examiner considered the Veteran’s relevant medical history, and cited to medical references, specifically noting that hypertension is present in more than 50 percent of patients with diabetes mellitus and that approximately 50 percent of hypertensive patients manifest insulin resistance. The examiner further identified various factors proposed to contribute to hypertension in patients with diabetes. As the VHA opinion considered the Veteran’s relevant medical history and was supported by rationale with reference to medical literature, it is deemed probative. See Stefl v. Nicholson, 21 Vet. App. 120, 123-24 (2007). To the extent that April 2013 and January 2017 VA examiners found that the Veteran’s hypertension was not caused or aggravated by diabetes mellitus, those opinions are deemed less probative as it appears they were based on an inaccurate medical history. More specifically, those opinions were predicated on the erroneous assumption that the Veteran’s hypertension was diagnosed years before his diabetes mellitus. examiners consider an accurate medical history. Thus, the opinions are deemed less probative. See Owens v. Brown, 7 Vet. App. 429, 433 (1995) (holding that VA may favor the opinion of one competent medical expert over that of another when decision makers give an adequate statement of reasons and bases). As a final matter, the Board observes that, in the time since the February 2018 VHA opinion, the National Academy of Sciences upgraded hypertension to the “sufficient” category from “limited or suggestive,” indicating that “there is enough epidemiologic evidence to conclude that there is a positive association” between hypertension and herbicide exposure. See http://www8.nationalacademies.org/onpinews/newsitem.aspx?RecordID=25137. Thus, here, given the positive February 2018 aggravation opinion, as well as evidence of a positive association between herbicide exposure and hypertension, the Board finds that the evidence of record is at least in relative equipoise, and any doubt is resolved in the Veteran’s favor. Accordingly, service connection for hypertension is granted. In light of the foregoing, the Board finds that the preponderance of the evidence supports the claim, and the benefit sought on appeal is granted. 38 U.S.C. §§ 1101, 1110, 5107; 38 C.F.R. §§ 3.303, 3.310. . (Signature on next page) S. C. KREMBS Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD A. Fagan, Counsel