Citation Nr: 18119376 Decision Date: 07/18/18 Archive Date: 07/18/18 DOCKET NO. 15-14 390 DATE: July 18, 2018 REMANDED The issue of entitlement to service connection for hypertension is remanded. REASONS FOR REMAND The Veteran served on active duty from July 1968 to July 1974, from June 1979 to July 1986, from May 2002 to February 2003, from February 2004 to June 2004, from March 2005 to August 2005, from November 2006 to March 2007, and from August 2008 to September 2011. The Veteran had multiple periods of service in the Southwest Asia theater of operations. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an August 2013 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Honolulu, Hawaii. The Board finds that it cannot yet make a fully-informed decision on the issue of service connection for hypertension as additional development is required. Specifically, as relayed by his representative in February 2018, the Veteran’s primary contention is that he had elevated blood pressure while on active duty that did not become severe enough to warrant medication until service with the National Guard. In his February 2014 Notice of Disagreement (NOD), the Veteran stated that his hypertension began during National Guard service in 1998 and was aggravated through multiple deployments. Currently, the Veteran’s claims file contains several Department of Defense Form 214s (DD 214) documenting periods of active duty service. However, the Board notes that the file is absent of documentation of any dates of the Veteran’s periods of active duty for training (ACDUTRA) and inactive duty for training (INACDUTRA). As service connection may be granted for a disease or injury incurred in or aggravated during a period of ACDUTRA or INACDUTRA, the Board finds that verification of the Veteran’s ACDUTRA and INACDUTRA periods in the 1990s with the National Guard is required prior to the adjudication of his claim on the merits. Relatedly, the Board notes that the VA medical opinion provided in February 2015 did not address the Veteran’s primary contention that his hypertension arose in 1998 during his service in the National Guard. As such, it is inadequate for adjudicative purposes and new medical opinion must also be obtained on remand. The matter is REMANDED for the following action: 1. Contact the Veteran’s Army National Guard Unit, the Defense Finance and Accounting Service, or any other appropriate sources to verify the Veteran’s periods of ACDUTRA and INACDUTRA from 1990 to 1999. Any negative responses should be in writing and should be associated with the claims file. 2. After the above has been completed to the extent possible, send the Veteran’s claims file to an appropriate VA clinician to issue a medical opinion as to the nature and etiology of the Veteran’s hypertension. The entire claims file, including a copy of this Remand, must be made available to and must be reviewed by the clinician. Thereafter, the clinician should address: (a.) Whether the Veteran’s hypertension clearly and unmistakably preexisted service, including the Veteran’s periods of ACDUTRA and INACDUTRA in the 1990s with the National Guard. (b.) If the answer to part (a) is positive, whether it is clear and unmistakable that the preexisting hypertension was not aggravated beyond its normal progression during service. (c.) If the answer to part (a) is negative, whether it is at least as likely as not (50 percent probability or more) that the Veteran’s currently-diagnosed hypertension had its onset in, was caused by, or is otherwise related to service—including as due to environmental exposures in Southwest Asia. In offering any opinion, the clinician should consider medical and lay evidence dated both prior to and since the filing of the claim (April 2011). Additionally, the clinician should specifically address the Veteran’s contention that his hypertension arose during his National Guard service in 1998 and was aggravated thereafter through multiple deployments. Lastly, a complete rationale for any opinions rendered must be provided. If the clinician cannot provide the requested opinions without resorting to speculation, he or she should please expressly indicate this and provide a supporting rationale as to why that is so. S. C. KREMBS Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD N.S. Pettine