Citation Nr: 18127751 Decision Date: 08/20/18 Archive Date: 08/20/18 DOCKET NO. 13-10 517 DATE: August 20, 2018 ORDER The claim of entitlement to service connection for hypertension is denied. FINDING OF FACT The preponderance of the evidence is against finding that the Veteran’s hypertension began during active service, or is otherwise related to an in-service injury, event, or disease. CONCLUSION OF LAW The criteria for service connection for hypertension are not met. 38 U.S.C. §§ 1110, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had honorable active duty service from October 1970 to March 1971 in the United States Army, with additional subsequent service in the Alabama National Guard as a member of the Army Reserve. The Board notes that entitlement to right ear hearing loss was granted in full in an April 2017 rating decision. The Veteran has not submitted a notice of disagreement regarding the rating or effective date assigned for the disability. Therefore, the issue of entitlement to service connection for right ear hearing loss is no longer on appeal and will not be addressed in this decision. See A.B. v. Brown, 6 Vet. App. 35 (1993). Entitlement to service connection for hypertension The Veteran contends that his hypertension manifested during active service. The question for the Board is whether the Veteran has a current disability that began during service or is at least as likely as not related to an in-service injury, event, or disease. The Board concludes that, while the Veteran has a diagnosis of hypertension, the preponderance of the evidence is against finding that it began during active service, or is otherwise related to an in-service injury, event, or disease. 38 U.S.C. §§ 1110, 1131, 5107(b); Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a), (d). The Veteran’s service treatment records do not indicate any findings of hypertension. On the February 1971 report of medical examination, the Veteran’s heart and vascular system were clinically normal. His blood pressure was 152/78, but did not warrant a diagnosis of hypertension. On the corresponding report of medical history, the Veteran denied any history of high or low blood pressure. Additionally, multiple treatment records after the Veteran’s separation from active service show no diagnosis of hypertension. Examinations associated with his reserve service did not find any hypertension in June 1974, October 1977, July 1981, August 1985, August 1990, March 1995, and January 1997. During that time the Veteran also consistently denied any current complaints or history of high or low blood pressure. Private treatment records in January 1994, April 1997, and May 1997 also specifically noted no diagnosis of hypertension. The Veteran was afforded a VA examination in October 2013. The examiner reviewed the claims file and performed an in-person examination. The examiner diagnosed hypertension. The examiner noted that it was less likely than not that the Veteran’s hypertension was related to his military service. Per claims file review, the examiner noted no diagnosis that speaks to hypertension. The Veteran was afforded another VA examination in January 2017. The examiner again reviewed the claims file and performed an in-person examination. The examiner found that the Veteran’s hypertension was less likely than not incurred in or caused by the Veteran’s service. The Veteran reported that he was found to have elevated blood pressure on an exam at the end of a period of active duty on in February 1971 and was told to follow up with his civilian physician for further evaluation and treatment of same. The Veteran stated he did so and also stated that medication was prescribed by his physician at that time. The Veteran reported that he has attempted to gather those records but they are not available. The Veteran currently has hypertension as evidenced by his current medication, his elevated blood pressures on this January 2017 exam, and review of medical records in recent years. Review of his military service medical records speak overwhelmingly to the point that he did not have diagnosed hypertension in active duty period October 1970 to March 1971 or in the remainder of his Army National Guard years until separation in March 1998, though elevated blood pressure readings are found on the February 1971 and also on the January 1997 exam. This examiner finds no record of the reported serially elevated blood pressures on three consecutive days in 1971. In September 1998, approximately six months after separation from Army National Guard, a clinic note from Dr. Charles Kerr specifically states that “he is on Vasotec for diabetic nephropathy and Cardura for BPH” (benign prostatic hypertrophy). The examiner found that this note strongly suggests that the Veteran was not diagnosed with hypertension at that point but rather was taking two medications commonly used for hypertension but also used for other purposes and apparently, in this Veteran’s case, renoprotective benefit with Vasotec and lessening of benign prostatic hypertrophy symptoms with Cardura. The examiner opined that it is less likely than not that this Veteran had hypertension in service as multiple documents and blood pressure readings through his service years do not indicate hypertension and there are specific statements from Veteran during his military career specifically stating he did not have high blood pressure and or hypertension and was not taking any medication. The examiner stated that occasional elevated blood pressure readings do not establish hypertension or a diagnosis of hypertension in and of themselves. A more appropriate description of these particular elevated blood pressures, based on the available evidence, would be “elevated blood pressure reading without diagnosis of hypertension.” The examiner noted that it is clear that the Veteran has hypertension now, and apparently going back to approximately 2001 based on review of available medical records. The examiner reiterated that it is less likely than not that the Veteran’s hypertension is etiologically related to his active duty military service. While the Veteran believes his hypertension is related to service, the Board reiterates that the preponderance of the evidence weighs against findings that his hypertension occurred during active service. Based on the evidence cited above, the Board finds that the preponderance of the evidence is against the claim of service connection for hypertension. As the preponderance of the evidence is against the claim for service connection for hypertension, the benefit of the doubt rule does not apply. 38 C.F.R. § 5107; 38 C.F.R. § 3.102. B. MULLINS Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Patricia Veresink