Citation Nr: 18136403 Decision Date: 09/18/18 Archive Date: 09/18/18 DOCKET NO. 14-41 559 DATE: September 18, 2018 ORDER Entitlement to service connection for cause of the Veteran’s death is granted. FINDINGS OF FACT 1. The Veteran’s death certificate listed his cause of death as hypertensive cardiovascular disease. 2. It is at least as likely as not that the Veteran’s hypertension was etiologically related to his service. CONCLUSION OF LAW The criteria for service connection for the cause of the Veteran’s death have been met. 38 U.S.C. §§ 101(16), 1101, 1131, 1133, 1310 (2012); 38 C.F.R. §§ 3.5, 3.303, 3.307, 3.309, 3.312 (2017). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from February 1976 to April 1983. He received the Humanitarian Service Medal and Sea Service Ribbon. In May 2011, the Veteran died. The appellant is the Veteran’s surviving spouse. In November 2017, a videoconference hearing was held and the appellant testified before the undersigned Veterans Law Judge. A transcript of the hearing is associated with the claims file. In April 2018, the Board requested an opinion from a Veterans Health Administration (VHA) physician. See 38 C.F.R. § 20.901 (2017) (the Board has the authority to obtain a VHA medical expert opinion when, in its judgment, such medical expertise is needed for an equitable disposition of an appeal). In August 2018, the requested VHA opinion was completed. Service Connection for Cause of Death Dependency and Indemnity Compensation (DIC) benefits are payable to the surviving spouse of a veteran if the veteran died from a service-connected disability. 38 U.S.C. § 1310; 38 C.F.R. § 3.5(a)(1). A veteran’s death will be considered as being due to a service-connected disability when the evidence establishes that the service-connected disability was either the principal or a contributory cause of death. 38 C.F.R. § 3.312(a). In determining whether service connection for cause of death is warranted, the laws and regulations generally applicable to establishing entitlement to service connection for a disability apply. 38 U.S.C. § 1310. In this regard, service connection may be granted for a disability resulting from a disease or injury incurred in or aggravated by service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a). Service connection generally requires credible and competent evidence showing: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service. Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009). For a DIC claim based on cause of death, the first Holton requirement, “evidence of a current disability, will always have been met (the current disability being the condition that caused the veteran to die).” Carbino v. Gober, 10 Vet. App. 507, 509 (1997), aff’d sub nom. Carbino v. West, 168 F.3d 32 (Fed. Cir. 1999). Turning to the facts of the present case, the evidence indicates that the Veteran had a current disability. Specifically, the Veteran’s death certificate lists his cause of death as hypertensive cardiovascular disease. See October 2017 Death Certificate, p. 2. Accordingly, the Board finds that the first element of service connection is established. See Holton, 557 F.3d at 1366. Regarding the second and third Holton elements, an alternative method of establishing these elements for chronic diseases such as hypertension is through a demonstration of disabling hypertension within a year of service, or in-service incurrence and continuity of symptomatology thereafter. 38 C.F.R. §§ 3.303(b), 3.309; see Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). The evidence demonstrates that the Veteran had the following blood pressure readings during service: 136/86, 148/88, 136/76, 124/89, 142/86 (three-day average), 130/80, 142/72, 112/82, 138/80, 128/72, 122/80, 130/84, 142/98, and 150/88. January 2015 STRs, pp. 4, 8, 13, 17, 18, 20, 21, 24, 30, 32, 34, 36; January 2015 STRs, pp. 2, 3, 5, 15. The Veteran was denied reenlistment in May 1984 due to high blood pressure, see May 1984 VA Treatment Records, p. 1, and subsequently filed a claim for service connection for hypertension. He underwent a VA examination in June 1984 but was found to be normotensive on examination. June 1984 VA Examination, p. 4. The appellant indicated at the November 2017 hearing that the Veteran received a hypertension diagnosis in 2003 or 2004 and that his blood pressure was monitored prior to that time. November 2017 Hearing Transcript, pp. 6-7. In the Veteran’s VA treatment records, the earliest indication of a hypertension diagnosis is April 1998. August 2010 VA Treatment Records, p. 137. In April 2018, the Board requested a medical opinion from a VHA internal medicine physician to clarify whether the Veteran’s hypertension had its onset during active duty service. Based on elevated blood pressure readings in service, the physician opined that it is at least as likely as not that the Veteran’s hypertension had its onset in service. The Board finds that the evidence related to in-service incurrence and continuity of symptomatology is at least in equipoise. When the evidence for and against a claim is in relative equipoise, the Board has an obligation to resolve all reasonable doubt in favor of the Veteran. See 38 U.S.C. § 5107; 38 C.F.R. § 3.102; see also Gilbert v. Derwinski, 1 Vet. App. 49 (1990). In resolving all reasonable doubt in the appellant’s favor, the Board finds that the second and third elements of service are established. See Walker, 708 F.3d 1331. Accordingly, service connection for cause of death is warranted. A. S. CARACCIOLO Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD W.V. Walker, Associate Counsel