Citation Nr: 19157136 Decision Date: 07/23/19 Archive Date: 07/23/19 DOCKET NO. 18-50 263 DATE: July 23, 2019 REMANDED Entitlement to service connection for hypertension is remanded. REASONS FOR REMAND The Veteran served on active duty from December 1989 to July 1990 and from December 1990 to May 1991, with additional service in the Army National Guard. This matter comes to the Board of Veterans’ Appeals from a July 2015 rating decision which, in pertinent part, denied entitlement to service connection for hypertension. Entitlement to service connection for hypertension is remanded. The Board cannot make a fully-informed decision on the issue of entitlement to service connection for hypertension. The Veteran has not been afforded a VA examination in connection with his claim and while the Veteran’s treating clinician opined in a July 2016 letter that there was a “50/50 probability” that the Veteran’s blood pressure was related to military service, the Board finds that the clinician did not provide an adequate rationale or basis for the opinion. Therefore, the Board finds that a remand is warranted for a VA examination and medical opinion as to the nature and etiology of the Veteran’s hypertension, to include whether the Veteran’s hypertension was caused by or otherwise related to service. Evidence indicates there may be outstanding treatment records. In a July 2015 letter, the Veteran’s treating clinician indicated that he was a patient at Sandbills Medical Center. A remand is required to allow VA to obtain authorization and request these records. Finally, the Veteran indicated that his hypertension began during his National Guard service. However, a review of the claims file does not find that his complete service treatment records, including separation and/or post-deployment examinations, have been obtained. The matter is REMANDED for the following actions: 1. Obtain the Veteran’s complete service personnel records, to include all documents pertaining to his service in the Army National Guard of South Carolina from July 1989 to July 1995. Verify all active duty for training and inactive duty training dates. If necessary, a request should be made to the Defense Finance and Accounting Service (DFAS). Document all requests for information as well as all responses in the claims file. 2. Obtain the Veteran’s complete service treatment records, to include documents pertaining to his service in the Army National Guard of South Carolina from July 1989 to July 1995, including separation and/or post-deployment examinations. Document all requests for information as well as all responses in the claims file. 3. Ask the Veteran to complete a VA Form 21-4142 for Sandhills Medical Center and any other provider who has treated him for his hypertension. Make two requests for the authorized records, unless it is clear after the first request that a second request would be futile. 4. Schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of any hypertension. The examiner must opine whether the Veteran’s hypertension at least as likely as not (1) began during active service, to include related to an in-service injury, event, or disease, including environmental exposures, a March 1991 redeployment examination noting borderline blood pressure, and a July 2016 letter from the Veteran’s treating clinician attributing the Veteran’s hypertension to service, (2) manifested within one year after discharge from any period of active service, or (3) was noted during service with continuity of the same symptomatology since service. If the examiner finds that the Veteran’s hypertension was not caused by or otherwise related to a period of active service, the examiner must opine whether it is at least as likely as not (1) proximately due to service-connected disability, or (2) aggravated beyond its natural progression by service-connected disability. 5. After completing the above, and any other development as may be indicated, the Veteran’s claim should be readjudicated based on the entirety of the evidence. If the claim remains denied, the Veteran and his representative should be issued a supplemental statement of the case (SSOC). An appropriate period of time should be allowed for response. Thereafter, the case should be returned to the Board for further appellate consideration, if otherwise in order. K. Parakkal Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD S. Owen, Associate Counsel The Board’s decision in this case is binding only with respect to the instant matter decided. This decision is not precedential, and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.