Citation Nr: 19166455 Decision Date: 08/27/19 Archive Date: 08/27/19 DOCKET NO. 17-05 696 DATE: August 27, 2019 ORDER Service connection for stroke residuals is granted. FINDING OF FACT The Veteran’s service-connected hypertension caused atrial fibrillation which caused a stroke. CONCLUSION OF LAW The criteria for service connection for stroke residuals have been met. 38 U.S.C. §§ 1110, 1131, 1137, 5103, 5103A, 5107 (2012); 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.310, 3.326(a) (2018). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served in the U.S. Marine Corps from July 1974 to September 1975. Entitlement to service connection for stroke residuals. Service connection may be granted for current disability arising from disease or injury incurred or aggravated by active service. 38 U.S.C. §§ 1110, 1131. Service connection may be granted for any disease diagnosed after discharge when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). Service connection generally requires (1) medical evidence of a current disability; (2) medical or, in certain circumstances, lay evidence of in-service incurrence or aggravation of a disease or injury; and (3) medical evidence of a nexus between the claimed in-service disease or injury and the current disability. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Service connection shall be granted on a secondary basis under the provisions of 38 C.F.R. § 3.310 where it is demonstrated that a service-connected disorder has caused or aggravated a nonservice connected disability. See Allen v. Brown, 7 Vet. App. 439 (1995). The Veteran had a stroke in May 2013. The private hospital records from the time of treatment state that the cause of the stroke was paroxysmal atrial fibrillation. Service connection is in effect for hypertension. A January 2015 VA medical opinion indicates that hypertension was one of the causes of atrial fibrillation and, therefore, one of the causes of the stroke. A February 2015 VA medical opinion indicates that hypertension did not cause the atrial fibrillation because the Veteran had other risk factors for atrial fibrillation, as well, and because his blood pressure was well-controlled at the time of the stroke, and because an echocardiogram at the time of the stroke did not indicate hypertensive heart disease. A January 2017 VA medical opinion stated that the Veteran’s blood pressure was elevated at the time of the stroke but reiterated that the echocardiogram at the time of the stroke did not indicate hypertensive heart disease. The January 2017 opinion also provided an explanation as to why the examiner did not think hypertension directly caused the stroke but, instead, that atrial fibrillation was the cause. The Board finds that the evidence is at least in equipoise as to whether hypertension caused the atrial fibrillation. As such, and affording the Veteran the benefit of the doubt, the Board finds that service connection for stroke residuals is warranted and the claim is granted. Vito A. Clementi Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. E. Miller, 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.