Citation Nr: 19117992 Decision Date: 03/12/19 Archive Date: 03/12/19 DOCKET NO. 10-28 963 DATE: March 12, 2019 ORDER Entitlement to service connection for hypertension, as due to exposure to herbicides, is granted. FINDING OF FACT The Veteran’s hypertension is etiologically related to the Veteran’s in-service herbicide exposure. CONCLUSION OF LAW The criteria for service connection for hypertension have been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active service from April 1969 to April 1971, to include in the Republic of Vietnam. Entitlement to service connection for hypertension, as due to exposure to herbicides. The Veteran seeks service connection for hypertension, to include as due to herbicide exposure. The Board concludes that the Veteran has hypertension that is related to exposure to herbicides in Vietnam. 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). Service connection is warranted. VA has conceded in-service exposure to Agent Orange based on the Veteran’s service in Vietnam, but hypertension is not a disease that is entitled to presumptive service connection due to herbicide exposure pursuant to 38 C.F.R. § 3.309 (e). However, in the recent Veterans and Agent Orange: Update 11 (2018), the National Academies of Sciences, Engineering and Medicine (NAS) found “sufficient evidence of an association” for hypertension and exposure to Agent Orange and other herbicides used during the Vietnam War. In that report, hypertension was upgraded from its previous classification in the category of “limited or suggestive” evidence of an association to the category of “sufficient” evidence of an association. According to NAS, “[t]he sufficient category indicates that there is enough epidemiologic evidence to conclude that there is a positive association” between hypertension and herbicide exposure. In a November 2017 opinion, a VA examiner opined that the Veteran’s hypertension was less likely as not caused or aggravated by his service-connected diabetes mellitus or coronary artery disease, and that it was more likely related to morbid obesity. The Board found that opinion inadequate because the examiner relied on “obesity” as determined by the Veteran’s weight in 2015 despite noting that hypertension was diagnosed in 1981. The Board obtained a VA expert medical opinion in January 2019. It was that expert’s opinion, based on the 2018 NAS report update that it was likely that the Veteran’s currently diagnosed hypertension was related to Agent Orange exposure during his years of service. The Veteran’s blood pressure was noted to be within the normal range in service. He was diagnosed more than 10 years after leaving service. Thus, the medical expert found that it was possible that his exposure to Agent orange during the service period led to the development of hypertension greater than 10 years after leaving service. The medical expert reported that the Veteran developed hypertension at such a young age (diagnosed 1981, Veteran was 29 years old), and from what the medical expert reviewed about the Veteran, there was no clear medical reason for development of hypertension at such a young age. The medical expert reported that association between Agent Orange and the development of hypertension cannot be excluded or proven with certainty, and in view of the data and the NAS 2018 updated report, there is certainly the possibility of exposure to Agent Orange and the development of hypertension. The Board finds the the January 2019 VA medical expert opinion persuasive as it considers the facts of the Veteran’s case and most recent NAS update and provides rationale for the opinion provided. Therefore, as it the January 2019 VA medical expert opinion finds that it is likely that the Veteran’s currently diagnosed hypertension is related to Agent Orange exposure during service, service connection for hypertension, as due to herbicide exposure, is warranted. M.E. LARKIN Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Robert J. Burriesci, Counsel