Citation Nr: 20007440 Decision Date: 01/30/20 Archive Date: 01/29/20 DOCKET NO. 12-08 025A DATE: January 30, 2020 REMANDED Entitlement to service connection for hypertension, to include as secondary to service-connected disabilities is remanded. Entitlement to service connection for right ulnar neuropathy, to include as secondary to service connection disabilities is remanded. REASONS FOR REMAND The Veteran had active duty military service in the United States Army from November 1995 to August 2003. For his meritorious service, the Veteran was awarded (among other decorations) the Army Commendation Medal. This appeal comes to the Board of Veterans’ Appeals (Board) from a March 2010 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in St. Petersburg, Florida. In December 2016 and August 2019, the Board remanded the issues for further development. 1. Entitlement to service connection for hypertension, to include as secondary to service-connected disabilities is remanded. The Veteran is seeking service connection for hypertension, to include as secondary to service-connected disabilities. The Board previously remanded the Veteran’s claim in order to obtain an opinion as to whether the Veteran’s hypertension is secondary to his service-connected disabilities. In an October 2019 opinion, a VA examiner concluded that the Veteran’s hypertension was not caused by his service-connected disabilities. However, the examiner did not address whether the Veteran’s disabilities were aggravated by his service-connected disabilities, as required for an adequate opinion. Further, earlier opinions of record opined that service connection on a direct basis was not warranted, as there was no evidence of hypertension in service. The Veteran’s service treatment records show that he was diagnosed with high blood pressure in service in December 1997; at that time the Veteran’s blood pressure was 148/92. In June 1999, the Veteran’s blood pressure was 133/86. On the Veteran’s June 2003 Report of Medical Examination for separation, his blood pressure was 146/88. Considering these deficiencies, a new opinion is required. 2. Entitlement to service connection for right ulnar neuropathy, to include as secondary to service-connected disabilities is remanded. The Veteran is seeking service connection for right ulnar neuropathy, to include as secondary to service-connected disabilities. Although opinions have been rendered addressing the theory of secondary service connection, an opinion has not been rendered addressing the theory of direct service connection. In a March 2017 VA examination, the VA examiner noted that the Veteran was diagnosed with right ulnar neuropathy in 1998, during the time the Veteran was still in active duty service. Therefore, on remand, the RO should obtain a VA addendum opinion that addresses the theory of direct service connection. The matters are REMANDED for the following action: 1. Obtain any outstanding VA treatment or private treatment records and associate with the claims file. 2. After the above development has been completed, obtain a VA addendum medical opinion on the nature and etiology of the Veteran’s hypertension. If an opinion cannot be rendered without affording the Veteran a VA examination, then the RO should schedule one. The record and a copy of this remand must be made available and reviewed by the examiner in conjunction with the examination. The VA examiner should address the following: (a.) Whether it is at least as likely as not that the Veteran’s hypertension is related to his military service, to include December 1997 diagnosis of high blood pressure and other high blood pressure readings? The Veteran’s blood pressure in June 1999 was 133/86 and 146/88 in June 2003. The VA examiner should discuss elevated blood pressure readings that occurred during service. (b.) Whether it is at least as likely as not that the Veteran’s hypertension is proximately due to, the result of, or aggravated by his service-connected disabilities. A rationale for all opinions must be provided. 3. Obtain a VA addendum medical opinion on the nature and etiology of the Veteran’s right ulnar neuropathy. If an opinion cannot be rendered without affording the Veteran a VA examination, then the RO should schedule one. The record and a copy of this remand must be made available and reviewed by the examiner in conjunction with the examination. The VA examiner should address the following: (a.) Whether it is at least as likely as not that the Veteran’s right ulnar neuropathy is related to his military service? A rationale for all opinions must be provided. Evan M. Deichert Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. Crawford, 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.