Citation Nr: 20008415 Decision Date: 01/31/20 Archive Date: 01/31/20 DOCKET NO. 14-37 496 DATE: January 31, 2020 REMANDED Service connection for hypertension is remanded. REASONS FOR REMAND The Veteran served on active duty from June 1969 to February 1972. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an August 2013 rating decision by the Department of Veterans Affairs (VA). This case was most recently remanded by the undersigned in March 2018 for further development; it has since been re-assigned to the undersigned. In June 2017, the Veteran testified at a Board hearing before the undersigned Veterans Law Judge; a transcript of that hearing is of record. The Veteran was provided a VA examination and opinion regarding his hypertension in October 2019. The VA examiner opined that the Veteran’s hypertension was less likely than not incurred in or caused by an event or injury during service because there is no documentation of hypertension until 2000, which is far beyond the time of the Veteran’s service. The VA examiner was additionally asked to provide an opinion as to whether the Veteran’s hypertension was caused or aggravated by his service-connected schizophrenia, to include the stress caused by the disability and the medication taken for it. The examiner provided two secondary service connection opinions. The first opinion provided by the VA examiner states that the “the claimed condition, which clearly and unmistakably existed prior to service, was not aggravated beyond its natural progression by an in-service event, injury, or illness. The hypertension was not aggravated beyond its natural course of progression and the aging process.” The Board finds this opinion inadequate for appellate review. There is no evidence anywhere in the record that the Veteran’s hypertension existed prior to service, nor is it mentioned in the VA examination provided by the same examiner. In fact, the examination notes a hypertension diagnosis in March 2000, and the examiner cites the date of the diagnosis in his other opinions. The examiner then provided another opinion that states: “the late onset hypertension developed far after the diagnosis of schizophrenia and was not aggravated by this service-connected condition or medications used to treat the disease.” The Board also finds this opinion inadequate for appellate review. In addition to contradicting the first secondary service connection opinion, the opinion is conclusory and provides no rationale. Further, neither opinion addresses causation; only aggravation. As such, remand is necessary for a new opinion. The matters are REMANDED for the following action: 1. The AOJ should obtain an addendum opinion as to the nature and etiology of the Veteran’s hypertension by a different examiner than the one who provided the October 2019 opinion. The examiner should review the file and provide a complete rationale for all opinions expressed. An examination should be scheduled only if deemed needed by the examiner. The examiner should provide an opinion as to whether it is at least as likely as not (50 percent or greater probability) that the disability was either caused or aggravated by the Veteran’s service-connected schizophrenia. In providing the opinion, the examiner should consider and discuss any lay statements of record, to include the Veteran’s statements regarding the onset and persistence of his symptoms. The opinion must address whether the disability increased in severity beyond its natural progression (i.e., was aggravated). If aggravation is found, the examiner should identify to the extent possible the baseline level of disability prior to the aggravation. In addition, the examiner should provide an opinion as to whether it is at least as likely as not (50 percent or greater probability) that the disability was either incurred in or otherwise related to the Veteran’s active duty service. The examiner may not solely rely on an absence of a VA presumption for a diagnosed disability and must discuss the Veteran’s specific background. 2. If upon completion of the above action the issues remain denied, the case should be returned to the Board after compliance with appellate procedures. E. I. VELEZ Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board I. Kerner, 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.