Citation Nr: 20064409 Decision Date: 10/02/20 Archive Date: 10/02/20 DOCKET NO. 14-25 083A DATE: October 2, 2020 ORDER Entitlement to service connection for hypertension is denied. FINDING OF FACT The preponderance of the evidence is against finding that hypertension began during active service, manifested to a compensable degree within one year of service, or is otherwise related to the Veteran’s service-connected depression. CONCLUSION OF LAW The criteria for service connection for hypertension have not been met. 38 U.S.C. §§ 1101, 1110, 1112, 5107, 7104; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309, 3.310, 4.104 Diagnostic Code (DC) 7101. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active service in the United States Army from August 1974 to August 1977. This matter comes before the Board of Veterans’ Appeals (Board) from a February 2013 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Colombia, South Carolina. Legal Criteria Service connection may be established for disabilities resulting from disease or injury incurred in or aggravated by active military service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303. Service connection may be granted for any disease initially diagnosed after discharge, when all the evidence, including that pertinent to service, establishes the disease was incurred in service. 38 C.F.R. § 3.303(d). Where a veteran served for at least 90 days during a period of war or after December 31, 1946, and manifests hypertension to a degree of 10 percent within one year from the date of termination of such service, such disease shall be presumed to have been incurred or aggravated in service, even if there is no evidence of such disease during the period of service. 38 U.S.C. §§ 1101, 1112; 38 C.F.R. §§ 3.307, 3.309. To show chronic disease in service, there is a required combination of manifestations sufficient to identify the disease entity, and sufficient observation to establish chronicity at the time, as opposed to merely isolated findings or a diagnosis including the word "chronic." When the fact of chronicity in service (or during any applicable presumptive period) is not adequately supported, then a showing of continuity after discharge is required to support the claim. 38 C.F.R. § 3.303(b). The term "chronic disease" refers to those diseases, such as hypertension, listed under section 1101(3) of the statute and section 3.309(a) of VA regulations. 38 U.S.C. § 1101(3); 38 C.F.R. § 3.309(a); Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). Service connection may be granted for a disability which is proximately due to or the result of a service-connected disability. 38 C.F.R. § 3.310(a). Additional disabilities resulting from the aggravation of a nonservice-connected disability by a service-connected disability is also compensable under 38 C.F.R. § 3.310(a). Allen v. Brown, 7 Vet. App. 439, 448 (1995) (en banc). Except as otherwise provided by law, a claimant has the responsibility to present and support a claim for benefits under laws administered by the Secretary. The Secretary shall consider all information and lay and medical evidence of record in a case before the Secretary with respect to benefits under laws administered by the Secretary. When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the Secretary shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107 (West 2014); 38 C.F.R. § 3.102 (2015); see also Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). To deny a claim on its merits, the evidence must preponderate against the claim. Alemany v. Brown, 9 Vet. App. 518, 519 (1996), citing Gilbert, 1 Vet. App. at 54. Analysis Hypertension is defined as diastolic blood pressure that is predominantly 90 millimeters (mm.) or greater, or systolic blood pressure that is predominantly 160 mm. or greater with a diastolic blood pressure of less than 90 mm. To support a diagnosis of hypertension, the blood pressure readings must be taken two or more times on at least three different days. See 38 C.F.R. § 4.104, Diagnostic Code 7101(Note 1). Reviewing the Veteran’s service treatment records, there are at least seven recorded readings of the Veteran’s blood pressure throughout active service. The 2019 medical examiner concluded that all of these readings were acute and did not meet the threshold for hypertension. Most importantly, the examiner noted that the July 1977 separation exam does not diagnose the Veteran with hypertension, the same instance where the Veteran had his highest recorded reading of 126/80. Further, the examiner concludes that hypertension did not manifest to a compensable degree within one year of separation from service, finding nothing in the Veteran’s records about the disability until decades later. After a review of medical literature for secondary service connection, the 2019 medical examiner explained that hypertension is not etiologically related to depression. Therefore, the examiner concluded that the Veteran’s current hypertension is less likely than not related to his service-connected depression. Finally, the examiner concluded that the Veteran’s current hypertension was less likely than not aggravated by his current service-connected depression because there is no evidence supporting this theory of entitlement in the record. The Veteran made several lay statements about his history of high blood pressure while in service. This includes statements that he had high blood pressure during and after active service, sometimes as high as 140/90, but none were recorded. During a hearing with the Board in May 2017, the Veteran stated that he first recalls being diagnosed with hypertension in 2000 and that a VA doctor once attributed it to his time in active service. While the Veteran is competent to report his memory of his medical history, his recollection is afforded little probative weight in this instance. This is because his recollection is not corroborated by the extensive and conflicting records found in his service treatment records (STR) and other subsequent records. The Veteran, while competent to discuss his symptoms that are commonly associated with hypertension, such as experiencing dizziness, is not medically competent to diagnose himself with the disability. The 2019 medical examiner’s opinion, however, is afforded great weight because it is extremely probative of the evidence of record. In coming to her negative nexus opinion on all theories of entitlement to service connection, the 2019 medical examiner specifically took account of the Veteran’s lay statements that he had elevated blood pressure while in service. Further, her opinion accounts for recent medical studies concerning the etiology of hypertension. This shows her critical analysis of all evidence of record. Additionally, there are no contrary medical opinions of record. Based on the evidence of record, the claim must be denied. The preponderance of the evidence weighs against finding that the Veteran’s current hypertension was incurred during or was otherwise related to the Veteran's active duty service. As such, the doctrine of reasonable doubt is not applicable to this claim. T. REYNOLDS Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Rob Schwartz, 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.