Citation Nr: 20021060
Decision Date: 03/24/20	Archive Date: 03/24/20

DOCKET NO. 17-52 401
DATE: March 24, 2020

REMANDED

Entitlement to service connection for hypertension is remanded.

Entitlement to service connection for renal failure, status-post transplant, to include as secondary to hypertension, is remanded.

Entitlement to service connection for an acquired psychiatric disability, claimed as depression, to include as secondary to hypertension and renal failure, status-post transplant, is remanded.

REASONS FOR REMAND

The Veteran served on active duty from July 1977 to July 1980.  This matter is on appeal from September 2014 and April 2015 rating decisions.  The Veteran presented testimony before the Board in March 2020.

During the March 2020 Board  hearing, the Veteran testified that he has been receiving private medical treatment for the claimed disabilities, to include treatment for depression every three months.  It is not clear from a review of the record that all private treatment records have been obtained.  A remand is required to allow VA to obtain authorization and request these records.

The Board cannot make a fully-informed decision on the issue of service connection for hypertension because no VA examiner has opined whether hypertension clearly and unmistakably preexisted the Veteran’s service and if so, whether it was aggravated therein.   

Finally, the Veteran contends that his depression and renal failure, status-post transplant, are secondary to hypertension.  Since a decision on the issue of service connection for hypertension could significantly impact a decision on the issues of service connection for depression and renal failure, the issues are inextricably intertwined.  Thus, a remand of these issues is required.

The matters are REMANDED for the following action:

1. Ask the Veteran to complete a VA Form 21-4142 for private treatment for the claimed disabilities from 1980 to the present.  Make two requests for the authorized records from the identified providers, unless it is clear after the first request that a second request would be futile.

2.  Once the development above is completed, schedule the Veteran for an examination by an appropriate clinician to determine the nature and etiology of his hypertension.  The examiner must opine whether hypertension clearly and unmistakably (undebatable) preexisted the Veteran’s service.  If the examiner finds it did clearly and unmistakably preexist service, the examiner must opine whether it was clearly and unmistakably not aggravated by service.  If the examiner finds that it either did not clearly and unmistakably preexist service, or was not clearly and unmistakably aggravated by service, the examiner must opine whether it is at least as likely as not related to an in-service injury, event, or disease, including notations of blood pressure reading of 128/110 in 1978 and an allergic reaction to iodinated contrast in 1979.  The examiner must provide the complete rationale for all opinions expressed.

3. Thereafter, and after any additional development necessary, to include ordering additional examinations, readjudicate the issues considering all evidence of record. If the benefit sought remains denied, provide the Veteran with a supplemental statement of the case, and return the case to the Board.

 

 

E. I. VELEZ

Veterans Law Judge

Board of Veterans’ Appeals

Attorney for the Board	K. L. Wallin, 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.