Citation Nr: 20022556
Decision Date: 04/01/20	Archive Date: 04/01/20

DOCKET NO. 13-35 720
DATE: April 1, 2020

REMANDED

The issue of service connection for hypertension, to include as secondary to service-connected diabetes mellitus, and/or as secondary to herbicide exposure is remanded.

REASONS FOR REMAND

The Veteran served on active duty from May 1970 to May 1973.  This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO).  In June 2015, the Board remanded this matter for further evidentiary development.

The Veteran asserts that his current hypertension disability is secondary to his service-connected type II diabetes mellitus and/or to herbicide exposure in service.

In June 2015, this matter was remanded by the Board to obtain an opinion as to whether the Veteran’s hypertension was caused or aggravated by his service-connected diabetes mellitus.  In August 2015, following review of the Veteran’s claims file, the VA examiner opined that the Veteran’s hypertension is less likely than not incurred in or caused by service.  The examiner reasoned that there was no documentation of hypertension in service and the Veteran’s blood pressure was 122/84 upon his March 1973 exit examination.  The examiner further stated that it was not until June 2005 that a diagnosis of hypertension was documented.  The examiner also stated, “[T]here is no herbicide relationship to any hypertension documented or studies proving any relationship to herbicide exposure.”

The Board notes that the Veteran is shown to have served in the Republic of Vietnam and is therefore presumed exposed to herbicide agents as result of his military service.  Contrary to the August 2015 VA examiner’s opinion, although hypertension is not listed as a disease associated with herbicide exposure under 38 C.F.R. § 3.309(e), the National Academy of Sciences Institute of Medicine has concluded that there is “limited or suggestive evidence of an association” between herbicide exposure and hypertension.  See 77 Fed. Reg. 47924, 47926-927 (Aug. 10, 2012).  As an adequate opinion has not yet been provided as to the possibility of a relationship between the Veteran’s hypertension and his presumed exposure to herbicide agents such as Agent Orange, a remand for a medical opinion is warranted.  See 38 U.S.C. § 5103A (d); 38 C.F.R. § 3.159(c)(4); McLendon v. Nicholson, 20 Vet. App. 79, 81 (2006).

The matters are REMANDED for the following action:

1. Forward the claims file to a physician in connection with the Veteran’s hypertension claim.  The physician should review the evidence in the claims file.

The physician should then provide an opinion as to whether it is at least as likely as not that the Veteran’s hypertension is due to herbicide exposure in service.

The opinion should include consideration of the National Academy of Sciences Institute of Medicine study that concluded that there is “limited or suggestive evidence of an association” between herbicide exposure and hypertension.

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2. The physician should provide a complete rationale or explanation for all opinions reached.

 

 

JAMES L. MARCH

Veterans Law Judge

Board of Veterans’ Appeals

Attorney for the Board	S. Griffith

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.