Citation Nr: 20022594 Decision Date: 04/01/20 Archive Date: 04/01/20 DOCKET NO. 16-15 285A DATE: April 1, 2020 ORDER Entitlement to service connection for hypertension is granted. FINDING OF FACT The Veteran’s hypertension is at least as likely as not related to his service in Vietnam and exposure to Agent Orange. CONCLUSION OF LAW The criteria for service connection for hypertension have been met. 38 U.S.C. §§ 1101, 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.304, 3.307, 3.309. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty with the U.S. Army from April 1968 to April 1970. He had service in the Republic of Vietnam. This matter was remanded in October 2019 for an addendum opinion. 1. Entitlement to service connection for hypertension as secondary to Agent Orange exposure Service connection may be granted for a disability resulting from a disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303(a). To establish entitlement to service-connected compensation benefits, a Veteran must show: “(1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service-the so-called ‘nexus’ requirement.” Holton v. Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2010) (quoting Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004)). The Veteran contends that his hypertension is related to his military service. Although he was not diagnosed with hypertension during service, post-service VA treatment records, to include the most recent February 2020 VA examination, confirmed a current diagnosis of hypertension. Having served in Vietnam during the applicable time period, the Veteran is presumed to have been exposed to Agent Orange. 38 U.S.C. § 1116(f); 38 C.F.R. § 3.307(a)(6)(iii). VA laws and regulations provide that if a Veteran was exposed to Agent Orange during service, certain listed diseases are presumptively service connected. 38 U.S.C. § 1116(a)(1); 38 C.F.R. § 3.309(e). 38 C.F.R. § 3.309(e) lists the diseases covered by the regulation. The Secretary of VA has determined that there is no positive association between exposure to herbicides and any other condition for which the Secretary has not specifically determined that a presumption of service connection is warranted. See Notice, 59 Fed. Reg. 341-46 (1994); Notice, 61 Fed. Reg. 41, 442-49 (1996); Notice, 72 Fed. Reg. 32, 395-32, 407 (Jun. 12, 2007); Notice, 74 Fed. Reg. 21,258-21, 260 (May 7, 2009); Notice, 75 Fed. Reg. 32540 (June 8, 2010). 38 C.F.R. § 3.309(e) specifically lists those diseases covered by the provision, and the list does not include hypertension. On November 15, 2018, the National Academies of Sciences, Engineering, and Medicine moved hypertension to the category of “sufficient” evidence of an association from its previous classification in the “limited or suggestive” category, indicating that there is enough epidemiologic evidence to conclude that there is a positive association between hypertension and exposure to herbicides, including Agent Orange. See Hypertension Upgraded in Latest Biennial Review of Research on Health Problems in Veterans That May Be Linked to Agent Orange Exposure During Vietnam War (Nov. 15, 2018), http://www8.nationalacademies.org/onpinews/newsitem.aspx?RecordID=25137 (last visited Nov. 20, 2018). Based on this new finding, the Board requested an addendum opinion in October 2019. Pursuant to the Board’s remand, a VA opinion was obtained in February 2020. The examiner stated that the Veteran’s hypertension is at least as likely as not due to an in-service injury, disease, or event. She reasoned that based on medical literature and research, there is sufficient evidence of an association between Agent Orange exposure and the development of hypertension. Based on the foregoing, the Board finds there is sufficient evidence to etiologically link the Veteran’s hypertension to his presumed exposure to herbicides while serving in Vietnam. As such, all elements of service connection for hypertension are met, and service connection is warranted. H.M. WALKER Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. McPhaull, 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.