Citation Nr: 20030150 Decision Date: 04/29/20 Archive Date: 04/29/20 DOCKET NO. 16-57 252 DATE: April 29, 2020 ORDER Service connection for hypertension is denied. FINDING OF FACT Hypertension was not shown during active service or within a year of active service discharge; and the weight of the evidence fails to establish that the Veteran’s diagnosed hypertension is etiologically related to his active service, to include his presumed herbicide agent exposure therein, or was caused or aggravated by the Veteran’s service-connected diabetes. CONCLUSION OF LAW The criteria for service connection for hypertension have not been met. 38 U.S.C. § 1110; 38 C.F.R. §§ 3.303, 3.309, 3.310. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active service from November 1965 to October 1967, to include service in the Republic of Vietnam. The Veteran also had reserve service. This case has been advanced on the Board's docket. Service Connection Service connection will be granted if the evidence demonstrates that a current disability resulted from an injury or disease incurred in or aggravated by active military service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303. Service connection requires competent evidence showing: (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. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Service connection may also be established under 38 C.F.R. § 3.303(b), where a condition in service is noted but is not, in fact, chronic, or where a diagnosis of chronicity may be legitimately questioned. The continuity of symptomatology provision of 38 C.F.R. § 3.303(b) has been interpreted as an alternative to service connection only for the specific chronic diseases listed in 38 C.F.R. § 3.309(a). See Walker v. Shinseki, 718 F.3d 1331 (Fed. Cir. 2013). Service connection may also be established with certain chronic diseases based upon a legal presumption by showing that the disorder manifested itself to a degree of 10 percent disabling or more within one year from the date of separation from service. Such disease shall be presumed to have been incurred in service, even though there is no evidence of such disease during the period of service. 38 U.S.C. §§ 1101, 1112, 1113, 1137; 38 C.F.R. §§ 3.307, 3.309(a). While the disease need not be diagnosed within the presumption period, it must be shown, by acceptable lay or medical evidence, that there were characteristic manifestations of the disease to the required degree during that time. Service connection may be granted on a presumptive basis for certain diseases associated with exposure to certain herbicide agents even though there is no record of such disease during service, if they manifest to a compensable degree any time after service, in a veteran who had active military, naval, or air service for at least 90 days, during the period beginning on January 9, 1962 and ending on May 7, 1975, in the Republic of Vietnam, including the waters offshore, and other locations if the conditions of service involved duty or visitation in Vietnam. 38 U.S.C. § 1116; 38 C.F.R. §§ 3.307, 3.309(e), 3.313. This presumption may be rebutted by affirmative evidence to the contrary. 38 U.S.C. § 1113; 38 C.F.R. §§ 3.307, 3.309. The Veteran’s service records show that he served in the Republic of Vietnam. As such, exposure to herbicide agents, such as Agent Orange, is presumed. However, hypertension is not among the list of diseases that are presumptively related to herbicide agent exposure under 38 C.F.R. § 3.309(e). As such, presumptive service connection based on herbicide agent exposure is not warranted. The Veteran filed a service connection claim for hypertension, which was denied by a November 2014 rating decision. The Veteran asserts that his hypertension is due to his active service or was caused or aggravated by his service-connected diabetes. For VA compensation purposes, the term “hypertension” means that the diastolic blood pressure is predominantly 90mm or greater, and isolated systolic hypertension means that the systolic blood pressure is predominantly 160mm or greater with a diastolic blood pressure of less than 90mm. Multiple blood pressure readings are required to confirm the diagnosis of hypertension with two or more readings on at least three different days. 38 C.F.R. § 4.104, Diagnostic Code 7101, Note 1. The Veteran’s STRs show that at his May 1965 entrance examination, his blood pressure was 140/78 and he denied having high blood pressure. His STRs do not show that he had any symptoms, complaints, or diagnoses for hypertension during his active service. At his October 1967 separation examination, his blood pressure was 126/76 and he again specifically denied having then, or having ever had, high blood pressure. After his separation from active service, the Veteran’s STRs from his reserve service show that he had normal blood pressure readings at February 1980, October 1983, and October 1987 physicals, and he continued to deny having any high blood pressure. At an August 1991 physical, he had a blood pressure reading of 130/90, but he continued to deny having any high blood pressure. However, at an August 1994 physical, his blood pressure was again normal at 110/80, and he denied having any high blood pressure. The Veteran’s medical records show that he was first diagnosed with hypertension May 2006, almost four decades after his separation from active service. As such, the record contains no diagnosis of hypertension either in service or within one year after service, which would preclude service connection on the basis of continuity of symptomology or on any presumptive basis. The Veteran has not argued to the contrary and instead argues his hypertension is result of his service-connected diabetes. There is also no medical evidence linking the Veteran’s current hypertension to his active service, and he has not submitted any medical opinion that even suggests that his hypertension either began during or was otherwise caused by his military service. See Shedden, 381 F.3d 1163, 1167. In October 2014, the Veteran was afforded a VA examination. After reviewing the Veteran’s claims file, interviewing the Veteran, and conducting an examination, the examiner opined that the Veteran’s hypertension was not due to his active service. The examiner reported that the Veteran’s STRs did not show any evidence of signs, symptoms, diagnosis, or treatment for hypertension or evidence of persistent consecutive elevated blood pressure readings during his active service. The examiner also opined that the Veteran’s hypertension was not caused by, related to, or aggravated by the Veteran’s service-connected diabetes. The examiner reported that there was no evidence of significant microalbuminuria to suggest diabetic nephropathy as an etiologic factor. In March 2019, the Veteran was afforded a VA examination. After reviewing the Veteran’s claims file, interviewing the Veteran, and conducting an examination, the examiner opined that the Veteran’s hypertension was not due to his active service, to include his exposure to herbicide agents. The examiner reported that the Veteran’s STRs did not show treatment for hypertension during his active service as the Veteran was not diagnosed with hypertension until 2006. The examiner also reported that there is no evidence in the medical literature that links hypertension to herbicide agent exposure. The examiner also opined that the Veteran’s hypertension was not caused by, related to, or aggravated by the Veteran’s service-connected diabetes. The examiner reported that there was no evidence of significant microalbuminuria to suggest diabetic nephropathy. The examiner reported that there was no objective evidence that the Veteran’s hypertension had been aggravated beyond its natural progression by the Veteran’s service-connected diabetes. The Veteran has not submitted any medical evidence supporting his assertion that his hypertension was due to or the result of his active service or caused or aggravated by his service-connected diabetes. VA obtained medical opinions in an effort to support the Veteran in establishing his claim. The October 2014 and March 2019 VA examiners opined that the Veteran’s hypertension was less likely than not due to or aggravated by his active service, to include any herbicide agent exposure, and was less likely than not caused or aggravated by his service-connected diabetes. After weighing all the evidence, the Board finds great probative value in the October 2014 and March 2019 VA examiners’ opinions. These negative opinions are sufficient to satisfy the statutory requirements of producing an adequate statement of reasons and bases where the expert has fairly considered material evidence which appears to support the Veteran’s position. Wray v. Brown, 7 Vet. App. 488, at 492-93 (1995). Consideration has been given to the Veteran’s assertions that his hypertension was due to his active service and/or due to his service-connected diabetes. He is clearly competent to report stress and symptoms of hypertension. See Jandreau v. Nicholson, 492 F.3d 1372 (Fed. Cir. 2007). However, he has not been shown to possess the requisite medical training, expertise, or credentials needed to render a diagnosis or a competent opinion as to medical causation. Nothing in the record demonstrates that he has received any special training or acquired any medical expertise in evaluating hypertension or diabetes. See King v. Shinseki, 700 F.3d 1339, 1345 (Fed. Cir. 2012). Accordingly, the Veteran’s assertions do not constitute competent medical evidence. Accordingly, as the criteria for service connection for hypertension have not been met, the Veteran’s claim is denied. KELLI A. KORDICH Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board T. Berryman, 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.