Citation Nr: 20031725 Decision Date: 05/06/20 Archive Date: 05/06/20 DOCKET NO. 13-16 881 DATE: May 6, 2020 REMANDED The claim for service connection for hypertension, to include as secondary to service-connected disability is remanded. REASONS FOR REMAND The Veteran served on active duty from May 1972 to February 1984. This matter is before the Board of Veterans' Appeals (Board) on appeal from a rating decision in April 2015 of the Department of Veterans Affairs (VA) Regional Office (RO). In September 2017, the Veteran testified during a videoconference hearing before the undersigned Veterans Law Judge. A transcript of that hearing is of record This claim was previously before the Board in January 2018 when it was remanded for additional development. The claim returned to the Board and in March 2019 was denied. The Veteran appealed the denial of the claim for service connection for hypertension to the Court of Appeals for Veterans Claims (Court). In December 2019, the Court granted a Joint Motion for Remand (JMR) filed by the parties vacating and remanding the Board’s March 2019 decision denying service connection for hypertension. 1. Entitlement to service connection for hypertension, to include as secondary to service-connected disability. The Board regrets further delay in this case, but finds that a remand is necessary to comply with the parties’ December 2019 JMR. In the JMR, the parties agreed that the Board erred in its March 2019 decision by not addressing a February 24, 2012 letter from the Veteran’s VA rheumatologist. This letter advised the Veteran to use the medication, etodolac, sparingly as it can “potentially affect your blood pressure.” The failure to address this statement is notable as a March 2018 VA opinion includes a finding that the Veteran was not taking any medications that would cause elevated blood pressure from 2012 to the present. The February 2012 rheumatologists’ statement and the March 2018 VA examiner’s opinion should be reconciled, and the Board finds that a new VA medical opinion is necessary to reconcile them. In addition, the Board notes that the current record does not establish when the Veteran was first diagnosed with hypertension. The Veteran’s rheumatologist noted an incident of “somewhat high” blood pressure after a January 2012 evaluation, and referred the Veteran to his primary care physician for treatment. No diagnosis of hypertension was rendered at that point, but in May 2013, the Veteran’s VA Medical Center (VAMC) problem list included a notation of blood pressure elevation with pain. In March 2015, the Veteran’s medication list included Lisinopril, used to treat high blood pressure, and a diagnosis of essential hypertension appeared on the Veteran’s VAMC problem list in August 2015. However, the VA records before the Board are not complete, and the Board finds that a determination as to when the Veteran was first diagnosed with hypertension is pertinent to the service connection claim on appeal. The matter is REMANDED for the following action: 1. Obtain the Veteran’s complete VA treatment records for the period from February 24, 2012 to the present. 2. Obtain an addendum opinion from an appropriate clinician regarding whether the Veteran’s hypertension is at least as likely as not caused or aggravated by any medication used to treat a service-connected disability. The Veteran is service connected for muscle pain syndrome, probable fibrositis. He contends that he has a long history of taking muscle relaxers and various pain medications that have increased his blood pressure and caused or aggravated hypertension. In February 2012, after an incident of high blood pressure in January 2012, he was advised by his VA rheumatologist to use the anti-inflammatory, etodolac, sparingly as it could “potentially” affect his blood pressure. However, in March 2018, a VA examiner opined that the Veteran had not taken any medications from 2012 to the present that could cause elevated blood pressure. In rendering the medical opinion requested above, the examiner should address the February 2012 and March 2018 statements and specifically determine whether the Veteran’s use of etodolac contributed to the causation or aggravation of hypertension. The examiner must address both the causation and aggravation prongs of the secondary service connection claim. M. H. HAWLEY Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. Riley, 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.