Citation Nr: 20039997 Decision Date: 06/11/20 Archive Date: 06/11/20 DOCKET NO. 12-17 847A DATE: June 11, 2020 REMANDED Entitlement to an initial compensable disability rating for hypertension is remanded. REASONS FOR REMAND The Veteran served on active duty from May 1974 to January 1975, from November 2005 to March 2006, and from October 2006 to December 2007, including service in Southwest Asia. In October 2017, the Board, in pertinent part, denied entitlement to a compensable rating for hypertension. The Veteran filed an appeal with the United States Court of Appeals for Veterans Claims (Court). Per a December 2019 Memorandum Decision, the Board’s decision regarding hypertension was vacated and remanded. While the Board had determined that a compensable rating was not warranted per 38 C.F.R. § 4.104, Diagnostic Code 7101, per the Memorandum Decision consideration needs to be given to schedular alternatives, to include whether an extraschedular rating is appropriate per 38 C.F.R. § 3.321(b). Such is necessary as the Veteran asserts that she has cardiac damage due to her hypertension, specifically left atrium enlargement. See 12/02/2019 CAVC Decision at 70-71; see also 01/14/2016 Form 9 at 2. A September 2016 VA examination reflects that in June 2010 there was a finding of left atrium enlargement indicating pulmonary hypertension. 09/20/2016 C&P Exam at 4. The Veteran should be afforded an examination to assess the symptomatology associated with her service-connected hypertension, and to determine whether she has any other disabilities associated with her hypertension, to include left atrium enlargement. Consideration should also be given to § 3.321(b)(1). The matter is REMANDED for the following action: 1. Schedule the Veteran for an examination to assess the severity of her hypertension. The examiner should review the virtual folder in connection with the examination. The examiner should measure the Veteran’s diastolic and systolic pressure, and also discuss the Veteran’s need for medication to control her hypertension. The examiner should describe all symptomatology associated with her hypertension. The examiner should respond to the following: a) Does the Veteran have a left atrium enlargement due to her service-connected hypertension? If yes, please describe symptomatology associated with her left atrium enlargement. If not, please explain why the enlargement is not attributable to the service-connected hypertension. b) Does the Veteran have a left atrium enlargement aggravated beyond its natural progression by her service-connected hypertension? If aggravation is found, the examiner should identify the baseline level of disability prior to such aggravation. A comprehensive rationale for all opinions expressed must be provided. The copy of the examination report and all completed test reports should thereafter be associated with the claims folder. If any opinion cannot be rendered without resorting to speculation, the examiner must explain in detail why an opinion cannot be offered. 2. Adjudicate entitlement to an initial compensable rating for hypertension, to include consideration of § 3.321(b)(1). Eric S. Leboff Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M.W. Kreindler, 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.