Citation Nr: 20042748 Decision Date: 06/24/20 Archive Date: 06/24/20 DOCKET NO. 17-60 737 DATE: June 24, 2020 REMANDED Entitlement to service connection for hypertension is remanded. REASONS FOR REMAND The Veteran had active military service from November 1965 to December 1968. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an April 2017 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). By way of background, in December 2019, the Board remanded the issues on appeal for further evidentiary development. Service connection for bilateral hearing loss was granted in an April 2020 rating decision. Therefore, the issue is no longer before the Board. REASONS FOR REMAND Entitlement to service connection for hypertension is remanded. At the outset, the Board notes that the Veteran has a current diagnosis of hypertension. See January 2017 CAPRI. A review of the service treatment records shows that in the September 1965 entrance examination and December 1968 separation examination the Veteran denied having high blood pressure. However, in the December 1968 separation examination it was noted that the Veteran’s blood pressure was 130/76, indicating elevated blood pressure. See January 2017 STR – Medical. The Veteran was afforded a VA examination in January 2020 wherein the examiner diagnosed the Veteran with hypertension and opined that the Veteran’s hypertension is less likely than not incurred in or caused by the claimed in-service injury, event, or illness. The examiner explained that a one-time reading of high blood pressure should not be used to make a diagnosis as it is not uncommon to have an isolated elevated reading in a normotensive individual. As an example, the examiner stated that the Veteran also had a one-time high blood pressure prior to service and if a one-time high blood pressure reading is sufficient for a diagnosis then hypertension would have manifested prior to service. Although the Veteran did not allege that his hypertension manifested as a result of his service in Vietnam, the Board notes that the Veteran was stationed in Vietnam. See January 2017 Military Personnel Record. As such, the Board finds that a remand is warranted as the National Academy of Science (NAS) determined in Veterans and Agent Orange: Update 11 (2018), that there is sufficient evidence of an association for hypertension and exposure to Agent Orange and other herbicides used during the Vietnam War. Hypertension has been upgraded from its previous classification in the category of “limited or suggestive” evidence of an association to the category of “sufficient” evidence of an association. According to NAS, “[t]he sufficient category indicates that there is enough epidemiologic evidence to conclude that there is a positive association” between hypertension and herbicide exposure. Accordingly, a remand is necessary for the VA examiner to consider this new scientific evidence. The matter is REMANDED for the following action: Obtain an addendum from the January 2020 examiner. The examiner should opine as to whether it is at least as likely as not that hypertension was caused by, or is otherwise etiologically related to, his presumed herbicide exposure. The examiner should consider the NAS 2018 conclusion that hypertension has been upgraded from its previous classification in the category of “limited or suggestive” evidence of an association to the category of “sufficient” evidence of an association. According to NAS, “[t]he sufficient category indicates that there is enough epidemiologic evidence to conclude that there is a positive association” between hypertension and herbicide exposure. A complete rationale for all opinions is requested. S. HENEKS Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board P. Noh, Associate 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.