Citation Nr: 20046780 Decision Date: 07/13/20 Archive Date: 07/13/20 DOCKET NO. 15-14 397A DATE: July 13, 2020 REMANDED Entitlement to service connection for hypertension, to include as secondary to service-connected disabilities, is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Navy from December 1976 to June 1984. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a June 2013 rating decision of an Agency of Original Jurisdiction (AOJ) of the Department of Veterans Affairs (VA). In June 2018, the Veteran testified at a videoconference hearing before a Veterans Law Judge (VLJ) who is no longer at the Board. On February 14, 2019, the Veteran was notified of a Board decision signed by that VLJ. The Board has vacated the February 14, 2019 Board decision insofar as it denied entitlement to service connection for hypertension. The law and regulations governing this appeal provide that a VLJ who is assigned to a proceeding and conducts a hearing shall participate in making the final determination of an appeal. See 38 C.F.R. § 20.604; see also 38 U.S.C. § 7107(c) (as in effect prior to February 19, 2019). However, as the VLJ who conducted the June 2018 hearing and who signed the February 14, 2019 Board decision is unable to participate in the disposition of this proceeding, the undersigned has been assigned. See 38 C.F.R. § 20.106. The Veteran may request another Board hearing if he desires one. See Quinn v. Wilkie, 31 Vet. App. 284 (2019) (explaining that under the version of a law applicable to this appeal, an appellant has a right to an additional hearing after a Board remand). With respect to the merits of the appeal, the Veteran asserts that cardiovascular disease is associated with anxiety and depression, see May 2015 VA Form 9 at 1, as well as that he has submitted relevant medical journal evidence. See July 2018 Correspondence. Moreover, there is medical evidence indicating that his service-connected mental disorder has manifested by anxiety and depression. See November 2014 VA Psychiatric Examination Report (noting that the Veteran meets the criteria for a non-specific anxiety condition that encompasses both anxiety and depressive symptoms). Additionally, the Veteran asserts that he is no longer able to control his blood pressure through diet and exercise because his arthritis precludes physical activity. See May 2015 VA Form 9 at 2. Furthermore, the evidence suggests that his physical activities are limited by service-connected disabilities. See, e.g., November 2014 VA Spine Examination Report (physical work precluded). This evidence triggers VA’s duty to provide an examination and secure a medical opinion. See 38 C.F.R. § 3.159(c)(4)(i). Thus, remand is necessary. To ensure the adequacy of the examination, the examiner should address direct and secondary service connection. The matters are REMANDED for the following action: Following a review of the claims file, the examiner should opine as to whether it is at least as likely as not (a 50 percent or greater probability) that the Veteran’s hypertension: (a) had its onset in service or is otherwise related to service; (b) is proximately due to service-connected disability(ies), including service-connected disabilities of the back, shoulders, knees, radiculopathy of the lower extremities, and/or a psychiatric disorder; or (c) has been aggravated (worsened beyond natural progression) by service-connected disability, including service-connected disabilities of the back, shoulders, knees, radiculopathy of the lower extremities, and/or a psychiatric disorder The physician should address the above taking into consideration his service-connected disabilities individually or in combination. Please address each sub-part ((a), (b), and (c)) separately in addressing the below requests. The examiner should address the Veteran’s assertion that his hypertension is related to his psychiatric disorder. The examiner’s attention is invited to the articles submitted by the Veteran. See, e.g., July 2018 Correspondence (“The Vital Link Between Chronic Disease and Depressive Disorders”) https://www.cdc.gov/pcd/issues/2005/jan/04_0066.htm. Moreover, the examiner’s attention is invited to the November 2014 VA psychiatric examination report indicating that the Veteran’s service-connected psychiatric disability is manifested by both anxiety and depression. The examiner should also address the Veteran’s assertion that he is no longer able to control his blood pressure with exercise due to his arthritis. The examiner’s attention is invited to the November 2014 VA examination reports indicating that he cannot perform physical labor and that he uses a cane due to service-connected disabilities. A complete rationale should be given for all opinions and conclusions expressed. In the event the examiner cannot provide an opinion without resorting to speculation, it is essential that the examiner provide a rationale for this conclusion (e.g. lack of sufficient information/evidence, the limits of medical knowledge, etc.). K. OSBORNE Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board D.M. Badaczewski, 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.