Citation Nr: 20053397 Decision Date: 08/12/20 Archive Date: 08/12/20 DOCKET NO. 16-62 626 DATE: August 12, 2020 ORDER Entitlement to service connection for hypertension is granted. FINDING OF FACT The evidence is at least in equipoise as to whether the Veteran's hypertension manifested during active duty service and has persisted since. CONCLUSION OF LAW The criteria for service connection for hypertension have been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304, 3.307, 3.309. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Marine Corps from September 1983 to April 1991. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a May 2015 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO) in Winston-Salem, North Carolina. In December 2018, the Board remanded the matter for additional development. Entitlement to service connection for hypertension. The Veteran initially claimed the hypertension was secondary to chronic renal disease, but the December 2018 Board decision denied entitlement to service connection for that disability. However, as noted in the December 2018 remand, evidence suggests the hypertension could have manifested during the Veteran’s active duty service. 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 service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.03. Service connection may also be granted for any disease diagnosed after discharge, when all evidence, including that pertinent to service, establishes that the disease was incurred in-service. 38 C.F.R. § 3.303(d). In order to establish service connection for the claimed disability, there must be (1) medical evidence of a current disability; (2) medical, or in certain circumstances, lay evidence of in-service incurrence or aggravation of a disease or injury; and (3) medical, or in certain circumstances, lay evidence of a nexus between the claimed in-service disease or injury and the current disability. See 38 C.F.R. § 3.303; see also Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004). Where a Veteran served 90 days or more during a period of war or during peacetime service after December 31, 1946, and a chronic disease, including hypertension, becomes manifest to a degree of 10 percent or more within one year from the date of termination of such service, such disease shall be presumed to have been incurred in or aggravated by service, even though there is no evidence of such disease during the period of service. This presumption is rebuttable by affirmative evidence to the contrary. 38 U.S.C. §§ 1101, 1112, 1113, 1137; 38 C.F.R. §§ 3.307, 3.309. If a condition listed as a chronic disease in § 3.309(a) is noted during service, but is either shown not to be chronic or the diagnosis could be legitimately questioned, then a showing of continuity of related symptomatology after discharge is required to support the claim. 38 C.F.R. § 3.303(b); see Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013) (holding that the continuity of symptomatology provisions of 38 C.F.R. § 3.303(b) only apply to a chronic disease listed in § 3.309(a)). When there is an approximate balance of positive and negative evidence regarding the merits of an issue material to the determination of the matter, the benefit of the doubt in resolving each such issue shall be given to the claimant. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. When a veteran seeks benefits and the evidence is in relative equipoise, the veteran prevails. Gilbert v. Derwinski, 1 Vet. App. 49 (1990). A preponderance of the evidence must be against the claim for benefits to be denied. Alemany v. Brown, 9 Vet. App. 518, 519 (1996). VA treatment records and an October 2019 VA examination report show hypertension has been diagnosed. Therefore, the remaining question before the Board is whether the Veteran's hypertension began during, is caused by, or is otherwise etiologically related to his military service. The Board has reviewed the record and finds that there is evidence both for and against the claim. The Veteran’s service treatment records are silent for a diagnosis of or treatment for hypertension. However, the records show an elevated blood pressure was noted multiple times during active duty service. His blood pressure was recorded as 120/92 in March 1986; 112/88 in August 1987; 130/90 in January 1990; and 150/100 in November 1990. The January 1990 service treatment record notes he had a history of high blood pressure. The copy of his April 1991 separation examination report is difficult to read, but appears to indicate his blood pressure was 128/90. Notably, VA defines hypertension as diastolic blood pressure that is predominantly 90mm or greater. 38 C.F.R. § 4.104, Diagnostic Code 7101. The October 2019 VA examiner opined that the hypertension was at least as likely as not incurred in or caused by the claimed in-service injury. The examiner noted the Veteran’s medical records were not available for review and that the opinion was based on the Veteran’s report that hypertension had been diagnosed during service. Specifically, the Veteran reported he had an elevated blood pressure that became hypertension during active duty service. He said he began receiving treatment for the hypertension from a private treatment provider the year after his discharge from service. The Veteran is competent to describe his medical history, and the Board finds his statements to be credible because while his service treatment records do not show hypertension was diagnosed during active duty service, he was noted to have elevate blood pressure. Moreover, the other evidence of record does not contradict his reported history. It’s not clear whether the examiner was able to review the Veteran’s post-service treatment records, but the Board finds the opinion probative because he considered the Veteran’s reported history, which he clearly also considered to be credible based on the available information. The Board finds the evidence for and against finding the Veteran’s hypertension manifested during service is of equal weight. The Board must therefore resolve all reasonable doubt in favor of the Veteran. See 38 U.S.C. § 5107; 38 C.F.R. § 3.102. Accordingly, service connection for hypertension is warranted. John J. Crowley Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board William A. Skowronski, 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.