Citation Nr: 21000315 Decision Date: 01/05/21 Archive Date: 01/05/21 DOCKET NO. 14-19 164 DATE: January 5, 2021 REMANDED Entitlement to service connection for hypertension is remanded. REASONS FOR REMAND The Veteran served on active duty from March 1980 to June 1980, from February 1981 to November 1988, and from March 2003 to June 2003. This case comes before the Board of Veterans’ Appeals (Board) on appeal of a December 2012 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified before the undersigned Veterans Law Judge in April 2017. In January 2018, February 2019, and August 2020, the Board remanded the case. The Veteran was afforded a VA examination in October 2020 pursuant to the August 2020 remand. Unfortunately, the VA examiner utilized an incorrect standard in determining the applicability of the presumption of soundness for the second time. The question for the medical professional in the August 2020 remand was to ascertain whether hypertension clearly and unmistakably preexisted the third period of service. The VA examiner opined “Yes, Pre-existed service” and “Less likely that hypertension is due to or aggravated by the third period of Service from March-June 2003.” The opinion submitted by the VA examiner was not responsive to the Board’s prior remand to use the specific language (clearly and unmistakably preexisted the third period of service). As such, correction is needed upon a further remand. The matter is REMANDED for the following action: Forward the claims file, including this remand and the August 2020 remand, to the October 2020 VA examiner (or, if unavailable, from a medical professional with appropriate expertise) for a record review and addendum opinion to address the possibility of a causal link between hypertension and the third period of service (from March to June in 2003). The VA examiner is requested to answer the following: Ascertain whether the Veteran’s hypertension clearly and unmistakably preexisted the third period of service. The VA examiner is reminded that the response to this question must be phrased in the exact terms (clearly and unmistakably preexisted) presented in this remand. If the Veteran’s hypertension did clearly and unmistakably preexist the third period of service, the VA examiner is requested to provide an opinion as to whether the Veteran’s hypertension clearly and unmistakably was NOT aggravated during the third period of service. The VA examiner is reminded that the response to this question must be phrased in the exact terms (clearly and unmistakably was NOT aggravated) presented in this remand If the Veteran’s hypertension did NOT clearly and unmistakably preexist the third period of service, the VA examiner is requested to provide an opinion as to whether the Veteran’s hypertension is at least as likely as not (a 50 percent or greater probability) etiologically related to the third period of service. The VA examiner is reminded that the response to this question must be phrased in the exact terms (at least as likely as not) presented in this remand All opinions must be supported by a rationale. A. C. MACKENZIE Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board D. Hetman 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.