Citation Nr: 21002588 Decision Date: 01/14/21 Archive Date: 01/14/21 DOCKET NO. 16-19 336 DATE: January 14, 2021 ORDER Entitlement to service connection for hypertension is granted. FINDING OF FACT The Veteran has a current diagnosis of hypertension which is etiologically related to herbicide exposure sustained in active service. CONCLUSION OF LAW The criteria for service connection for hypertension have been met. 38 U.S.C. §§ 1110, 1131, 5107 (2018); 38 C.F.R. §§ 3.102, 3.303 (2019). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from January 1973 to December 1980. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a September 2013 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). In August 2018, the Veteran testified at a hearing before the undersigned Veterans Law Judge. A transcript of the hearing is of record. This issue was previously before the Board in March 2019, at which time it was remanded for additional development. The case has now been returned to the Board for further appellate action. Service Connection – Hypertension The Veteran asserts that he has hypertension that is as a result of herbicide exposure during his active service. In the alternative, the Veteran has asserted that his hypertension was caused or chronically worsened by his service-connected diabetes mellitus. As discussed in the March 2019 Board decision, the Board has conceded that the Veteran was exposed to herbicides while in active service. A review of the medical evidence of record shows that the Veteran has a current diagnosis of hypertension and receives treatment for the same. The Board acknowledges that hypertension is not a disability that is presumptively related to herbicide exposure. 38 C.F.R. § 3.309 (e) (2019). However, a recent determination from the National Academy of Sciences upgraded hypertension to the “sufficient” category from “limited or suggestive,” indicating that there is enough epidemiologic evidence to conclude that there is a positive association between hypertension and herbicide exposure. The Veteran was afforded VA examinations for his hypertension in July 2013 and January 2020, and an addendum VA medical opinion was provided in August 2020. At those times, the examiners opined that the Veteran’s hypertension was less likely than not as a result of his active service. In that regard, the examiners noted the Veteran did not have hypertension during active service, and that the Veteran had hypertension prior to his diagnosis of diabetes mellitus though the Veteran was described as an unreliable historian, so the exact timeline is unclear. The Board finds the August 2020 addendum opinion found that there were several risk factors for the Veteran’s hypertension. However, the examiner included exposure to herbicides as a risk factor for his hypertension diagnosis. The examiner was unable to provide a clear cause of the hypertension. In sum, the Veteran is presumed to have been exposed to herbicides while in active service, and he has a current diagnosis of hypertension. The August 2020 VA examiner indicated that the Veteran’s exposure to herbicides during his active service was one risk factor to his hypertension diagnosis. There is sufficient evidence to conclude that there is a positive association between hypertension and herbicide exposure. Accordingly, the Board finds that the evidence for and against the claim is at least in equipoise. Therefore, the benefit of the doubt must be resolved in favor of the Veteran, and entitlement to service connection for hypertension is warranted. 38 U.S.C. § 5107 (b) (2018); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). Kristin Haddock Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board D. Andrew Ledman II 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.