Citation Nr: 21003231 Decision Date: 01/21/21 Archive Date: 01/21/21 DOCKET NO. 12-10 993 DATE: January 21, 2021 REMANDED Entitlement to service connection for hypertension is remanded. REASONS FOR REMAND The Veteran served on active duty from May 1959 to June 1979. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a September 2010 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). In January 2018, the Board remanded the case for further development, which has been completed. Stegall v. West, 11 Vet. App. 268, 271. Hypertension The Veteran asserts that he is entitled to service connection for hypertension. A review of the Veteran’s service treatment records (STRs) reveals that the Veteran had a number of elevated blood pressure readings during service. Diastolic blood pressures were recorded in the low and mid-80’s and systolic blood pressures were recorded in the low and mid-130’s. Given the elevated blood pressure measurements during service and given that the Veteran currently has a diagnosis of hypertension, the Veteran should be provided a VA examination to obtain an opinion regarding whether the current hypertension is linked to military service. McLendon v. Nicholson, 20 Vet. App. 79, 81 (2006). The matter is REMANDED for the following action: 1. Obtain updated VA and/or pertinent private treatment records. If such records are unavailable, the Veteran’s claim file must be clearly documented to that effect and the Veteran notified in accordance with 38 C.F.R. § 3.159(e). 2. Schedule the Veteran for a VA examination to determine the nature and etiology of any hypertension found on examination. The examiner must review the Veteran’s claims file, and such review should be noted in the examination report. If the Veteran fails to report for the examination, please provide an opinion based on a review of the record. Based upon the examination results and review of the claims folder, the examiner is to provide the following opinion: Whether it is at least as likely as not that the Veteran’s hypertension first developed during service or within a year of discharge from service. The term "at least as likely as not" does not mean within the realm of medical possibility, but rather that the medical evidence both for and against a certain conclusion is so evenly divided that it is as medically sound to find in favor of such a conclusion as it is to find against it. The examiner must specifically address the Veteran’s blood pressure readings in his service treatment records and continuity of symptoms since service. The opinion and rationale should reflect such consideration. See December 2009 STR – Medical Records; see also January 2010 Medical Treatment Record – Government Facility; see also July 2014 Medical Treatment Record – Government Facility. Please explain in detail any opinion provided and the supporting rationale. In all opinions rendered, the examiner is advised that the Veteran is competent to report his symptoms and treatment history including his reports of elevated blood pressure due to his alleged in-service injury with continued symptoms to the present. If there is a medical basis to doubt the history provided by the Veteran, the examiner should indicate this in the examination report and provide a rationale for that determination. If the medical professional cannot provide an opinion without resorting to mere speculation, he or she shall provide a complete explanation for why an opinion cannot be rendered. In so doing, the medical professional shall explain whether the inability to provide a more definitive opinion is the result of a need for additional information, or that he or she has exhausted the limits of current medical knowledge in providing an answer to that particular question(s). (Continued on the next page) G. A. WASIK Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board V. Schmidt 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.