Citation Nr: 21003242 Decision Date: 01/21/21 Archive Date: 01/21/21 DOCKET NO. 13-28 724A DATE: January 21, 2021 REMANDED Entitlement to service connection for hypertension is remanded. REASONS FOR REMAND The Veteran served on active duty from April 1968 to April 1972, to include service in the Republic of Vietnam. This appeal arises from a March 2011 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). The Board of Veterans’ Appeals (Board) remanded the hypertension issue in September 2016. Entitlement to service connection for hypertension is remanded. The Veteran contends that he has hypertension caused by his presumed exposure to herbicide agents, to include Agent Orange, during his service in the Republic of Vietnam. See November 2009 Claim Form (VA Form 21-526); August 2013 Brief (contending that the Veteran’s hypertension is secondary to herbicide exposure because he is a “boots-on-the-ground veteran of the Vietnam War”). While VA afforded the Veteran an examination in January 2020 in accordance with the Board’s September 2016 remand instructions, the examiner did not address the Veteran’s contention regarding his hypertension being causing by in-service herbicide exposure. The Board notes that the l ist of diseases associated with exposure to certain herbicide agents does not include hypertension. See 38 C.F.R. § 3.309(e). Even so, the Veteran’s exposure to Agent Orange herbicide agents is presumed in light of the circumstances of his service and even though he is not entitled to presumptive service connection, consideration is still warranted of whether his presumed exposure directly caused his hypertension. Combee v. Brown, 34 F.3d 1039, 1042 (Fed. Cir. 1994). The medical evidence of record, to include the January 2020 examination report, shows that the Veteran has hypertension. Again, the January 2020 VA examiner did not address whether hypertension could be directly service-connected based on his in-service Agent Orange herbicide exposure in light of his specific circumstances of service, medical history, and other risk factors. See generally Polovick v. Shinseki, 23 Vet. App. 48 (2009). A new VA examination is, therefore, necessary to adequately consider direct service connection. Id.; see also Combee, 34 F.3d at 1042. The matter is REMANDED for the following action: 1. Forward the claims file to an appropriate clinician for review concerning the hypertension claim. The reviewing clinician should provide an opinion as to whether it is at least as likely not (50 percent or greater probability) that the Veteran’s hypertension is related to his service, to include presumed herbicide exposure. A complete rationale, to include consideration of medical literature, the circumstances of the Veteran’s military service, any risk factors the Veteran may have for hypertension, his treatment records since service, his lay statements describing any symptoms since service, and other pertinent information should accompany any opinion provided, and all should be separately identified. The examiner is advised the Veteran’s Agent Orange exposure is presumed and a negative opinion merely based on the fact that hypertension is not a presumptive condition associated with Agent Orange herbicide will be deemed insufficient for adjudication purposes. Polovick, 23 Vet. App. 48. 2. After the above development and any other development deemed necessary is completed, readjudicate the claim. If the benefit sought on appeal remains denied, the Veteran and his representative should be furnished a supplemental statement of the case and given the opportunity to respond. Shereen M. Marcus Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A. Santiago, 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.