Citation Nr: 21003980 Decision Date: 01/25/21 Archive Date: 01/25/21 DOCKET NO. 14-32 001 DATE: January 25, 2021 ORDER Entitlement to service connection for hypertension, as due to exposure ot herbicides, is granted. FINDINGS OF FACT 1. The Veteran’s exposure to herbicides during service in the Republic of Vietnam during the Vietnam Era is presumed. 2. The evidence is in relative equipoise as to whether the Veteran’s hypertension was caused by presumed exposure to herbicides. CONCLUSION OF LAW The criteria for entitlement to service connection for hypertension have been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307. 3.309. REASONS AND BASES FOR FINDINGS AND CONCLUSION The Veteran served on active duty from December 1968 to December 1970. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a May 2013 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). In December 2017, the Veteran testified at a video-conference hearing before the undersigned Veterans Law Judge (VLJ). A transcript of that hearing has been associated with the claims file. In March 2019, the Board remanded this matter for further development. That development having been completed, this matter has returned to the Board for further appellate review. Entitlement to service connection for hypertension The Veteran asserts that his hypertension is related to his active duty service, specifically as a result of his exposure to herbicides while serving in Vietnam. See December 2017 Hearing Transcript. Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a). Establishing service connection generally requires competent medical or lay evidence of (1) a current disability; (2) an in-service incurrence or aggravation of a disease or injury; and (3) a nexus between the claimed in-service disease or injury and the present disability. See Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009). A claimant is entitled to the benefit of the doubt when there is an approximate balance of positive and negative evidence on any issue material to the claim. See 38 U.S.C. § 5107; 38 C.F.R. § 3.102 (providing, in pertinent part, that reasonable doubt will be resolved in favor of the claimant). When the evidence supports the claim or is in relative equipoise, the claim will be granted. See Gilbert v. Derwinski, 1 Vet. App. 49, 55 (1990); see also Wise v. Shinseki, 26 Vet. App. 517, 532 (2014). If the preponderance of the evidence weighs against the claim, it must be denied. See id.; Alemany v. Brown, 9 Vet. App. 518, 519 (1996). The Veteran has a current diagnosis of hypertension. Additionally, the Veteran served in the Republic of Vietnam, and therefore his exposure to herbicides is presumed. 38 U.S.C. § 1116(f); 38 C.F.R. § 3.307(a)(6)(iii). Accordingly, the Veteran satisfies the first two criteria of service connection. Turning to the third criterion, the Board first notes that hypertension is not included on the list of diseases presumed to have been incurred in service in Vietnam. 38 U.S.C. § 1116(a); 38 C.F.R. §§ 3.307(a)(6); 3.309(e). However, service connection may be awarded on a direct basis, if the evidence establishes that hypertension is related to herbicide agent exposure. The Board notes that in its 2018 Update the National Academy of Sciences (NAS) indicated that there is “sufficient” evidence of an association between hypertension and herbicide agent exposure. The NAS therefore upgraded hypertension from its prior classification in the “limited or suggestive” evidence category to the category of “sufficient” evidence of an association. That is, “[e]pidemiologic evidence is sufficient to conclude that there is a positive association.” In support of his claim, the Veteran submitted an opinion by a private physician. Following an in-person examination and review of the claims file, the examiner opined that it was more likely than not that the Veteran’s hypertension was related to his active duty service. The examiner rationalized that the Veteran’s in-service occipital headaches and lightheadedness were the early symptoms of his essential hypertension. See November 2018 Ellis Clinic Independent Medical Examination Report. The Board notes that there is a negative etiological opinion of record in the form of June 2020 VA examination report. The June 2020 VA examiner found there was no indication that hypertension had been linked with exposure to herbicides in any possible etiological way. However, as stated above, in 2018 the NAS found sufficient evidence to conclude there was a positive association between exposure to herbicides and hypertension. The Board finds that the evidence for and against the claim, as to whether the Veteran’s hypertension was caused by his active duty service, including his presumed exposure to herbicides, is at least in equipoise. Therefore, the Board resolves reasonable doubt in favor of the Veteran. See 38 U.S.C. § 5107; 38 C.F.R. § 3.102; see also Gilbert, 1 Vet. App. at 55. Accordingly, service connection for hypertension is granted. P.M. DILORENZO Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board S. M. Stedman, Associate 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.