Citation Nr: 21004040 Decision Date: 01/25/21 Archive Date: 01/25/21 DOCKET NO. 10-41 510 DATE: January 25, 2021 REMANDED Entitlement to service connection for hypertension is remanded. Entitlement to service connection for a cervical spine disability is remanded. REASONS FOR REMAND The Veteran served on active duty from September 1977 to August 1994. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a March 2010 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). In January 2015, the Veteran testified at a hearing before the undersigned Veterans Law Judge. A transcript of that hearing is of record. This matter was last before the Board in February 2020 and was remanded for further development. The case has been returned to the Board for further appellate action. 1. Entitlement to service connection for hypertension is remanded 2. Entitlement to service connection for a cervical spine disability is remanded The Veteran asserts that his hypertension is secondary to his service-connected post-traumatic stress disorder (PTSD) and that a cervical spine disability is secondary to his service-connected arthritis of the lumbar spine. In December 2016, a VA examiner opined that the Veteran’s hypertension was not caused by his PTSD and that a cervical spine disability not caused by his arthritis of the lumbar spine. In March 2018, the Board remanded both claims in order to obtain opinions as to whether the claimed disabilities were aggravated by the service-connected disabilities. See Allen v. Brown, 7 Vet. App. 439, 448-49 (1995). In October 2019, a VA examiner reviewed the evidence of record and opined that the Veteran’s hypertension was not aggravated by his PTSD because “no psychiatric disease causes hypertension.” The examiner also opined that a cervical spine disability was not aggravated by the Veteran’s arthritis of the lumbar spine because there is “no nexus of the two.” As the examiner essentially reiterated the previous opinions regarding causation and failed to provide a rationale to support either conclusion, the Board remanded the claims in February 2020 to obtain supplemental opinions. In accordance with the February 2020 remand directives an addendum opinion was obtained in March 2020. Nevertheless, the same examiner did not provide adequate rationales for his conclusions. While further delay is regrettable, in light of the above, the Board finds that an additional remand is warranted for a new opinion by an examiner who has not previously examined the Veteran to address the claims. See Stegall v. West, 11 Vet. App. 268, 271 (1998). The matters are REMANDED for the following action: 1. Obtain a medical opinion, from a different examiner if possible, with respect to the Veteran’s service connection claim for hypertension. If another examination is deemed necessary to respond to the question, one should be scheduled. After a review of the claims file, the examiner should provide an opinion as to whether it is at least as likely as not (50 percent or higher probability) that the Veteran’s hypertension was worsened beyond normal progression (aggravated) by his service-connected PTSD. Please explain why or why not. If the examiner finds the hypertension has been aggravated by service-connected PTSD, the examiner should attempt to quantify the degree of aggravation beyond the baseline level of the hypertension that is due to service-connected PTSD. 2. Obtain a medical opinion, from a different examiner if possible, with respect to the Veteran’s service connection claim for a cervical spine disability. If another examination is deemed necessary to respond to the question, one should be scheduled. After a review of the claims file, the examiner should provide an opinion as to whether it is at least as likely as not (50 percent or higher probability) that a current cervical spine disability was worsened beyond normal progression (aggravated) by the Veteran’s service-connected arthritis of the lumbar spine. Please explain why or why not. If the examiner finds the cervical spine disability has been aggravated by the service-connected lumbar spine disability, the examiner should attempt to quantify the degree of aggravation beyond the baseline level of the cervical spine disability that is due to the service-connected lumbar spine disability. K. A. BANFIELD Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A. Asare, 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.