Citation Nr: 21004936 Decision Date: 01/28/21 Archive Date: 01/28/21 DOCKET NO. 14-35 196A DATE: January 28, 2021 ORDER Entitlement to service connection for hypertension is denied. FINDING OF FACT The Veteran’s hypertension did not have its onset during service or within one-year of discharge from service; post-service diagnosed hypertension is not attributable to service. CONCLUSION OF LAW The criteria for entitlement to service connection for hypertension have not been met. 38 U.S.C. §§ 1110, 1112, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from September 1976 to September 1980, with subsequent service in the Reserves. The matter comes before the Board of Veterans’ Appeals (Board) on appeal from a June 2013 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified at a travel board hearing before the undersigned Veterans Law Judge (VLJ) in November 2016. The hearing transcript is of record. The Board remanded the claim in March 2018 and September 2020 for further development by the RO. The case has been returned to the Board for further appellate action. Entitlement to service connection for hypertension The Veteran seeks service connection for hypertension, to include a contention that it was incurred due to in-service asbestos exposure. See May 2017 statement in support of claim. The Veteran’s DD Form 214 shows that his military occupational specialty (MOS) was serviceman store clerk, which is presumed to have had minimal exposure to asbestos. Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. § 3.303. The three-element test for service connection requires evidence of: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury. Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004). Certain chronic diseases, to include hypertension, will be presumed related to service if they were noted as chronic in service; or, if they manifested to a compensable degree within a presumptive period following separation from service; or, if continuity of the same symptomatology has existed since service, with no intervening cause. 38 U.S.C. §§ 1101, 1112, 1113, 1137; Walker v. Shinseki, 708 F.3d 1331, 1338 (Fed. Cir. 2012); Fountain v. McDonald, 27 Vet. App. 258 (2015); 38 C.F.R. §§ 3.303(b), 3.307, 3.309(a). The question for the Board is whether the Veteran has a chronic disease that manifested to a compensable degree in service or within the applicable presumptive period, or whether continuity of symptomatology has existed since service. For VA purposes, hypertension or isolated systolic hypertension must be confirmed by readings taken two or more times on at least three different days. The term hypertension means the diastolic blood pressure (the bottom number) is predominantly 90mm. or greater, and isolated systolic hypertension means that the systolic blood pressure (the top number) is predominantly 160mm. or greater with a diastolic blood pressure of less than 90mm. 38 C.F.R. § 4.104, Diagnostic Code 7101, Note 1. The Board concludes that, while the Veteran currently has hypertension, it was neither chronic in service, nor manifested to a compensable degree in service or within the one-year presumptive period, and continuity of symptomatology is not established. The August 2018 VA examination report indicates that the Veteran was not diagnosed with hypertension until the 1990s, approximately 10 years after separation from service and well outside of the applicable presumptive period. Service connection for hypertension may still be granted on a direct basis; however, the preponderance of the evidence is against finding that a medical nexus exists between the Veteran’s hypertension and service. 38 U.S.C. §§ 1110, 1131; Holton v. Shinseki, 557 F.3d 1363, 1366 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a), (d). The Veteran’s service treatment records (STRs) contain multiple blood pressure readings that are not suggestive of hypertension for VA purposes during service. The STRs are not otherwise suggestive of hypertension during service. The August 2018 VA examiner opined that hypertension is less likely than not incurred in or caused by the claimed in-service injury, event or illness, as a review of medical records showed normal blood pressures throughout active duty. There is no evidence of instances of elevated blood pressure or circumstances that would cause elevated blood pressure. The Veteran was not diagnosed with hypertension until many years following active duty. The Veteran’s exit examination indicated a blood pressure of 118/66. The examiner also noted in the disability benefits questionnaire portion of the examination that the Veteran reported onset following military service, as well as headaches associated with high blood pressure. In an October 2020 addendum, the VA examiner opined that hypertension is less likely than not incurred in or caused by the claimed in-service injury, event or illness, to include exposure to asbestos. The examiner stated that there is no evidence of hypertension while in service, citing the 1980 exit examination blood pressure reading. A U.S. Navy Reserve examination dated 1984 showed a blood pressure reading of 110/72. Onset was noted to be the 1990s, which is more than a decade following service. Furthermore, asbestos exposure is not associated with hypertension, pursuant to current, widely accepted, peer-reviewed medical literature. The Board acknowledges the lay statements of record, to include the Veteran’s reported symptoms of headaches and light-headedness toward the end of his service, and the assertion that the Veteran’s hypertension is related to service. See November 2016 Board hearing. However, the Veteran in this case is not competent to provide a nexus opinion regarding this issue. The issue is medically complex. He does not have the requisite specialized knowledge, training, or credentials to make such a determination. Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (Fed. Cir. 2007); see also Kahana v. Shinseki, 24. Vet. App. 428 (2011). Thus, although the Board has carefully considered the lay contentions of record suggesting that his hypertension began during service, the Board ultimately affords the objective medical evidence of record, which weighs against finding such a connection, with greater probative weight than the lay opinion. Consequently, the Board affords more probative weight to the competent medical evidence of the August 2018 and October 2020 VA examination report and addendum. Here, the Board finds that the August 2018 and October 2020 VA medical opinions are based on an accurate medical and lay history as well as medical documentation provided in the claims file, to include the Veteran’s STRs. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008) (noting that most of the probative value of a medical opinion comes from its reasoning). Additionally, the Board notes that neither the Veteran nor his representative have presented or identified any contrary medical opinion or treatment that supports his claim. As the preponderance of the evidence is against the claim, the benefit-of-the-doubt doctrine cannot be applied. 38 U.S.C. § 5107(b); Gilbert v. Derwinksi, 1 Vet. App. 49, 53-56 (1990). Thus, service connection for hypertension is not warranted. Nathaniel J. Doan Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board M. Minaya, 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.