Citation Nr: 21063286 Decision Date: 10/13/21 Archive Date: 10/13/21 DOCKET NO. 17-10 855 DATE: October 13, 2021 REMANDED Entitlement to service connection for hypertension, to include as secondary to herbicide exposure, is remanded. Entitlement to service connection for chronic obstructive pulmonary disease (COPD), to include as secondary to herbicide exposure, is remanded. REASONS FOR REMAND The Veteran had active military service from December 1967 to May 1971. He is the recipient of several medals, to include a Republic of Vietnam Gallantry Cross, a Vietnam Service Medal, and a Vietnam Campaign Medal. These matters come before the Board of Veterans' Appeals (Board) on appeal from a September 2013 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO). 1. Entitlement to service connection for hypertension, to include as secondary to herbicide exposure, is remanded. 2. Entitlement to service connection for COPD, to include as secondary to herbicide exposure, is remanded. The Veteran contends that his hypertension and COPD are related to his military service. Specifically, he contends that his conditions are related to Agent Orange (AO) exposure. Service personnel records document that the Veteran had service in the Republic of Vietnam from May 1968 to May 1969. Therefore, his exposure to AO (herbicide agents) is conceded. To support this theory of entitlement, the Veteran's representative referenced a medical article, "Veterans and Agent Orange (AO): Update 11" (2018). See IHP, September 2021. The article contends that there is now "sufficient" evidence of an association between hypertension and herbicide agent exposure to warrant service connection. In light of the medical literature referenced by the Veteran's representative showing suggestive evidence of an association between hypertension and Agent Orange exposure, the Board finds that a medical opinion must be obtained to address this theory of entitlement to service connection, as well as to direct service connection. See 38 U.S.C. § 5103A; McClendon v. Nicholson, 20 Vet. App. 79, 81 (2006). Additionally, the Veteran has not been afforded a VA examination with respect to his COPD claim. There is no medical opinion of record as to whether the Veteran's claimed condition is related to his military service, including presumed exposure to herbicide agents. Where there is evidence of a current disability and an in-service incident or injury, and the possibility of a nexus between them, remand is required to obtain an examination and medical opinion. 38 U.S.C. § 5103A; 38 C.F.R. § 3.159. The matters are REMANDED for the following actions: 1. Obtain updated VA treatment records that are not already associated with the claims file. 2. Schedule the Veteran for a VA examination with an examiner with appropriate expertise to determine the nature and etiology of the Veteran's hypertension. After a thorough review of the claims file and examination, the examiner is asked to address the following: (a.) Whether the Veteran's hypertension is at least as likely as not (50 percent or greater probability) (i) incurred in service, (ii) incurred within a year of service, or (iii) caused by service, to include the Veteran's conceded exposure to Agent Orange herbicides. The examiner is cautioned that an opinion based solely on the fact that any diagnosed condition is not a presumptive condition for herbicide exposure is not sufficient. Rather, the examiner is to address the Veteran's specific military history, exposure history, medical history, risk factors, and any other relevant factors in ascertaining whether his hypertension is attributable to service in light of his in-service herbicide exposure. The examiner should consider the full record, to include the lay statements in support of the Veteran's claim and the medical article referenced by the Veteran indicating a relationship between herbicide exposure and hypertension: "Veterans and Agent Orange (AO): Update 11" (2018). 3. Schedule the Veteran for a VA respiratory conditions examination to determine the nature and etiology of his COPD. After a thorough review of the claims file and examination, the examiner is asked to address the following: (a.) Whether it is at least as likely as not (50 percent or greater probability) that the Veteran's COPD was (i) incurred in service, (ii) incurred within a year of service, or (iii) caused by service, to include the Veteran's conceded exposure to Agent Orange herbicides. The examiner is cautioned that an opinion based solely on the fact that any diagnosed condition is not a presumptive condition for herbicide exposure is not sufficient. Rather, the examiner is to address the Veteran's specific military history, exposure history, medical history, risk factors, and any other relevant factors in ascertaining whether his COPD is attributable to service in light of his in-service herbicide exposure. A complete rationale for all opinions reached should be provided. KRISTI L. GUNN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Krista Johnson, 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.