Citation Nr: 21065080 Decision Date: 10/25/21 Archive Date: 10/25/21 DOCKET NO. 17-45 432 DATE: October 25, 2021 ORDER Entitlement to service connection for hypertension as secondary to service-connected posttraumatic stress disorder (PTSD) is granted. REMANDED Entitlement to a total disability rating based on individual unemployability due to service-connected disabilities (TDIU) is remanded. FINDING OF FACT The Veteran's hypertension is causally related to his service-connected PTSD. CONCLUSION OF LAW The criteria for entitlement to service connection for hypertension as secondary to service-connected PTSD have been met. 38 U.S.C. §§ 1110, 1131, 5107(b); 38 C.F.R. §§ 3.102, 3.310(a). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from July 1970 to July 1974, with subsequent service in the United States Marine Corps Reserves from February 1977 to January 1981, including a period of ACDUTRA in July 1979. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a February 2016 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). This matter was remanded by the Board in May 2020 for further development. 1. Entitlement to service connection for hypertension as secondary to service-connected PTSD is granted. Service connection may be established on a secondary basis for a disability proximately due to or aggravated by a service-connected disease or injury. 38 C.F.R. § 3.310; see also Ward v. Wilkie, 17-1204 (holding that a "permanent worsening" of a non-service-connected disability is not required to establish secondary service connection on the basis of aggravation (i.e., aggravation may include temporary worsening of a disability); Allen v. Brown, 7 Vet. App. 439 (1995) (en banc). To establish secondary service connection, a veteran must show: (1) the existence of a present disability; (2) the existence of a service-connected disability; and (3) a causal relationship between the present disability and the service-connected disability. See Wallin v. West, 11 Vet. App. 509, 512 (1998). Here, the Veteran is service connected for PTSD. He submitted an opinion from a private physician who found that his hypertension is causally related to his PTSD. See May 2019 Private Medical Evaluation. The Board finds the private physician's opinion highly probative, as he discussed in detail the Veteran's history and supported the opinion with rationale. There is no contrary medical evidence of record. Accordingly, entitlement to service connection for hypertension as secondary to service-connected PTSD is granted. REASONS FOR REMAND 2. Entitlement to a TDIU is remanded. The Veteran asserts that his service-connected disabilities impact his ability to obtain and maintain substantially gainful employment. On remand the Board finds that a VA examination and opinion are warranted to address the impact of the Veteran's service-connected disabilities on his occupational functioning. The matters are REMANDED for the following action: 1. Obtain the Veteran's updated VA treatment records. 2. Schedule the Veteran for an appropriate VA examination or telehealth interview, review of the record, etc. if an in-person examination is not feasible) to evaluate the issue of entitlement to a TDIU. The examiner should elicit from the Veteran his complete educational, vocational, and employment history and should note his complaints regarding the impact of his service-connected disabilities on his employment. After a full examination and review of the claims file, the examiner should identify all limitations imposed on the Veteran as a consequence of his service-connected disabilities. The examiner is asked to comment on and describe the functional impairment caused solely by the service-connected disabilities as it pertains to the Veteran's ability to function in an occupational environment. The opinion need not state whether the Veteran's disabilities prevent him from obtaining or maintaining substantially gainful employment, or whether the Veteran is capable of sedentary employment. Rather, the examiner should discuss how and to what extent the Veteran's service-connected disabilities affect his ability to perform occupational tasks. The examiner should, for instance, describe the limitations and restrictions imposed by his service-connected conditions with respect to factors such as her ability to sit, stand, walk, lift, carry, push, pull, bend, and maintain energy and focus for up to eight hours per day, and in terms of whether such disabilities might require absences from work and/or breaks from work. The examiner must provide a comprehensive report including complete rationales for all opinions and conclusions reached, citing the objective medical findings leading to the conclusions. If any opinion cannot be rendered without resorting to speculation, the examiner must state whether the need to speculate is caused by a deficiency in the state of general medical knowledge, i.e., no one could respond given medical science and the known facts, or by a deficiency in the record or the examiner, i.e., additional facts are required, or the examiner does not have the needed knowledge or training. P.M. DILORENZO Veterans Law Judge Board of Veterans' Appeals Attorney for the Board T. Mohammad 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.