Citation Nr: 21065173 Decision Date: 10/25/21 Archive Date: 10/25/21 DOCKET NO. 20-03 805 DATE: October 25, 2021 REMANDED Entitlement to service connection for hypertension is remanded. REASONS FOR REMAND This appeal has been advanced on the Board's docket pursuant to 38 C.F.R. § 20.900(c). 38 U.S.C. § 7101(a)(2). The Veteran served on active duty in the Army from June 1956 to June 1958. This case comes before the Board of Veterans' Appeals (Board) on appeal from an August 2016 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO). In August 2020, the Board remanded the Veteran's claim for additional development. The Board notes there was substantial compliance with its August 2020 remand directives. See Stegall v. West, 11 Vet. App. 268, 271 (1998); D'Aries v. Peake, 22 Vet. App. 97, 105 (2008). However, the Board regrettably finds that another remand is necessary, prior to readjudication of the claim. The Veteran contends that he currently has hypertension that had its onset during active service, or was otherwise incurred during active duty service. After review of the record, the Board finds that further development of the medical evidence is needed prior to adjudication of the claim, and in accordance with VA's duty to assist. In May 2021, the Veteran was afforded a VA examination and medical opinions to determine the current nature and etiology of his claimed condition. Upon examination, the examiner diagnosed the Veteran with hypertension, and provided favorable opinions that the condition had its onset during active duty service and manifested within one year of his separation. However, the Board finds these opinions to be inadequate due to the examiner failing to provide rationales to support the overall positive conclusions. Due to the inadequacies of the May 2021 VA medical opinions, the VA requested that addendum VA medical opinions be provided, which was completed in August 2021. Upon review, the examiner provided unfavorable opinions that the Veteran's hypertension had its onset during active service or otherwise manifested within one year of separation from active service. Nevertheless, the Board finds these opinions to also be inadequate, as the examiner improperly relied solely on the lack of objective medical evidence in-service and the lack of contemporaneous medical evidence post-service corroborating a diagnosis of hypertension. Additionally, the examiner provided contradictory statements noting that the Veteran did not recall the onset of his hypertension, but further stated that the Veteran reported being treated for hypertension in service. Lastly, the examiner noted that a review of the records in the claims file were silent for a mention of hypertension in service, in which the Board finds inaccurate, as the file does not contain the Veteran's service treatment records (STRs) for review due to them being destroyed in a fire. Therefore, the Board finds that the Veteran should be provided addendum VA medical opinions that adequately addresses the claim. Accordingly, a remand is necessary to address the matter discussed above. The matter is REMANDED for the following action: 1. Request the Veteran to identify all medical providers (VA and private) from whom he has received treatment for his hypertension and obtain any outstanding records and associate them with the Veteran's claims file. 2. After associating all newly acquired records with the claims file, send the claims file back to the August 2021 VA examiner, to provide addendum VA medical opinions to determine the nature and etiology of the Veteran's hypertension. If the August 2021 VA examiner is not available, please forward the claims file back to the May 2021 VA examiner. If the May 2021 and August 2021 VA examiners are both not available, please forward the claims file to another appropriate clinician. The entire claims file, including a copy of this remand, must be made available to the examiner, and note review of the record in the examination report. Any indicated tests or studies should be performed, and all relevant evidence should be discussed. All pertinent medical complaints, symptoms, and clinical findings must be reported in detail. If the examiner finds that a new VA examination must be scheduled prior to providing the opinion, schedule such an examination. Following complete review of the record, the examiner must address the following: (a) Opine whether it is at least as likely as not (50 percent or greater probability) that the Veteran's hypertension had its onset during any period of active duty service, or otherwise is etiologically related to his active duty service. Please note: as the Veteran's STRs are unavailable for review, the examiner cannot rely on this, in any way, to support a negative opinion. Also, as the Board finds that the Veteran's lay statements of record, to include being treated for hypertension during active service, are competent and credible, the examiner must discuss these statements in the requested opinions. (b) Any opinion should include a detailed rationale. The examiner should consider the entire claims file, and discuss the Veteran's lay statements regarding the nature, onset, and chronicity of symptoms. The examiner is advised that the Veteran is competent to report symptoms, and that his reports must be considered in formulating the requested opinion. (c) If the examiner is unable to offer the requested opinion, it is essential that the examiner offer a rational for the conclusion that an opinion could not be provided without resorting to speculation, together with a statement as to whether there is additional evidence that could enable an opinion to be provided, or whether the inability to provide the opinion is based on the limits of medical knowledge. DELYVONNE M. WHITEHEAD Veterans Law Judge Board of Veterans' Appeals Attorney for the Board B. Hodges, 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.