Citation Nr: 21071091 Decision Date: 11/29/21 Archive Date: 11/29/21 DOCKET NO. 18-04 537 DATE: November 29, 2021 REMANDED 1. A rating in excess of 10 percent for hypertension is remanded. 2. Service connection for a heart condition, to include as secondary to service-connected hypertension is remanded. REASONS FOR REMAND The Veteran served on active duty from February 1985 to February 1988, and from September 2002 to September 2003, with additional Reserve service. This appeal to the Board of Veterans' Appeals (Board) is from a November 2016 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). The Board, in the May 2019 decision, remanded the case to the RO for further development. In the May 2020 decision, the Board denied entitlement to a rating in excess of 10 percent for hypertension. The Veteran appealed the Board's May 2020 decision to the United States Court of Appeals for Veterans Claims (Court), which in an August 2021 order, granted the parties' August 2021 joint motion for remand (JMR), vacating the Board's May 2020 decision and remanding the claim for compliance with the terms of the JMR. 1. A rating higher than 10 percent for hypertension. 2. Service connection for a heart condition, to include as secondary to service-connected hypertension. The Veteran asserts that his hypertension disability is more severe than currently rated. In the August 2021 JMR, the parties agreed that a vacatur and remand of the Board's May 2020 decision was appropriate, considering Bailey v. Wilkie, 33 Vet. App. 188 (2021), which was decided after the decision on appeal. As stated above, the Court granted the August 2021 JMR. The Court stated that, on remand, a retrospective opinion is warranted to allow the Board to apply discuss the impact of the Court's decision in Bailey, and to address whether the evidence of record reasonable raises a claim of entitlement to service connection for a heart condition related to his hypertension claim, such that VA was obligated to develop and adjudicate said heart condition as opposed to requiring the Appellant to initiate the claim separately. Id. Pursuant to 38 C.F.R. § 3.155(d)(2), the claim for service connection for a heart condition as secondary to service-connected hypertension has been raised by the record and is included herein. See Bailey v. Wilkie, 33 Vet. App. 188 (2021) (VA must consider secondary service connection claims that were reasonably raised during VA's consideration of the proper evaluation level of a service-connected disability). The August 2016 VA Hypertension examination report which notes that the Appellant had been diagnosed with hypertension as well as coronary artery disease (CAD) and inferior myocardial infarction. The August 2016 Heart Conditions DBQ reiterated the Veteran's diagnosis of an acute, subacute, or old myocardial infarction, and CAD. It also, in restating a history of the Veteran's heart conditions, noted "a long history of hypertension with lack of control of medications from VA." As such, the Board finds that in the aggregate record, the Veteran has asserted a claim of service connection for a heart condition secondary to his service-connected hypertension. Remand is therefore required for VA to obtain medical opinions that fully address whether the Veteran's nonservice-connected heart condition was secondary to the Veteran's hypertension, and to determine any other manifestations of the Veteran's hypertension. The matters are REMANDED for the following actions: 1. Obtain any outstanding VA treatment records. 2. Obtain an addendum opinion (with examination or telehealth interview only if deemed necessary by the provider) from an appropriate VA medical professional. The examiner should, after review of the record, clarify all manifestations of the Veteran's service-connected hypertension disability. Then, the examiner should opine whether the condition(s) at least as likely as not (50 percent or greater probability) onset during or are otherwise related to the Veteran's military service or to the service-connected hypertension disability. 3. In offering this opinion, the examiner must thoroughly review the claims file and discuss: (a) The August 2016 Hypertensive DBQ's notation that the Veteran was diagnosed with hypertension as well as CAD and inferior myocardial infarction, and (b) The August 2016 Hypertension DBQ referencing the Veteran's long-standing history of hypertension with lack of control of medications from the VA. 4. If the examiner feels that the requested opinions 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). J. Kirby Veterans Law Judge Board of Veterans' Appeals Attorney for the Board T. Booker 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.