Citation Nr: 21071725 Decision Date: 12/01/21 Archive Date: 12/01/21 DOCKET NO. 18-10 090 DATE: December 1, 2021 ORDER Entitlement to service connection for hypertension is denied. FINDING OF FACT The preponderance of the evidence of record is against finding that the Veteran has had hypertension for VA purposes at any time during or approximate to the pendency of the claim. CONCLUSION OF LAW The criteria for service connection for hypertension are not met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 4.104. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Army from March 2000 until his honorable discharge in April 2006 and from April 2009 until his honorable discharge in May 2010. These matters come before the Board of Veterans' Appeals (Board) on appeal from an October 2016 rating decision of the Regional Office of the Department of Veterans Affairs (VA). In July 2020, the Veteran testified before the undersigned at a hearing via videoconference. A transcript of his testimony has been associated with the claims file. In February 2021, the Board remanded the case to the Regional Office for further development. Specifically, the Board directed the Regional Office to obtain a new VA examination directly addressing whether the Veteran had a current diagnosis of hypertension for VA purposes. Service Connection VA provides compensation for a disability resulting from disease or injury incurred in or aggravated by service. This is referred to as a "service connection." 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. Regulations also provide that service connection may be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). Generally, service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303(a). To establish a right to compensation for a present disability, a Veteran must show: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service the so-called "nexus" requirement. Holton v Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2009) (quoting Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004)). Service connection may be granted for any disease initially diagnosed after discharge when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). Furthermore, in deciding whether service connection is warranted for a disability, VA is responsible for determining whether the evidence supports the claim or is in relative equipoise, with the Veteran prevailing in either event, or whether a preponderance of the evidence is against the claim, in which case the claim is denied. 38 U.S.C. § 5107 (2014); 38 C.F.R. § 3.102 (2018); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of the matter, the benefit of the doubt will be given to the Veteran. Id. 1. Entitlement to service connection for hypertension. The Veteran asserts that service connection is warranted for hypertension. Service connection based on any theory of entitlement is not warranted without a current diagnosis. Brammer v. Derwinski, 3 Vet. App. 223, 225 (1992). The evidence demonstrates that the Veteran has no current diagnosis of hypertension. Under VA regulations, hypertension must be confirmed by readings taken two or more times on at least three different days. The regulation also clarifies that the term "hypertension" means that the diastolic blood pressure is predominantly 90mm or greater, and isolated systolic hypertension means that the systolic blood pressure is predominantly 160mm or greater with a diastolic blood pressure of less than 90mm. 38 C.F.R. § 4.104, Diagnostic Code (DC) 7101, Note (1). Additionally, in order for hypertension to be considered compensably disabling, the evidence must show that diastolic pressure is predominantly 100 or more, systolic pressure is predominantly 160 or more, or there is a history of diastolic pressure predominantly 100 or more requiring continuous medication for control. 38 C.F.R. § 4.104, DC 7101. The Veteran was afforded a VA examination in April 2021. The examiner noted that the blood pressure readings reported by the Veteran as well as the readings taken at his examination would not lead to a diagnosis of hypertension for VA purposes. The April 2021 VA examiner took readings of 128 over 85, 132 over 70, and 136 over 82. Prior blood pressure readings in the August 2016 VA examination were also not sufficient to diagnosis him with hypertension. He reported readings from home of 164 over 85, 152 over 90 on April 28, 2021, and of 145 over 97 and 147 over 88 on April 29, 2021. While he is competent to describe his symptoms, he does not have the requisite medical training, expertise, or credentials needed to render a diagnosis or a competent opinion as to medical diagnosis of hypertension. Therefore, the Veteran is not competent to provide an opinion on whether or not he has hypertension. See Jandreau v. Nicholson, 492 F. 3d 1372, 1377 (2007). He is also not competent to take his own blood pressure and does not have the requisite medical training and knowledge to do so. The Board gives the readings taken by medical professionals at his VA examinations and at VA treatment appointments more weight than the readings provided by the Veteran and taken at his home. The Veteran has never been diagnosed with hypertension and he has never been on hypertension medications. See July 2020 VA Hearing Transcript. There is no competent medical evidence of record that the Veteran has a diagnosis of hypertension for VA purposes or that he has been prescribed or taken medication to control hypertension symptoms. As such, his claim for entitlement to service connection for hypertension is denied. In reaching this decision, the Board considered the doctrine of reasonable doubt, however, as the preponderance of the evidence is against the Veteran's claim, the doctrine is not for application. Gilbert v. Derwinski, 1 Vet. App. 49 (1990). M. Tenner Veterans Law Judge Board of Veterans' Appeals Attorney for the Board S. A. Johnston, 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.