Citation Nr: 21072506 Decision Date: 12/03/21 Archive Date: 12/03/21 DOCKET NO. 15-45 686 DATE: December 3, 2021 REMANDED Service connection for hypertension. REASONS FOR REMAND The Veteran served on active duty from November 1990 to May 1991, to include service in Southwest Asia. He also served in the National Guard. The case is on appeal from a January 2012 rating decision. In a June 2018 decision, the Board denied service connection for prostate cancer and a psychiatric disorder. The issue of service connection for hypertension was remanded for additional development. Service connection for hypertension. Pursuant to the Board's June 2018 remand, the Veteran was afforded a VA examination in August 2019. See September 2019 examination report. Thereafter, additional evidence was associated with the file, and thus, an addendum opinion was obtained in June 2021. Although a negative nexus opinion was provided, it does not in any way address the Veteran's assertion that hypertension is a result of exposure to environmental hazards, such as missile explosions, burn pits, and dust, during service in Southwest Asia, including Iraq, in association with his duties as military police in support of Operation Desert Shield/Desert Storm. See DD FORM 214; March 2018 Translation Related documents; October 2010 notice of disagreement; September 2010 Photographs. The Veteran's service records confirm service in Southwest Asia from January 1991 to May 1991. Because the VA examination is incomplete, remand is warranted for an addendum opinion. The matter is REMANDED for the following action: Forward the claims file to an appropriate medical professional in connection with the hypertension claim. The clinician should be provided with and review the Fact Sheets entitled "Burn Pits in Iraq, Afghanistan, and Djibouti on the Horn of Africa" and "Particulate Matter throughout Iraq, Afghanistan, and Djibouti." Whether an in-person examination is necessary is left to the discretion of the examiner. After reviewing the above, the examiner should opine as to whether it is at least as likely as not that the Veteran's hypertension is related to exposure to environmental hazards, including missiles, burn pits, and dust, during service in Southwest Asia, including Iraq, in 1991. The examiner is advised that a negative opinion cannot be based solely on the fact that the disability is not on the list of diseases that are presumptively associated with service in Southwest Asia. Hence, in answering this question, the examiner is asked to disregard whether the disorder is one for which a "presumption" is established and, instead, to answer whether the medical condition is a result of environmental exposures in Southwest Asia even though it is not on any list of "presumptive" diseases. The examiner should not rely on silence in the medical records unless it can be explained: (a) why the silence in the available records can be taken as proof that the symptom(s) did not occur, including why the fact would have normally been recorded if present, or (b) why the absence of medical records is medically significant. Corey Bosely Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M. Taylor 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.