Citation Nr: 21073180
Decision Date: 12/07/21	Archive Date: 12/07/21

DOCKET NO. 12-29 356
DATE: December 7, 2021

REMANDED

Entitlement to service connection for hypertension, to include as secondary to service-connected disabilities is remanded.

REASONS FOR REMAND

The Veteran served on active duty from November 1974 to November 1994.

This matter comes before the Board of Veterans' Appeals (Board) on appeal from an April 2012 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO).

The Veteran testified by videoconference in May 2013 before the undersigned Veterans Law Judge. A transcript of that hearing has been associated with the file. 

By way of history, the Veteran appealed an August 2017 Board decision, which denied entitlement to hypertension, to the Court of Appeals for Veterans Claims (Court). By a May 2018 Order, the Court, pursuant to a Joint Motion for Remand (JMR), vacated the Board's August 2017 decision and remanded the case for action consistent with the JMR. The Board remanded the case in February 2019 for further development. After completion of the development, the Board again denied the claim in a September 2020 decision and the Veteran appealed to the Court. In a June 2021 JMR, the Court remanded the case to the Board for action consistent with the JMR. 

Entitlement to service connection for hypertension, to include as secondary to service-connected disabilities is remanded.

VA treatment records show the Veteran stated that his blood pressure increases with knee pain. The Court, in the May 2018 JMR, instructed the Board to obtain a medical opinion for hypertension as secondary to service connected bilateral knee disability. In a January 2020 medical opinion, the examiner found that the Veteran's hypertension was not due to or aggravated by his knee condition or any other service-connected disability. He also noted that the Veteran has several service-connected conditions involving pain, but pain is not a causative or aggravating factor for hypertension. 

In a March 2020 rating decision, just two months after the VA hypertension examination, the Veteran was service connected for additional conditions, including allergic rhinitis and bilateral lower extremity radiculopathy. The Board then denied the hypertension claim in September 2020, without any further medical opinions contemplating the additional service connected disabilities.  The June 2021 JMR directs the Board to address whether a medial opinion is needed to determine whether these additional service connected disabilities caused or aggravated the Veteran's claimed hypertension.  As there is no medical opinion of record concerning these questions, one will be sought.  

The matters are REMANDED for the following action:

1. The Veteran should be asked to identify any additional records he wishes considered relating to this claim.  The identified records should be sought.

2. Obtain a VA medical opinion by an appropriate clinician to address the following:  

(a.) whether the Veteran's hypertension is at least as likely as not proximately due to his service-connected allergic rhinitis and bilateral lower extremity radiculopathy, or 

(b.) whether it is at least as likely as not the Veteran's hypertension has been aggravated beyond its natural progression by his service- connected allergic rhinitis and bilateral lower extremity radiculopathy.

The claims file should be made available and reviewed by the opinion provider. If deemed necessary, afford the Veteran a VA examination. The reasons for the conclusions expressed should be fully explained in the report. 

 

M. E. KILCOYNE

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	B. Jaigirdar, 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.