Citation Nr: 21075336 Decision Date: 12/20/21 Archive Date: 12/20/21 DOCKET NO. 15-06 773A DATE: December 20, 2021 REMANDED Entitlement to service connection for hypertension is remanded. REASONS FOR REMAND The Veteran served in active-duty service with the Army from January 1997 to June 1998. This matter is on appeal from a September 2014 rating decision. The Board remanded this appeal in July 2018 and August 2021 for additional development. Unfortunately, the Board finds that remand is warranted for additional development. In the August 2021 Board decision, the Board remanded for an addendum opinion to consider elevated blood pressure readings in May 1997 in the Veteran's service treatment records (STRs)a where they were recorded at 145/90 and 136/88 respectively. In a September 2021 VA addendum opinion, the examiner opined that it was less likely than not the Veteran's hypertension was related to active-duty service. The examiner stated that they were unable to locate any record indicating the Veteran's hypertension was diagnosed within one year of separation from service. The examiner first stated that all relevant records have been reviewed. The examiner next addressed the May 1997 elevated blood pressure readings of 145/90 and noted the Veteran was being seen for an injury to his hand at the time. The examiner indicated that subsequent blood pressure readings were within normal limit and further stated that "in order to diagnosis hypertension there needs to be different readings on three different days of elevated blood pressure to diagnosis hypertension." However, the Board notes that review of the Veteran's STRs shows that apart from the May 1997 elevated blood pressure readings, there were also elevated blood pressure readings in July 1997 measured at 134/81 and then in August 1997 measured at 131/88. The examiner does not address these readings or explain why these readings were not considered in determining whether there was a diagnosis of hypertension. As such, the Board finds the opinion inadequate, and remand warranted for addendum opinion. The matters are REMANDED for the following action: 1. Obtain and associate with the claims file all updated and outstanding treatment records. 2. Return the claims file to the VA examiner who provided the September 2021 VA medical opinion, if available, for clarification and additional opinions. If that examiner is not available, the claims file should be provided to another physician to obtain the requested opinion. After review of the claims file, the examiner is asked to respond to the following: (a.) Address the July 1997 and August 1997 elevated blood pressure readings of 134/81 and 131/88 to evaluate if the readings are sufficient for reconsideration of the opinion findings of no diagnosis of hypertension in service. (b.) The examiner is advised that the Veteran is competent to report in-service events and treatment, and the Veteran's symptoms and history, and such reports and assertions must be specifically acknowledged and considered in formulating any opinions. If the examiner rejects the Veteran's reports, the examiner must provide a reason for doing so. (c.) If the VA examiner is unable to provide an opinion without resort to speculation, he or she should explain whether the inability is due to the limits of the examiner's medical knowledge, medical knowledge in general or there is evidence that, if obtained, would permit the opinion to be provided. A clearly stated rationale for any opinion offered should be provided. 3. After completion of the above and any additional development deemed necessary, the issues on appeal should be reviewed with consideration of all applicable laws and regulations. If any benefit sought remains denied, the Veteran should be furnished a supplemental statement of the case and be afforded the opportunity to respond. Thereafter, the case should be returned to the Board for appellate review. MICHAEL LANE Veterans Law Judge Board of Veterans' Appeals Attorney for the Board J. Yang, Attorney-Advisor 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.