Citation Nr: 21075756 Decision Date: 12/21/21 Archive Date: 12/21/21 DOCKET NO. 19-03 662 DATE: December 21, 2021 REMANDED Entitlement to service connection for hypertension is remanded. Entitlement to service connection for an acquired psychiatric disorder is remanded. REASONS FOR REMAND The Veteran served a period of active duty for training (ACDUTRA) from September 1975 to December 1975 with the United States Army Reserve, with additional service to be determined. In December 2020, he testified at a hearing before the undersigned Veterans Law Judge. A transcript of the proceeding is in the record. 1. Entitlement to service connection for hypertension is remanded. The Veteran contends that he has experienced periods of high blood pressure since a period of reserve service sometime in 1980 or 1981. See Board hearing testimony. He also related his hypertension to pain he experiences from his service-connected residuals of a stress fracture to the feet. Initially, the Board observes that the record appears to have an incomplete set of the Veteran's military personnel records. Remand is needed to obtain records related to his Army Reserve service and to verify all qualifying periods of service. In July 2016, the Veteran underwent a VA examination where he was diagnosed with hypertension. However, the examiner's opinion failed to address the Veteran's direct service connection theory of entitlement. While the opinion addressed secondary service connection, the opinion was conclusory and relied on the wrong legal standard addressing whether hypertension was aggravated by the Veteran's service-connected bilateral feet disabilities. Remand is needed to obtain a more thoroughly reasoned addendum opinion addressing all theories of entitlement. 2. Entitlement to service connection for an acquired psychiatric disorder is remanded. The Veteran generally contends that he suffers from an acquired psychiatric disorder that began sometime in 1980 or 1981 during a period of reserve service. He stated that while convoying some trucks to Fort Sill in Oklahoma he experienced a panic attack. He has also attributed his panic attack symptoms to his high blood pressure and his service-connected bilateral feet disabilities. See June 2012 hearing testimony. In July 2016, the Veteran underwent a VA mental disorders examination. The examination report provides contradictory findings that the Veteran has been diagnosed with a mental disorder, and that there is no mental disorder diagnosis. No explanation was provided for the contradictory statements in the report. The Veteran's VA treatment records show that as recently as December 2019, depression was listed among his active medical problems. Remand is needed to obtain a new VA examination and opinions to address whether any diagnosed psychiatric condition during the appeal period is related to either any verified period of military service or secondary to his service-connected disabilities. The matters are REMANDED for the following action: 1. Take appropriate steps to verify the Veteran's periods of military service, including all periods of active duty, active duty for training, and inactive active duty for training. Document all requests for information as well as all responses in the record. 2. If additional periods of service are verified, obtain complete service treatment records and service personnel records for any period of service. Document all requests for information as well as all responses in the record. 3. After completion of the above, obtain an opinion from an appropriate clinician regarding the likely etiology of the Veteran's diagnosed hypertension. Copies of all pertinent records must be made available to the examiner for review. If the examiner determines that an opinion cannot be provided without an examination, (or telehealth interview, review of the record, etc., if an in-person examination is not feasible) one should be scheduled. The clinician should answer the following questions: (a.) Is it at least as likely as not (50 percent probability or greater) that the Veteran's diagnosed hypertension had its onset in or is otherwise related to a verified period of military service? (b.) Is it at least as likely as not (50 percent probability or greater) that the Veteran's diagnosed hypertension was caused or aggravated (defined as any increase in disability) by his service-connected residuals of a stress fracture to the feet? A complete rationale must be provided that considers both the medical evidence of record, as well as the Veteran's statements concerning the onset and progression of his disability. 4. Schedule the Veteran for a psychiatric examination (or telehealth interview, review of the record, etc., if an in-person examination is not feasible) to determine the nature and etiology of any acquired psychiatric disability diagnosed during the appeal period, that is, since June 2012. If the Veteran is diagnosed with PTSD, the examiner must explain how the diagnostic criteria are met and opine whether it is at least as likely as not related to a verified in-service stressor. If any other acquired psychiatric disorders are diagnosed, the examiner must opine whether each diagnosed disorder is at least as likely as not related to a verified period of military service. The examiner is also asked to address whether it is at least as likely as not that any diagnosed psychiatric condition was caused or aggravated (defined as any increase in disability) by his service-connected residuals of a stress fracture to the feet. A complete rationale must be provided for all opinions. If the examiner cannot provide an opinion without resort to speculation, the examiner must state why this is so. 5. Confirm that the VA medical opinion provided comports with this remand, specifically that the standard for the secondary aggravation opinion is any increase in disability, not the standard of beyond the natural progression as noted on the examination form itself. If not, get an addendum. M. E. LARKIN Veterans Law Judge Board of Veterans' Appeals Attorney for the Board J. Komperda, 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.