Citation Nr: 21076360 Decision Date: 12/23/21 Archive Date: 12/23/21 DOCKET NO. 18-20 965 DATE: December 23, 2021 REMANDED Service connection for hypertension is remanded. REASONS FOR REMAND The Veteran served on active duty from October 1984 to October 1987 in the U.S. Army. This matter comes before the Board of Veterans' Appeals (Board) from an April 2014 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO) in Huntington, West Virginia. The Veteran testified before the undersigned Veterans Law Judge at a Board hearing in April 2021. A copy of the transcript is associated with the record. This matter was previously before the Board in June 2021, at which time the issue on appeal was remanded to obtain a new VA examination and opinion. Although further delay is regrettable, the Board finds that remand is necessary for additional development. The Veteran was afforded a VA examination in October 2021. However, the Board finds the VA opinion is inadequate because it is conclusory and did not consider all medications and treatment for his service-connected colitis. Additionally, the Veteran contends that his hypertension is related to weight fluctuation due to his colitis. See August 2013 Correspondence. The Veteran's VA and private treatment records document weight fluctuation and obesity. However, this was not addressed in the October 2021 VA opinion. The Veteran also contends that his hypertension is related to his service-connected psychiatric disability. See April 2021 Hearing Transcript. During the examination, the Veteran reported that his hypertension had its onset when he began having panic attacks. The Board cannot make a fully-informed decision on the issue of service connection for hypertension because no VA examiner has opined whether his hypertension is related to his service-connected depression with specific phobia. Accordingly, remand is warranted to obtain a new VA opinion. The matter is REMANDED for the following action: Obtain an opinion from an appropriate physician to determine the nature and etiology of the Veteran's hypertension. If an examination is deemed necessary to respond to the questions presented, one should be scheduled. After review of the claims file, the physician should opine as to the following: (a.) Whether it is at least as likely as not (50 percent or greater probability) that the Veteran's hypertension is (1) proximately due to or (2) aggravated beyond its natural progression by the Veteran's service-connected colitis or depression with specific phobia, specifically including weight fluctuation due to colitis, panic attacks, anxiety, and any and all treatment and medication taken by the Veteran to treat his conditions. (b.) Whether it is at least as likely as not that obesity served as an "intermediate step" between the Veteran's service-connected disabilities and his hypertension, specifically including any and all treatment and medication taken by the Veteran to treat his conditions. The physician should opine whether the Veteran's service-connected disabilities caused or aggravated the Veteran's obesity. If so, was the obesity that resulted from the service-connected disabilities a substantial factor in causing his hypertension? Would his hypertension have occurred, but for the obesity caused by the service-connected disabilities? The physician should identify and discuss all treatment and medications prescribed to the Veteran for his colitis and depression with specific phobia. The physician must consider the Veteran's medical history and lay statements of record. A complete rationale must be provided for all opinions offered. If an opinion cannot be offered without resort to mere speculation, the physician must fully explain why this is the case and identify what additional evidence, if any, would allow for a more definitive opinion. JOHN Z. JONES Veterans Law Judge Board of Veterans' Appeals Attorney for the Board T. Kernen, 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.