Citation Nr: 21076402 Decision Date: 12/23/21 Archive Date: 12/23/21 DOCKET NO. 18-04 677A DATE: December 23, 2021 ORDER Entitlement to service connection for hypertension is granted. FINDING OF FACT The Veteran's hypertension began during his active duty service. CONCLUSION OF LAW The criteria for entitlement to service connection for hypertension have been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the Navy from March 1986 to July 2009. This case comes before the Board of Veterans' Appeals (Board) on appeal from a July 2014 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO) in Sioux Falls, South Dakota. In August 2021, the Veteran testified before the undersigned Veterans Law Judge (VLJ) at a virtual hearing. A transcript of the hearing is of record. 1. Entitlement to service connection for hypertension. The Veteran contends that his hypertension began during his active duty service, as evidenced by his in-service elevated blood pressure readings. Generally, service connection may be granted for a disability resulting from disease or injury incurred in or aggravated during military service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. Establishing service connection generally requires evidence showing (1) current disability; (2) in-service incurrence in or aggravation of a disease or injury; and (3) a nexus between the claimed in-service disease or injury and the present disability. Holton v. Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2010); 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a). Additionally, service connection may be granted for a disease that is first diagnosed after discharge when the evidence establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). Certain "chronic diseases", such as hypertension, may be presumed to have been incurred during service if manifested to a compensable degree within one year of separation from active military service; however, if the evidence of the record is insufficient to establish a disease was chronic in service, and/or manifested within the specified time period, then there must be a continuity of disease symptoms shown after discharge in order to warrant service connection. 38 C.F.R. § 3.303(b). The requirement that a chronic disease become manifest to a degree of 10 percent during service, or the applicable post-service presumptive period does not require that the chronic disease be diagnosed during the presumptive period, but only that there be then shown by acceptable medical or lay evidence characteristic manifestations of the disease to the required degree, followed without unreasonable time lapse by definite diagnosis. Symptomatology shown in the prescribed period may have no marked significance when first observed, but in the light of subsequent developments it may gain considerable significance. 38 C.F.R. § 3.307(c). The Veteran is currently diagnosed with hypertension, as shown by post-service VA medical treatment records in the claims file. Service treatment records (STRs) reveal the Veteran had numerous elevated blood pressure readings in 1992, 1998, 2001, 2002, 2004, 2005, 2006, and 2007, with an assessment/diagnosis of hypertension given in October 2008. Post-service medical records also reveal elevated blood pressure readings and history of hypertension, with prescribed medication for treatment. The Board notes that while the Veteran's elevated in-service blood pressure readings and in-service diagnosis of hypertension do not meet the VA criteria of hypertension (due to his diastolic pressure not being greater than or equal to 90 mm HG or his systolic pressure not being greater than or equal to 160mm HG, confirmed by readings taken two or more times on at least three different days. 38 C.F.R. § 4.104, Diagnostic Code 7101, Note (1)), the Board takes judicial notice that hypertension is medically defined as "sustained elevation of resting systolic blood pressure (130 mm Hg), diastolic blood pressure (80 mm Hg), or both." See https://www.merckmanuals.com/professional/cardiovascular-disorders/hypertension/hypertension. Under the commonly accepted definition for a diagnosis of hypertension, the Veteran's in-service readings would have qualified him as hypertensive, and the in-service diagnosis given deemed appropriate. Additionally, the Board reiterates that there is no requirement for such a diagnosis for VA purposes in service or within the one-year presumptive period to establish service connection for a chronic disease. See Traut v. Brown, 6 Vet. App. 495 (1994) (establishing service connection on a presumptive basis does not require that a chronic disease be diagnosed within the applicable time period; rather, symptoms that manifest within this time period may subsequently be determined to have been early manifestations of a chronic disease). Therefore, due to the elevated blood pressure readings in service (medically defined as hypertensive) and post-service, the Veteran's lay statements regarding onset, clinical evidence showing a diagnosis of hypertension less than a year before his separation from active duty, and post-service clinical evidence of a history of hypertension with prescribed medication, the Board finds that, resolving all reasonable doubt in favor of the Veteran, there is a sufficient basis to find that this chronic disease first manifested in service and has continued ever since. As such, service connection for the Veteran's hypertension is warranted; and the claim is granted. DELYVONNE M. WHITEHEAD Veterans Law Judge Board of Veterans' Appeals Attorney for the Board B. Carter, 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.