Citation Nr: 21077623 Decision Date: 12/30/21 Archive Date: 12/30/21 DOCKET NO. 18-48 586 DATE: December 30, 2021 REMANDED Service connection for hypertension. REASONS FOR REMAND The Veteran served on active duty from October 1972 to October 1976. The claim is on appeal from a March 2017 rating decision. In December 2021, the Veteran testified at a Board hearing. Service connection for hypertension. The Veteran contends that his hypertension started during his military service. He states that during service many blood pressure readings were taken reflecting hypertension, but that military doctors were reluctant to prescribe medications. See August 2017 notice of disagreement (NOD). At the December 2021 Board hearing, he testified that he received an official diagnosis as early as 1977 shortly after release from service, and has been on hypertension medication since that time. Service treatment records (STRs) show that the Veteran's blood pressure was measured at 126/76 at the time of his August 1972 enlistment examination, and at 136/86 at the time of separation. STRs also show elevated blood pressure readings in September and October 1975. The Veteran was afforded a VA examination in February 2017. The examiner noted elevated blood pressure readings in his STRS; however, the examiner opined that the Veteran's hypertension was less likely than not related to service. She provided the rationale that for a hypertension diagnosis, elevated readings must occur at least one week apart, and that the original elevated readings in service were rechecked one week later and found to be within normal limits. At his December 2021 Board hearing, the Veteran stated that he received treatment for hypertension at Castle Air Force Base (AFB) in 1986. It does not appear that these records have been requested, and are potentially relevant to the Veteran's claim. At the hearing the Veteran also submitted additional private treatment records dating back to 1998, and stated that even earlier records of hypertension treatment were unavailable as they had been destroyed. The Board finds that a new VA examination is warranted with consideration of the newly submitted private treatment records, and treatment records from Castle AFB if available. Additionally, a new opinion is needed to estimate the likely onset of hypertension, to the extent reasonably possible and with consideration of the Veteran's lay statements, and if there is a medical reason for the lack of diagnosis during the Veteran's military service. The matters are REMANDED for the following action: 1. Ask the Veteran to provide releases necessary for VA to secure copies of all records pertaining to his claimed treatment of hypertension at Castle AFB. Make two requests for the authorized records unless it is clear after the first request that a second request would be futile. If any records requested are unavailable, the reason must be explained for in the record. 2. After the steps above have been completed, schedule the Veteran for an examination (or telehealth interview, review of the record, etc., if an in-service examination is not feasible) by an appropriate clinician to determine the nature and etiology of the Veteran's hypertension. The record, including a complete copy of this remand, should be made available for review. The examiner is then asked to opine as to whether the Veteran's hypertension at least as likely as not (50 percent or greater possibility) had its onset during or within one year of service, or is otherwise related to, his active military service. The examiner is asked to specifically consider and address: (1) the Veteran's lay statements of onset of the condition, to include receiving a diagnosis and prescribed medication in 1977; (2) STR entries of elevated blood pressure readings; (3) the estimated onset of hypertension to the extent reasonably possible; and (4) any medical reason why a diagnosis of hypertension was not provided during service. If the absence of treatment before or after service plays a role in the formation of the opinion, the medical importance of this should be explained. The examiner should provide rationale for all opinions expressed, including by citing to the record. RYAN T. KESSEL Veterans Law Judge Board of Veterans' Appeals Attorney for the Board S. Morford, 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.