Citation Nr: 21005428 Decision Date: 02/01/21 Archive Date: 02/01/21 DOCKET NO. 13-11 692 DATE: February 1, 2021 REMANDED Entitlement to service connection for hypertensive heart disease is remanded. REASONS FOR REMAND The Veteran served on active duty from May 1970 to January 1972, and active duty for training in May 1995. This matter is before the Board of Veterans’ Appeals (Board) on appeal from a rating decision by a Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified before the undersigned Veterans Law Judge in December 2015. A transcript is included in the record. 1. Hypertensive Heart Disease The Veteran contends that his hypertensive heart disease is etiologically related to service, specifically due to exposure to a herbicide or toxic chemicals during Operation Red Hat. In the alternative, the Veteran contends that his service-connected disabilities caused or aggravated his hypertensive heart disease. The record contains October 2020 memorandums that indicates that research was conducted into whether the Veteran was exposed to toxins or a herbicide during the Veteran’s service. The response in the memorandum was there was no pending or associated exposure. The Veteran submitted evidence of exposure to toxic munitions from January 1971 to September 1971. The Veteran submitted an October 1971 “Certificate of Achievement” for exception performance of duty in connection of the removal of toxic chemical munitions. The record on appeal also contains a copy of a photograph that includes the Veteran, noting that he was part of personnel sent TDY from the 175th Ordnance Company during operation Red Hat. The Veteran underwent a VA examination in January 2020. The examiner opined the Veteran’s hypertensive heart disease is less likely than not is otherwise etiologically related to service to include any documented exposure to herbicides, or other chemical or toxic substances. The examiner reasoned that although there was an April 2016 VA opinion which noted that the Veteran was exposed to Agent Orange and other potential toxins during Operation Red Hat in Okinawa, the January 2020 examiner found no actual documentation of exposure. The examiner also opined that the Veteran’s hypertensive heart disease is less likely than not proximately due to or the result of a service-connected disability, or alternatively aggravated by a service-connected disability. The examiner reasoned that none of these conditions (posttraumatic stress disorder, cervical spine disability, bilateral pes planus, a left knee disability and bilateral shoulder disability) are not considered to be causative factors or aggravating factors of heart disease. The Board finds that based on the evidence provided by the Veteran, a remand is required in order to obtain a VA medical opinion that addresses whether exposure to toxic chemical munitions caused the Veteran’s hypertensive heart disease. The January 2020 VA examiner failed to provide an opinion as to whether such exposure was etiologically related to service as the examiner found that there was no actual documentation of exposure. The Board finds that the certificate of achievement as well as the other readily available information regarding Operation Red Hat is adequate documentation for a VA examiner to provide such an opinion. Further, the Board finds that the examiner’s rationale as to the whether the Veteran’s service-connected disorders is not adequate for adjudication. The Board finds the examiner’s one sentence conclusory opinion for secondary service connection is inadequate as it does not provide sufficient explantation to support the determination made and it is unclear what evidence supports his determinations as the examiner failed to discuss in his rationale the underlying facts of the Veteran’s service, post-service history, or medical literature in support of his opinions. Therefore, upon remand the examiner must provide a secondary service-connection opinion with a full and complete rationale. The matters are REMANDED for the following action: 1. Obtain an addendum opinion from an appropriate clinician regarding the etiology of the Veteran’s hypertensive heart disease, the examiner must opine as to the following: (a.) Whether the Veteran’s hypertensive heart disease is at least as likely as not related to the documented Operation Red Hat exposure to toxic chemical munitions from January 1971 to September 1971. (b.) Whether it is at least as likely as not that the Veteran’s hypertensive heart disease is proximately due to or the result of a service connected disability, or alternatively, aggravated (permanently worsened beyond the natural progress of such disorder) by a service-connected disability (service connection is in effect for posttraumatic stress disorder; cervical spine disability; bilateral pes planus; left knee disability; and left and right shoulder disabilities). (Continued on the next page)   (c.) The examiner must provide a complete rationale for all opinions provided. S. L. Kennedy Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Robert Batten 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.