Citation Nr: 21005691 Decision Date: 02/02/21 Archive Date: 02/02/21 DOCKET NO. 15-31 495 DATE: February 2, 2021 ORDER Entitlement to service connection for hypertension, as secondary to service-connected posttraumatic stress disorder (PTSD), is granted. FINDING OF FACT Resolving reasonable doubt in the Veteran’s favor, his hypertension is secondary to his service-connected PTSD. CONCLUSION OF LAW The criteria for service connection for hypertension have been met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.310. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from May 1966 to March 1970. The matter comes before the Board of Veterans’ Appeals (Board) on appeal from an April 2015 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO). In March 2019, the Veteran testified at a hearing before the undersigned Veterans Law Judge. A copy of the proceeding is associated with the electronic claims file. Subsequently, the Board remanded the matter for further development in August 2019 and August 2020. Service Connection for Hypertension The Veteran contends that his hypertension is secondary to his service-connected PTSD. Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated during service. 38 U.S.C. § 1131; 38 C.F.R. § 3.303. In order to establish service connection on a direct basis, the record must contain (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Secondary service connection is warranted where a claimed disability is proximately due to or the result of a service-connected disease or injury. 38 C.F.R. § 3.310(a). The threshold legal requirements for a successful secondary service connection claim are evidence of (1) a current disability for which secondary service connection is sought; (2) a disability already service-connected; and (3) competent evidence that the already service-connected disability caused or aggravated the disability for which service connection is sought. Id. The Veteran’s medical records reflect a diagnosis of hypertension and long-term use of daily, prescribed medications to manage his hypertension. Thus, the first element of service connection for a current disability have been met. In August 2020, the Board remanded that matter to obtain an addendum VA medical opinion. Specifically, the Board noted that the November 2019 VA medical opinion, which concluded that there was no evidence that the Veteran’s PTSD has aggravated his hypertension, as his blood pressure readings have remained stable for many years without a change in his medications or dosages, was conclusory. The Board noted that the VA examiner failed to consider the Veteran’s lay statements that the daily symptoms he experiences as a result of PTSD impact his blood pressure. In a September 2020 VA addendum medical opinion, the VA examiner noted that blood pressure readings can be higher when there is increase stress in a person’s body, so the Veteran could be experiencing aggravation of his blood pressure intermittently when his PTSD is elevated. However, she concluded that the Veteran’s noted blood pressure readings do not reflect this; no rationale or explanation was provided for this finding. Considering the evidence of record, and the Board’s prior attempts to obtain an adequate medical opinion, the Board finds that an additional attempt to obtain such an opinion is not warranted on this record. Accordingly, the Board resolves reasonable doubt in the Veteran’s favor and finds that service connection for hypertension, as secondary to service-connected PTSD, is warranted. 38 U.S.C. § 5107(b); 39 C.F.R § 3.102; Gilbert v. Derwinski, 1 Vet. App. 49, 55–57 (1990). Nathaniel J. Doan Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board C. Robinson, 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.