Citation Nr: 21006461 Decision Date: 02/04/21 Archive Date: 02/04/21 DOCKET NO. 15-24 471 DATE: February 4, 2021 REMANDED Entitlement to service connection for hypertensive vascular disease, to include hypertension and isolated systolic hypertension, is remanded. REASONS FOR REMAND The Veteran served in the United States Navy on active duty from January 1974 to January 1978 and January 1987 to January 1998. The issue comes before the Board of Veterans’ Appeals (Board) on appeal from a May 2015 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified at a hearing before the undersigned Veterans Law Judge in January 2019. A transcript of the hearing has been included with the record. In June 2019, the Board denied the Veteran’s claim for service connection for hypertension. The Veteran appealed the Board’s decision to the United States Court of Appeals for Veterans Claims (Court). In September 2020, the Court granted a Joint Motion for Partial Remand (JMPR). The Court found that the Board failed to provide adequate reasons and bases for its denial of the Veteran’s claim. Specifically, the Court found the Board relied on an inadequate medical opinion in support for the denial of service connection. Pursuant to the JMPR, the Court vacated and remanded the matters to the Board. Entitlement to service connection for hypertensive vascular disease, to include hypertension and isolated systolic hypertension, is remanded. The Veteran contends that he suffers from hypertension which he developed during active duty service. Additionally, the Veteran asserts that he was prescribed medication to manage his elevated blood pressure. In March 2015, the Veteran underwent a VA hypertension examination. The examiner reviewed the Veteran’s VA claims file and conducted an in-person examination. The VA examiner reported that the Veteran’s service treatment records (STRs) were not included in the Veteran’s file. The VA examiner provided that as the STRs were unavailable for review, the examiner was unable to opine to the nature and etiology of the Veteran’s hypertension. The VA examiner provided an addendum opinion in April 2015 after the Veteran’s STRs were scanned and included into the claims file. The VA examiner provided the opinion that the Veteran’s hypertension was not caused by or incurred in service. The examiner stated the evidence of record did not contain a diagnosis or treatment of hypertension in service or within one year from the Veteran’s separation from active service. Remand is required to provide the Veteran an adequate examination to address the nature and etiology of the Veteran’s hypertension. When VA determines to provide an examination or obtain a VA opinion, it must ensure that the examination or opinion is based upon consideration of the Veteran’s medical history. See Barr v. Nicholson, 21 Vet. App. 303, 312 (2007). Absent a reasoned medical explanation and without supporting data, a medical opinion is inadequate to adjudicate the Veteran’s claim. Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008). A mere conclusory medical opinion is insufficient. An opinion must support its conclusion with an analysis that the Board can consider and weigh against contrary opinions. See Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007). Here, remand is required to obtain a new VA medical opinion that provides adequate reasoning and support as to the etiological relationship between the Veteran’s hypertension and service. Moreover, a new medical opinion is needed to address the Veteran’s assertions that he received treatment for his hypertensive blood pressure condition and was diagnosed with hypertension in service. The matters are REMANDED for the following action: Schedule the Veteran for a VA examination with an appropriate examiner to determine the etiology of the Veteran’s claimed hypertension. The record and a copy of this Remand must be made available to the examiner. The examination may be conducted via telehealth or similar service during the social distancing restrictions of the COVID-19 pandemic. Any indicated tests and studies must be accomplished, and all clinical findings must be reported in detail, and correlated to a specific diagnosis. Following a review of the entire record, the Veteran’s competent lay statements, as well as the Veteran’s report regarding the onset and progression of his current symptomatology, the examiner should opine as to whether it is at least as likely as not (50 percent probability or more) that the Veteran’s hypertension had its onset during or is otherwise related to the Veteran’s active duty service. The examiner must provide a comprehensive report including a clearly stated rationale for any opinions offered and conclusions reached, citing the objective medical findings leading to the conclusions, and must not be based solely on the lack of records. In this regard, the Board emphasizes that the Veteran is competent to report his symptoms and history, and such statements by the Veteran regarding symptomatology and medical history must be specifically acknowledged and considered in formulating any opinions concerning the onset and severity of his disability. If such reports are rejected by the examiner, a reason for doing so must be provided. JENNIFER HWA Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A.V. Bona, 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.