Citation Nr: 21007709 Decision Date: 02/10/21 Archive Date: 02/10/21 DOCKET NO. 17-26 822 DATE: February 10, 2021 REMANDED The claim of entitlement to service connection for hypertension is remanded. REASONS FOR REMAND The Veteran had active service from October 2010 to November 2011 and from April 2013 to May 2014. This matter comes before the Board of Veterans’ Appeals (Board) from a January 2017 rating decision by the Agency of Original Jurisdiction (AOJ). A Board hearing was held in May 2020. A transcript is of record. The Veteran seeks service connection for hypertension. He maintains that his elevated blood pressure is related to his service-connected posttraumatic stress disorder (PTSD). See June 2016 VA Form 21-4138. Service treatment records contain a March 2014 post deployment assessment report that indicates isolated elevated blood pressure. The Veteran was advised to decrease caffeine and salt and make a followup appointment to monitor his blood pressure. Isolated elevated blood pressure was again noted in April 2014, and the Veteran was advised to follow up with his primary care manager. On VA examination in August 2016, the examiner indicated that the Veteran had not been diagnosed with hypertension. While the records reviewed by the VA examiner are not clear as to whether a diagnosis of hypertension was appropriate, subsequent records do show that the Veteran has been treated for hypertension. A November 2019 record from Bremerton Naval Hospital indicates that the Veteran was prescribed hydrochlorothiazide for his blood pressure. Moreover, an undated private record indicates that the Veteran was prescribed Lisinopril for his blood pressure. Considering records showing elevated blood pressures during active service, current treatment for hypertension, and the Veteran’s assertion such is related to his service-connected PTSD, the Board concludes that an additional examination is necessary to determine the etiology of the Veteran’s claimed hypertension. The matter is REMANDED for the following action: 1. Schedule the Veteran for an examination to determine the etiology of his claimed hypertension. The claims file must be made available to the examiner. All necessary tests and studies should be accomplished, and all clinical findings should be reported in detail. Following review of the record and examination of the Veteran, the examiner should provide an opinion with respect to whether it is at least as likely as not that hypertension is related to any incident of service, to include findings of elevated blood pressure in March and April 2014. The examiner should also provide an opinion with respect to whether it is at least as likely as not (50 percent or more probability) that hypertension was caused OR aggravated (worsened beyond normal progression) by the Veteran’s service-connected PTSD. In rendering these opinions, the examiner is advised that the Veteran is competent to report his symptoms and history. Such reports must be acknowledged and considered in formulating any opinion. If the examiner rejects the Veteran’s reports, he or she must provide an explanation for such rejection. The examiner is not to improperly discount the Veteran’s lay statements or mistakenly rely on an absence of medical evidence in the record to support his or her conclusions. The complete rationale for all opinions should be set forth and a discussion of the facts and medical principles involved would be of considerable assistance to the Board. If an opinion cannot be provided without resorting to mere speculation, the examiner must provide a complete explanation for why an opinion cannot be rendered. In so doing, the examiner must explain whether the inability to provide a more definitive opinion is the result of a need for additional information, or that he or she has exhausted the limits of current medical knowledge in providing an answer to that particular question. (Continued on the next page)   2. Then, readjudicate the Veteran’s claim, with application of all appropriate laws, regulations, and case law, and consideration of any additional information obtained as a result of this remand. If the decision remains adverse to the Veteran, he and his representative should be furnished a supplemental statement of the case (SSOC) and afforded an appropriate period within which to respond thereto. DONNIE R. HACHEY Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. Barone, 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.