Citation Nr: 21009352 Decision Date: 02/22/21 Archive Date: 02/22/21 DOCKET NO. 07-25 792 DATE: February 22, 2021 REMANDED Entitlement to service connection for hypertension, including as due to in-service exposure to an herbicide agent, service-connected diabetes mellitus, service-connected myocardial infarction, or service-connected posttraumatic stress disorder (PTSD), is remanded. REASONS FOR REMAND The Veteran had active service from November 1968 to October 1971, including in combat in the Republic of Vietnam from September 1969 to September 1970. This case has a long procedural history. Most recently, in October 2020, the Board remanded the currently appealed claim to the Agency of Original Jurisdiction (AOJ) for additional development. The Veteran essentially contends that he incurred hypertension during active service and experienced continuous post-service disability. He alternatively contends that his conceded in-service exposure to an herbicide agent while on active combat service in the Republic of Vietnam from September 1969 to September 1970 caused or aggravated (permanently worsened) his hypertension. He also alternatively contends that his service-connected diabetes mellitus, service-connected myocardial infarction, or service-connected PTSD caused or aggravated his hypertension. The Board acknowledges that this appeal has been remanded previously, most recently in October 2020. Unfortunately, having reviewed the record evidence, and although the Board is reluctant to contribute to "the hamster-wheel reputation of Veterans law" by remanding this appeal again, additional development is required before the underlying claim can be adjudicated on the merits. Cf. Coburn v. Nicholson, 19 Vet. App. 427, 434 (2006) (Lance, J., dissenting) (finding that repeated remands "perpetuate the hamster-wheel reputation of Veterans law"). In the October 2020 remand, the Board directed that the AOJ obtain addendum opinions concerning the contended etiological relationships between the Veteran’s hypertension and his conceded in-service exposure to an herbicide agent, service-connected diabetes mellitus, service-connected myocardial infarction, and service-connected PTSD. These opinions were obtained in December 2020. Unfortunately, a review of the opinion concerning the contended etiological relationship between the Veteran’s hypertension and service-connected myocardial infarction shows that it is unlikely to survive judicial review. The VA clinician opined that it was less likely than not that the Veteran’s service-connected myocardial infarction caused or aggravated his hypertension. The rationale for this opinion was, “There is no evidence in [the claims] file showing that the Veteran’s hypertension worsened secondary to the [myocardial infarction] as the [blood pressure] readings did not increase and remain increased over a period of time after the second [myocardial infarction] in 2006.” This statement suggests that the VA clinician found the lack of medical records documenting an etiological link between hypertension and the service-connected myocardial infarction persuasive support for her negative nexus opinion. The Board notes that the absence of contemporaneous records does not preclude granting service connection for a claimed disability. See Buchanan v. Nicholson, 451 F.3d 1331, 1337 (Fed. Cir. 2006) (finding lack of contemporaneous medical records does not serve as an "absolute bar" to the service connection claim); Barr v. Nicholson, 21 Vet. App. 303 (2007) ("Board may not reject as not credible any uncorroborated statements merely because the contemporaneous medical evidence is silent as to complaints or treatment for the relevant condition or symptoms"). Thus, the Board finds that, on remand, the AOJ should obtain another addendum opinion on this matter. The matters are REMANDED for the following action: 1. Forward the claims file to a clinician for an opinion as to whether there is an etiological relationship between the hypertension and the heart disease and myocardial infarction. If possible, this opinion should be obtained from a clinician other than the clinician who provided the VA medical opinion dated on December 16, 2020. The Veteran does not need to report for examination. Based on a review of the claims file, the clinician is asked to opine whether it is at least as likely as not that the Veteran’s coronary artery disease and myocardial infarction caused or aggravated his hypertension. A rationale must be provided for any opinion(s) expressed. 2. Readjudicate the appeal. R. FEINBERG Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Michael T. Osborne, 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.