Citation Nr: 21010804 Decision Date: 02/25/21 Archive Date: 02/25/21 DOCKET NO. 17-30 453 DATE: February 25, 2021 ORDER Service connection for hypertension is granted. REMANDED The issues of entitlement to service connection for a neck disability, bilateral shoulder disability, thoracolumbar spine disability, and sciatica secondary to the thoracolumbar spine are remanded. FINDING OF FACT The Veteran’s current hypertension had its clinical onset in service. CONCLUSION OF LAW The criteria for service connection for hypertension are met. 38 U.S.C. §§ 1110, 1111, 5107(b); 38 C.F.R. §§ 3.102, 3.303(a), 3.307(a)(3), 3.309(a). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from August 2010 to August 2015. This matter is before the Board following her appeal of a June 2016 rating decision. In November 2020, the Veteran testified at a Board hearing before the undersigned. Service Connection The Veteran is seeking service connection for hypertension, which she asserts had its onset during her period of active duty service. Following review of the record, the Board agrees and finds that service connection for hypertension is warranted. Service connection may be established for a disability resulting from disease or injury incurred in or aggravated by service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303. Establishing service connection generally requires competent evidence of three things: (1) a current disability; (2) an in-service precipitating disease, injury, or event; and (3) a causal relationship, i.e., a nexus, between the current disability and the in-service event. Fagan v. Shinseki, 573 F.3d 1282, 1287 (Fed. Cir. 2009); 38 C.F.R. § 3.303(a). Consistent with this framework, service connection is warranted for a disease first diagnosed after discharge when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). Hypertension is classified as a “chronic disease” under 38 C.F.R. § 3.309(a). Presumptive service connection for chronic diseases must be considered on three bases: chronicity during service, continuity of symptomatology since service, and manifestations within one year of the appellant’s separation from service. 38 C.F.R. § 3.303(b); Walker v. Shinseki, 708 F.3d 1331, 1338 (Fed. Cir. 2013). Here, the Veteran’s service treatment records (STRs) show that she had normal blood pressure during an entrance examination in May 2009, and no history of high blood pressure was noted or reported during that examination or during a subsequent August 2010 pre-training examination. The Veteran was then found to have elevated blood pressure in October 2012, with a reading of 132/103. By March 2013, uncontrolled systemic hypertension was assessed, and the Veteran was placed on blood pressure medication. In April 2013, it was noted that the Veteran’s log of home blood pressure readings showed average blood pressure of greater than 140/90. Then, during her March 2015 separation examination, the Veteran reported her history of high blood pressure. Post-service treatment records dating from 2016 show continued treatment and medication prescribed for hypertension. Given the foregoing, the Board finds that the Veteran’s current hypertension clearly had its clinical onset during service such that service connection is warranted. See 38 C.F.R. § 3.303(b); Walker, 708 F.3d at 1335. REASONS FOR REMAND The issues of entitlement to service connection for neck, bilateral shoulder, thoracolumbar spine, and sciatic disabilities are remanded. The Veteran was scheduled in May 2016 for a VA general medical examination to address her neck, bilateral shoulder, thoracolumbar spine, and sciatic claims. However, in May and June of 2016, she notified VA that she was in the process of moving to another state and would therefore not be able to attend the scheduled examination. In a May 2016 statement, she requested that the examination be rescheduled following her move. However, it does not appear that any further attempt was made to reschedule the examination. The Board finds that the Veteran has provided good cause for her inability to attend the VA general medical examination scheduled in May 2016. Therefore, remand is necessary in order to provide her another opportunity to appear for a VA examination(s) related to her pending claims of entitlement to service connection for neck, bilateral shoulder, thoracolumbar spine, and sciatic claims. On remand, the Veteran should identify all sources of treatment for her claimed joint disabilities and sciatica, and any outstanding records should be obtained. The matters are REMANDED for the following action: 1. Obtain any updated and/or outstanding VA treatment records. 2. Ask the Veteran to submit, or to identify and authorize VA to obtain, any private medical records related to treatment she has received for neck, shoulder, back, or sciatic disability. Request any records properly identified. If any records cannot be obtained after reasonable efforts have been made, notify the Veteran of the attempts made and allow her the opportunity to obtain records herself. 3. After the foregoing development, to the extent possible, schedule the Veteran for a VA examination(s) by an appropriate clinician to determine the nature and etiology of the Veteran’s neck, shoulder, back, and/or sciatic disabilities. The Veteran is notified that it is her responsibility to report for her scheduled examination(s) and to cooperate in the development of the claims. The examiner is requested to offer the requested opinions based on file review in the event the Veteran does not appear for her VA examination. All indicated tests and studies should be conducted and all clinical findings reported in detail. The entire claims file and this REMAND should be made available to and be reviewed by the examiner in conjunction with this request. Following review of the claims file and examination of the Veteran, the examiner should provide an opinion regarding the following: (a) Please identify all current neck, shoulder, and back disabilities, and any associated sciatica or radiculopathy. (b) For each diagnosed disorder, please state whether it is a least as likely as not (50 percent probability or greater) that the disorder had its onset in service, within one year of separation from service, or is otherwise related to service, including any disabilities that may be considered to either have their clinical onset during or as a result of active service. The examiner is advised that the Veteran is competent to report her symptoms and her reports must be considered in formulating the requested opinions. If the Veteran’s reports are discounted, the examiner should provide a reason for doing so. A complete rationale for the examiner’s opinions should be provided, citing to specific evidence of record, as necessary. If the examiner cannot provide a requested opinion without resorting to speculation, it must be so stated, and the examiner must provide the reasons why an opinion would require speculation. The examiner must indicate whether there was any further need for information or testing necessary to provide an opinion. Additionally, the examiner must indicate whether any opinion could not be rendered due to limitations of knowledge in the medical community at large and not those of the examiner. S. C. Krembs Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A. Fagan 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.