Citation Nr: 21011181 Decision Date: 03/01/21 Archive Date: 03/01/21 DOCKET NO. 13-34 187A DATE: March 1, 2021 REMANDED Entitlement to service connection to hypertension, to include as due to Agent Orange exposure, is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from January 1951 to February 1974. He died February 2018. The Appellant is his surviving spouse. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a March 2011 rating decision from a Department of Veterans Affairs (VA) Regional Office (RO). Although the Board regrets further delay, remand is necessary to ensure compliance with previous remand directives and proper development. When there is not substantial compliance with Board remand requests, the Board errs as a matter of law when it does not ensure compliance. Stegall v. West, 11 Vet. App. 268 (1998). Hypertension The Veteran was afforded a December 2020 VA medical opinion in response to the Board’s September 2020 remand. The examiner opined that the Veteran’s hypertension was less likely than not related to his Agent Orange exposure. However, in proffering his opinion, the examiner did not address the National Academies of Sciences Engineering and Medicine (NAS) Veterans and Agent Orange: Update 11 (2018) as required by the Board remand instructions. Instead, the examiner merely cited to “some medical literature” and did not provide any discussion of the NAS findings. As such, the VA examiner did not adequately comply with the Board remand instructions. Further, the examiner did not adequately assess whether the Veteran’s hypertension was related to his active duty service and, as such, the Board finds an additional medical opinion is required to determine the etiology of the Veteran’s hypertension, to include as whether it is etiologically related to his conceded in-service herbicide exposure. The matters are REMANDED for the following action: Obtain a medical opinion from a VA examiner, who has yet to opine on this case, with sufficient expertise to comment on the etiology of the Veteran’s hypertension disability. All pertinent evidence of record must be made available to and reviewed by the examiner. Any indicated studies should be performed. Following a review of the relevant records and lay statements, the examiner should state an opinion with respect to whether the Veteran’s hypertension at least as likely as not (a 50 percent probability or greater) originated during the Veterans period of active service or is otherwise etiologically related to his active service, to include as due to Agent Orange exposure while serving in Vietnam. The examiner must provide a complete rationale for all proffered opinions. In this regard, the examiner must discuss and consider the Veteran’s competent lay statements made throughout the record. Specifically, the examiner should address the Veteran’s reports of being treated for high blood pressure while in active duty service. In rendering an opinion, the examiner must address the NAS finding that there is sufficient evidence of an association between exposure to herbicide agents and hypertension. If the examiner is unable to provide any required opinion, he or she should explain why. If the examiner cannot provide an opinion without resorting to mere speculation, he or she shall provide a complete explanation as to why this is so. If the inability to provide a more definitive opinion is the result of a need for additional information, the examiner should identify the additional information that is needed. T. REYNOLDS Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board T. Gresham 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.