Citation Nr: 21011543 Decision Date: 03/02/21 Archive Date: 03/02/21 DOCKET NO. 17-25 594 DATE: March 2, 2021 REMANDED Entitlement to special monthly compensation (SMC) based on housebound status and/or the need for aid and attendance (A & A) is remanded. Entitlement to service connection for stroke/cerebrovascular accident (CVA) is remanded. REASONS FOR REMAND The Veteran served on active duty from July 1968 to July 1971, including service in Vietnam. This matter was initially on appeal before the Board of Veterans Appeals (Board) from June 2016 and January 2017 decisions of a Department of Veterans Affairs (VA) Regional Office (RO). In a November 2018 decision, the Board, in pertinent part, denied the claims for service connection for hypertension and entitlement to special monthly compensation (SMC). The Veteran appealed. In a subsequent October 2019 decision, the Court of Appeals for Veterans Claims (Court) vacated the November 2018 decision and remanded the claims back to the Board for readjudication consistent with the decision. In March 2020, the Board remanded the claims for service connection for hypertension and SMC for further development. In a December 2020 rating decision, the RO granted service connection for hypertension. Consequently, this matter is no longer on appeal. In a December 2020 supplemental statement of the case, the RO continued the denial of the claim for SMC. Entitlement to service connection for stroke/ cerebrovascular accident (CVA) is remanded. Entitlement to special monthly compensation (SMC) based on housebound status and/or the need for aid and attendance (A & A) is remanded. In a January 2021 notification letter accompanying the December 2020 rating decision (that granted service connection for hypertension and assigned a noncompensable rating), the RO advised the Veteran that if he believed that his cerebral vascular accident (CVA/stroke, which occurred in December 2014) was caused by a service-connected disability or by his military service, he should submit a claim for this condition on the prescribed claim form. The RO also indicated that VA may presume that certain types or causes of strokes are related to hypertension. Also in January 2021, the Court of Appeals for Veteran Claims (Court), in a three judge decision, held that VA is required to develop and adjudicate related claims for secondary service connection for disabilities, including complications, that are reasonably raised during the adjudication of a formally initiated claim for the proper evaluation level for the primary service-connected disability. See Bailey v. Wilkie, No. 19-2661 (Jan. 6, 2021). Given that in determining the rating for the Veteran’s newly service-connected hypertension, the RO specifically identified the Veteran’s stroke/CVA as a disability that may constitute a complication of the hypertension, a claim for service connection for the stroke/CVA has been reasonably raised by the record and must be formally adjudicated. As the existing evidence of record does not clearly indicate whether the Veteran’s stroke/CVA is secondary to his hypertension, a remand is required for further development of this claim. This development should include obtaining any available private treatment records for the Veteran’s stroke/CVA, which occurred in December 2014, including from First Health Moore Regional Hospital, and obtaining an opinion from a qualified medical professional concerning the likelihood of a causal relationship between the Veteran’s hypertension and his stroke. Additionally, as the evidence shows that the Veteran’s stroke/CVA has caused considerable impairment in his ability to care for himself, the claim for SMC based on housebound status and/or the need for aid and attendance is inextricably intertwined with the claim for service connection for stroke/CVA and must also be remanded. The matters are REMANDED for the following action: 1. Develop the claim for service connection for stroke/CVA to include as secondary to service-connected hypertension. 2. If available, obtain private medical records pertaining to the Veteran’s treatment for stroke/CVA, which occurred in December 2014, including records from First Health Moore Regional Hospital. 3. Obtain an opinion from a qualified medical professional, concerning the likelihood that the Veteran’s stroke/CVA occurring in December 2014 was caused or aggravated by his hypertension. The medical professional should review the claims file in conjunction with the examination, including any records of treatment for hypertension and stroke/CVA. After claims file review, the professional should provide an opinion in answer to the following questions: A) Is it at least as likely as not that the Veteran’s hypertension caused or contributed to cause, the Veteran’s stroke/CVA? B) Is it at least as likely as not that the Veteran’s stroke/CVA has been aggravated by the Veteran’s hypertension? If aggravation is found, the examiner should identify to the extent possible the baseline level of disability prior to the aggravation and determine what degree of additional impairment is attributable to the service-connected disability. 4. Adjudicate the claim for service connection for stroke/CVA as secondary to hypertension, and readjudicate the claim for entitlement to SMC based on housebound status and/or the need for aid and attendance. S. HENEKS Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Dan Brook, 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.