Citation Nr: 21013226 Decision Date: 03/09/21 Archive Date: 03/09/21 DOCKET NO. 16-13 069 DATE: March 9, 2021 REMANDED Entitlement to service connection for hypertension, to include as due to herbicide exposure is remanded. REASONS FOR REMAND The Veteran served on active duty from October 1966 to October 1969, to include service in the Republic of Vietnam. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a January 2013 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). The Board remanded the claim for further development in November 2018 to obtain an addendum opinion for hypertension and to issue a statement of the case (SOC) for service connection for tinnitus. Thereafter, a May 2020 SOC denied service connection for tinnitus. 1. Entitlement to service connection for hypertension, to include as due to herbicide exposure is remanded. The Veteran filed a claim for service connection for hypertension in November 2010. The Board remanded the claim for an opinion regarding the potential relationship between the Veteran's hypertension and his herbicide agent exposure. In August 2019, following a VA examination it was opined that it is less likely than not that the Veteran's hypertension is due to or the result of herbicide exposure. The examiner reasoned “while recent studies have suggested an association with herbicide exposure and hypertension, this study involved members of the chemical corps which had a high exposure to herbicides. Veterans not in the chemical corps did not have an increased risk. The Veteran’s military occupational specialty (MOS) indicates he was not assigned to the chemical corps.” The Board finds this opinion to be inadequate because as the Board has previously recognized the Veteran as having served in the Republic of Vietnam, his herbicide exposure is presumed regardless of his MOS. Additionally, the November 2018 Board remand recognized the National Academy of Sciences (NAS) 2006 upgrade. The Board recognizes an additional NAS upgrade of hypertension to the "sufficient" category from "limited or suggestive," indicating that "there is enough epidemiologic evidence to conclude that there is a positive association" between hypertension and herbicide exposure. See Veterans and Agent Orange: Update 11 (2018). Accordingly, remand is also warranted to consider this change. The matters are REMANDED for the following action: 1. Obtain an addendum opinion for the Veteran's claimed hypertension. The claims file, to include this Board remand, must be made available to and reviewed by the examiner. A note that such review was completed should be provided in the examiner’s report. The examiner should offer comments and an opinion as to whether it is at least as likely as not (i.e., a 50 percent or greater probability) that the Veteran's hypertension is etiologically related to his presumed in-service herbicide exposure? In so opining, the examiner is advised of the following: (1) the NAS upgrade of hypertension to the "sufficient" category from "limited or suggestive," indicating that "there is enough epidemiologic evidence to conclude that there is a positive association" between hypertension and herbicide exposure (see Veterans and Agent Orange: Update 11 (2018)); and (2) the Board is cognizant that hypertension is not a presumptive disease associated with herbicide exposure. The Board seeks a medical opinion on the likelihood that this Veteran's hypertension is related to his herbicide exposure given his medical history, family history, existence of or absence of other risk factors, and any other additional factors deemed relevant by the examiner. The examiner should provide a detailed rationale for his or her opinion. TANYA SMITH Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Edwin B. Esmenda, Associate 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.