Citation Nr: 21014686 Decision Date: 03/15/21 Archive Date: 03/15/21 DOCKET NO. 15-40 574 DATE: March 15, 2021 ORDER Service connection for orthostatic hypotension is denied. FINDING OF FACT The Veteran does not have a diagnosis of orthostatic hypotension. CONCLUSION OF LAW The criteria to establish entitlement to service connection for orthostatic hypotension have not been met. 38 U.S.C. § 1131; 38 C.F.R. § 3.303(d). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the U.S. Air Force Reserve from January 1979 to July 1982. He had extended periods of active duty training (ACDUTRA) from August 1982 to December 2002. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from an August 2012 rating decision of the St. Petersburg, Florida Regional Office (RO). In February 2019, the Veteran was afforded a videoconference hearing before the undersigned Veterans Law Judge (VLJ). During the hearing, the VLJ engaged in a colloquy with the Veteran toward substantiation of the claim. Bryant v. Shinseki, 23 Vet. App. 488, 496-97 (2010). A hearing transcript is in the record. In July 2019, the Board remanded the appeal to the RO for additional action. There was substantial compliance with the Board’s remand directives. Stegall v. West, 11 Vet. App. 268 (1998). Service Connection – Orthostatic Hypotension Service connection may be granted for a current disability arising from a disease or injury incurred in or aggravated by active service. 38 U.S.C. § 1131. Service connection may be granted for any disease 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). Service connection generally requires (1) medical evidence of a current disability; (2) medical or, in certain circumstances, lay evidence of an in-service incurrence or aggravation of a disease or injury; and (3) medical evidence of a nexus between the claimed in-service disease or injury and the current disability. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). The law is well settled that in the absence of proof of a current disability, there can be no valid claim. Boyer v. West, 210 F.3d 1351 (Fed. Cir. 2000); Brammer v. Derwinski, 3 Vet. App. 223 (1992). As an initial matter, in July 2020, the Veteran submitted an Appeals Satisfaction Notice and requested to withdraw the claim. However, the Veteran’s withdrawal was not effective because an October 2020 VA addendum, pursuant to the July 2019 Board remand, was provided and the Veteran’s representative submitted a February 2021 brief. 38 C.F.R. § 19.55. The Veteran asserts that his orthostatic hypotension was caused by his active duty service. The claim will be denied because the Veteran does not have a diagnosis of orthostatic hypotension. In a March 1981 service treatment record (STR), the Veteran was provisionally diagnosed with orthostatic hypotension based on three blood pressure readings: recumbent – 122/70; sitting – 102/70; and standing – 94/62. The Veteran was sent for an internal medicine evaluation concerning his low blood pressure for pilot training. In a March 1981 service consultation report, the service medical examiner indicated that the Veteran had normal postural blood pressure responses before and after exercise. It was noted that the Veteran had no symptoms relative to one finding of mild orthostatic drop in blood pressure. In his January 1982 service medical history report, the Veteran answered in the negative to the question of whether he then had, or once had low blood pressure. Private treatment records reflect no complaints, treatment or diagnosis for low blood pressure or orthostatic hypotension. In the July 2011 VA examination, the Veteran reported experiencing dizziness upon standing too quickly and that his non-VA medical provider advised the Veteran to monitor his blood pressure. The VA examiner indicated that the Veteran did not have hypertensive heart disease. The July 2011 VA examination was of low probative value because it was not clear whether the Veteran was diagnosed with orthostatic hypotension. 38 C.F.R. § 4.2; See Prejean v. West, 13 Vet. App. 444, 448-49 (2000). In the February 2019 Board hearing, the Veteran testified that the July 2011 VA examiner did not diagnose him with orthostatic hypotension. In the October 2020 VA addendum, the examiner indicated that the Veteran did not have a diagnosis of orthostatic hypotension because it was acute, isolated and resolved without residuals. The examiner also indicated that orthostatic hypotension was not a diagnosis and that it was merely a symptom of an underlying cause such as dehydration, deconditioning, drug administration, neurological conditions, poor nutrition or normal bodily changes due to aging. The VA addendum is highly probative because the examiner’s indication that the Veteran had no diagnosis of orthostatic hypotension was based on an accurate and complete understanding of the Veteran’s medical history. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008). A preponderance of the evidence is against a finding that the Veteran has a current diagnosis of orthostatic hypotension. The October 2020 VA examiner indicated that the Veteran did not have a diagnosis of orthostatic hypotension. Significantly, the Veteran has not submitted competent evidence of a diagnosis of orthostatic hypotension. Therefore, service connection is not warranted and the claim is denied. Vito A. Clementi Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board B. Cohen, 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.