Citation Nr: 21015275 Decision Date: 03/17/21 Archive Date: 03/17/21 DOCKET NO. 16-29 564 DATE: March 17, 2021 REMANDED Service connection for hypertension, including as due to herbicide exposure or prostate cancer, is remanded. REASONS FOR REMAND The Veteran served on active duty from September 1967 to April 1969, to include service in the Republic of Vietnam. In September 2019, the Veteran testified before the undersigned Veterans’ Law Judge; a copy of the transcript is associated with the record. The Board has previously remanded this matter. Hypertension In his March 2021 Informal Hearing Presentation (IHP), the Veteran asserted that his hypertension has been aggravated by his service connected prostate cancer. As prior VA examinations did not address the impact the Veteran’s prostate cancer might have had on the Veteran’s hypertension, these examinations are inadequate, and a remand is necessary to obtain a new examination.   The matter is REMANDED for the following action: Schedule the Veteran for a VA examination to determine the nature and etiology of his hypertension. The claims file, including a copy of this Remand, must be made available to the examiner and the examiner should indicate in his/her report whether or not such was reviewed. All necessary tests and studies should be accomplished. The examiner must provide an opinion whether the Veteran’s hypertension: a. is at least as likely as not (50 percent or greater probability) incurred in, or is otherwise related to, active service, to include exposure to herbicides; or b. is at least as likely as not proximately due to or aggravated by his service-connected prostate cancer. The examiner is to note that the Veteran was exposed to herbicides in the Republic of Vietnam. A negative opinion based on herbicide exposure should not be premised on the absence of the disease from 38 C.F.R. § 3.309(e). The examiner should consider that the National Academy of Sciences elevated hypertension to the “Limited or Suggestive Evidence” category, i.e., “evidence suggests an association between exposure to herbicides and the outcome, but a firm conclusion is limited because chance, bias, and confounding could not be ruled out with confidence.” 79 Fed. Reg. 20,308-309. The Veteran’s lay assertions as to onset and continuity of symptomatology should be recorded and considered. A rationale for all opinions must be provided. JOHN Z. JONES Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A. Parrish, 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.