Citation Nr: 21015786 Decision Date: 03/18/21 Archive Date: 03/18/21 DOCKET NO. 15-23 797 DATE: March 18, 2021 REMANDED Service connection for diabetes mellitus type II is remanded. Service connection for hypertension is remanded. REASONS FOR REMAND The Veteran had active duty service from March 1975 to February 1981 and from May 1981 to May 1995. The instant issues, as well as well as the issues of entitlement to service connection for a low back disability, right ankle disability, and temporomandibular joint syndrome (TMJ), were remanded by the Board in January 2019. Subsequently, in a June 2020 rating decision, the Agency of Original Jurisdiction (AOJ) granted entitlement to service connection for lumbar strain with myofascial pain syndrome and right ankle lateral collateral ligament sprain. In a December 2020 rating decision, the AOJ granted service connection for TMJ. As such is a full grant of the benefits sought for those three issues, they are not before the Board. See Grantham v. Brown, 114 F.3d 1156 (Fed. Cir. 1997). While the Board regrets additional delay, the instant claims must be remanded again. In this regard, VA obtained medical opinions in August 2020. In the opinion regarding the Veteran’s diabetes, the examiner indicated a review of pertinent medical records and concluded that diabetes was less likely than not related to a service-connected condition. By way of rationale, the examiner provided a review of the Veteran’s medical history and concluded that medical records were consistent with the claimant having diabetes. The examiner did not explain why, from a medical standpoint, diabetes was not caused by the Veteran’s service-connected disabilities, to specifically include anemia, which was the question posed. Regarding the Veteran’s hypertension, the examiner did not address the notation of high blood pressure in the Veteran’s service records or the orthostatic hypertensive episode in August 1987, and did not address the specific medical question of whether hypertension has been caused or aggravated by any of the medications taken for any of the Veteran’s service-connected disabilities. That inquiry is especially relevant given the examiner’s conclusion that the Veteran has “essential hypertension,” which does not have any clinically known cause. Accordingly, the Board will remand for addendum opinions. The matters are REMANDED for the following action: 1. Obtain a VA addendum opinion from a clinician other than the August 2020 VA examiner to address whether the Veteran’s diabetes is at least as likely as not (1) proximately due to a service-connected disability, or (2) aggravated beyond its natural progression by a service-connected disability, specifically her service-connected anemia. The Board leaves it to the discretion of the examiner to determine whether an in-person examination is necessary. A complete rationale must be provided. 2. Obtain a VA addendum opinion from a clinician other than the August 2020 VA examiner to address whether the Veteran’s hypertension is at least as likely as not related to an in-service injury, event, or disease, including her note of high blood pressure, any high blood pressure readings during service, and the hypertensive episode during service. The examiner should also address whether the Veteran’s hypertension is at least as likely as not (50 percent probability or more) (1) proximately due to a service-connected disability, or (2) aggravated beyond its natural progression by a service-connected disability, to include any medications related to her service-connected disabilities. The Board leaves it to the discretion of the examiner to determine whether an in-person examination is necessary. The examiner should also address whether any currently diagnosed hypertension had onset within one year following separation from service. A complete rationale for all opinions must be provided. 3. After undertaking the development above and any additional development deemed necessary, readjudicate the appeal. Jenna Brant Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Polly Johnson, 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.