Citation Nr: 21016116 Decision Date: 03/19/21 Archive Date: 03/19/21 DOCKET NO. 20-06 028 DATE: March 19, 2021 REMANDED Entitlement to service connection for hypertension is remanded. REASONS FOR REMAND The Veteran served on active duty from June 1963 to August 1966. This matter comes to the Board of Veterans’ Appeals (Board) on appeal from a January 2019 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). In February 2021, the Veteran appeared at a hearing before the undersigned Veterans Law Judge. A copy of the hearing transcript is of record. This appeal has been advanced on the Board’s docket pursuant to 38 C.F.R. § 20.900(c); 38 U.S.C. § 7107(a)(2). 1. Entitlement to service connection for hypertension is remanded. Although the Board regrets the delay, additional development is needed prior to further disposition of the claim of entitlement to service connection for hypertension. Medical records show that the Veteran is currently diagnosed with hypertension. The Veteran contends that currently diagnosed hypertension is due to active service. Specifically, the Veteran asserts that hypertension is related to exposure to herbicide agents. The Veteran is presumed to have been exposed to herbicide agents because of naval service in the offshore eligible waters as defined in the Blue Water Navy Vietnam Veterans Act of 2019, Public Law 116-23. However, hypertension is not a disease for which presumptive service connection based on exposure to herbicide agents is warranted. 38 C.F.R. § 3.309(e). That finding does not preclude the Veteran from pursuing a claim for service connection to be established on a direct basis. Combee v. Brown, 34 F.3d 1039 (Fed. Cir. 1994). The Veteran has not been provided a VA examination which addresses any relationship between hypertension and presumed herbicide agent exposure in service. VA’s duty to assist includes, in appropriate cases, the duty to conduct a thorough and contemporaneous medical examination which is accurate and fully descriptive. McLendon v. Nicholson, 20 Vet. App. 79 (2006); Green v. Derwinski, 1 Vet. App. 121 (1991). Because the Veteran’s hypertension may have been caused by service, the Board finds that a VA opinion to determine any relationship between the Veteran’s hypertension and service should be scheduled. VA should obtain all relevant VA and private treatment records which could potentially be helpful in resolving the Veteran’s claim. Murphy v. Derwinski, 1 Vet. App. 78 (1990); Bell v. Derwinski, 2 Vet. App. 611 (1992). The Veteran is notified that it is his responsibility to report for any scheduled examination and to cooperate in the development of the claim. The consequences for failure to report for a VA examination without good cause may include denial of the claim. 38 C.F.R. § 3.655. The matters are REMANDED for the following action: 1. Request the Veteran identify the names, addresses, and approximate dates of treatment for all VA and non-VA health care providers who provided treatment for his hypertension. After securing the necessary releases, attempt to obtain all copies of pertinent treatment records identified by the Veteran that are not currently of record. At a minimum, obtain any outstanding VA treatment records. All attempts to obtain records must be documented in the claims folder. 2. Then, schedule the Veteran for a VA examination to determine the nature and etiology of diagnosed hypertension. The examiner must review the claims file, including this Remand and the lay evidence of record, including hearing testimony, and should indicate that review in the examination report. Exposure to herbicide agents during service in Vietnam is presumed. After reviewing the claims files, the examiner should opine whether it is at least as likely as not (50 percent or greater probability) that hypertension is etiologically related to active service or any event, disease, or injury during service, including whether the hypertension (1) began during active service, (2) is related to presumed herbicide agent exposure, (3) manifested within one year after separation from service, (4) was noted during service with continuity of the same symptomatology since service, (5) was caused by any service-connected disability or treatment for any service-connected disability, to include prostate cancer status post total prostatectomy, or (6) was aggravated (increased in severity beyond the natural progress of the disorder) by any service-connected disability or treatment for any service-connected disability, to include prostate cancer status post total prostatectomy. The examiner is asked to specifically address whether it is at least as likely as not (50 percent or greater probability) that the Veteran’s hypertension was caused by exposure to herbicide agents. The examiner should reconcile that with NAS studies regarding whether hypertension is related to exposure to herbicide agents. A clearly stated rationale for each opinion offered must be provided and must not be based solely on the lack of an in-service record of the claimed disability. The expert is advised that the absence of hypertension from the list of disabilities which are presumed to be the result of exposure to herbicide agents is not a sufficient explanation for a negative opinion. Harvey P. Roberts Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Mondesir, Eric 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.