Citation Nr: 21016137 Decision Date: 03/19/21 Archive Date: 03/19/21 DOCKET NO. 20-08 662 DATE: March 19, 2021 ORDER The petition to reopen the claim for service connection for hypertension is granted. Entitlement to service connection for hypertension is granted. FINDINGS OF FACT 1. The claim for entitlement to service connection for hypertension was initially denied in the December 2016 Rating Decision. The Veteran was notified of the decision, filed a notice of disagreement (NOD), but did not perfect his appeal, thus it became a final decision. 2. The evidence is at least in relative equipoise as to whether the Veteran’s hypertension is proximately due to his service-connected posttraumatic stress disorder (PTSD). CONCLUSIONS OF LAW 1. New and material evidence has been received to reopen the claim for service connection for hypertension. 38 U.S.C. § 5108; 38 C.F.R. § 3.156(a). 2. The criteria for service connection for hypertension as secondary to service-connected PTSD are met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.310. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from September 1965 to July 1969. The Board of Veterans’ Appeals (Board) notes that the Veteran’s claim for hypertension was initially denied in December 2016. He filed a petition to reopen the claim in May 2018. The preliminary question of whether a previously denied claim should be reopened is a jurisdictional matter that must be addressed before the Board may consider the underlying claim on its merits. Barnett v. Brown, 8 Vet. App. 1, 4 (1995), aff’d, Barnett v. Brown, 83 F.3d 130 (Fed. Cir. 1996). As such, the Board has included the petition to reopen the claim for the Veteran’s hypertension claim as reflected in the issues on appeal. 1. The petition to reopen The Veteran filed a petition to reopen his claim for entitlement to service connection in May 2018. See May 2018 VA Form 21-526b. Legal criteria Generally, a claim that has been denied in a final unappealed decision may not thereafter be reopened and allowed. An exception to this rule is 38 U.S.C. § 5108, which provides that if new and material evidence is presented or secured with respect to a claim which has been disallowed, VA shall reopen the claim and review the former disposition of the claim. New and material evidence is defined as evidence not previously submitted to agency decision makers that bears directly and substantially upon the specific matter under consideration; such new and material evidence can neither be cumulative nor redundant of the evidence previously of record, and must raise a reasonable possibility of substantiating the claim. 38 U.S.C. § 3.156(a); Hickson v. Shinseki, 23 Vet. App. 394, 398 (2010). The Board will generally presume the credibility of the newly submitted evidence for determining whether new and material evidence has been presented. Duran v. Brown, 7 Vet. App. 216, 220 (1994). The threshold for determining whether new and material evidence raises a reasonable possibility of substantiating a claim is “low.” Shade v. Shinseki, 24 Vet. App. 110, 117 (2010). In deciding whether new and material evidence has been submitted, the Board looks at the evidence submitted since the last final denial of the claim on any basis. Hickson v. West, 12 Vet. App. 247, 251 (1999). Relevant Facts and Analysis The application to reopen the claim for entitlement to service connection for hypertension is granted. Here, the claim for entitlement to service connection for hypertension was denied in the December 2016 rating decision for lack of nexus between the Veteran’s service-connected heart disability and because hypertension was not a presumptive Agent Orange disease. The Veteran was notified of the decision and filed an NOD in February 2017. However, the Veteran did not perfect his appeal after the issuance of the October 2017 statement of the case (SOC) by submitting a VA Form 9 or equivalent in response. See 38 U.S.C. § 7105; 38 C.F.R. § 20.1103. Thus, the December 2016 rating decision became a final decision. At the time of the December 2016 rating decision, the evidence of record included the Veteran’s service treatment records (STRs) and military personnel records, private treatment records from NJU Cancer Treatment Center received in September 2016 and October 2016, VA Treatment records from East Orange VA Medical Center in CAPRI received August 2015, a September 2018 VA Form 21-4138, and November 2016 VA examination and medical opinion. The evidence received since the December 2016 Rating Decision includes: a medical article entitled “Increased blood pressure in veterans without post-traumatic stress disorder: A case-control study”, a July 2018 VA Medical Opinion, and a December 2017 letter from the Veteran’s private cardiologist Dr. R.B. The Board finds that this evidence is new as it was not previously before the VA and it is relevant because it relates to the issue of nexus between the Veteran’s current disability and his service-connected disabilities. Notably, Dr. R.B. and the July 2018 VA examiner provided positive secondary nexus opinions for the Veteran’s hypertension claim. Accordingly, the Veteran’s claims for hypertension is reopened based on new and material evidence. 2. Service connection The Veteran contends that his hypertension was caused or aggravated by his service-connected PTSD. See May 2018 VA Form 21-526b, Veteran Supplemental Claim. Legal Criteria Service connection may be granted for any current disability that is the result of a disease contracted or an injury sustained in the line of duty during active military service. 38 U.S.C. § 1110; 38 C.F.R. § 3.303(a). Service connection may be granted for a disease diagnosed after discharge, when the evidence, including that pertinent to service, establishes the disease was incurred in service. 38 C.F.R. § 3.303(d). To prevail on the issue of entitlement to secondary service connection, there must be (1) evidence of a current disability; (2) evidence of a service-connected disability; and (3) nexus evidence establishing a connection between the service-connected disability and the current disability. See Wallin v. West, 11 Vet. App. 509, 512 (1998); 38 C.F.R. § 3.310 (2018). Relevant Facts and Analysis The July 2018 VA examiner confirmed that the Veteran has a current diagnosis of hypertension. See July 2018 Hypertension DBQ. As such, the first element of service connection on a secondary basis has been met. The second element on the issue of entitlement to secondary service connection is also met, as the Veteran is service connected for PTSD. See December 2017 Rating Decision. Finally, the nexus element is met, because the July 2018 VA examiner opined that the Veteran’s hypertension was caused or aggravated by his service-connected PTSD. In her rationale, the examiner noted that there have been many studies which have shown an association between PTSD and hypertension. She further stated that “persons with PTSD have been reported to have an increased risk of hypertension.” Id. The Board affords great probative weight to the July 2018 VA examiner’s medical opinion because it was supported by adequate rationale that considered the lay and medical evidence. Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008). The medical opinion is also consistent with the medical article submitted by the Veteran entitled “Increased blood pressures in veterans with post traumatic stress disorder: A case-control study” as well as the studies cited by the examiner which noted an association between hypertension and PTSD. Notably, there is no other medical nexus opinion between the Veteran’s hypertension and service-connected PTSD. Therefore, after resolving reasonable doubt in the Veteran’s favor, the Board finds that the July 2018 VA opinion supports the finding that the Veteran’s hypertension is related to service-connected PTSD at least to an evidentiary position of equipoise. See Gilbert v. Derwinski, 1 Vet. App. at 49 (1990). Accordingly, service connection for hypertension has been granted on a secondary basis. (Continued on the next page) YVETTE R. WHITE Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board G. Lilly, Associate Attorney 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.