Citation Nr: 21020728 Decision Date: 04/08/21 Archive Date: 04/08/21 DOCKET NO. 13-16 273 DATE: April 8, 2021 REMANDED Service connection for hypertension, to include as secondary to service-connected asthma, is remanded. Service connection for diabetes mellitus, to include as secondary to service-connected asthma, is remanded. REASONS FOR REMAND The Veteran served honorably in the United States Marines Corps from February 1989 to October 1989 and in the United States Army from September 1993 to February 1994 and from September 2002 to December 2003. These matters come to the Board of Veterans’ Appeals (Board) on appeal from an October 2012 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). This appeal is being adjudicated under the legacy appellate framework. In the June 2013 substantive appeal perfecting this matter to the Board, the Veteran indicated that he did not desire a personal hearing before the Board. These matters were previously before the Board, and, in March 2014 and April 2020, the Board remanded these matters for further development. 1. Service connection for hypertension, to include as secondary to service-connected asthma, is remanded. 2. Service connection for diabetes mellitus, to include as secondary to service-connected asthma, is remanded. Although the Board sincerely regrets further delay, another remand is required in order to afford the Veteran every possible consideration. In April 2020, the Board remanded this matter in order to provide the Veteran with a medical opinion in order to discuss whether or not the Veteran’s hypertension or diabetes was proximately due to or aggravated by the Veteran’s previously service-connected asthma. In June 2020, the Veteran was provided a detailed medical opinion responsive to the Board’s remand instructions. The opinion meticulously detailed the causes of hypertension and diabetes and ruled out the possibility of either disability being proximately due to or aggravated by the Veteran’s previously service-connected asthma. Nevertheless, the Veteran has been granted service connection for a variety of disabilities other than asthma, and the opinion – though ruling out the possibility of service connection as secondary to asthma – is not sufficiently detailed to determine whether or not the Veteran is entitled to service connection as secondary to the Veteran’s other previously service-connected disabilities. Therefore, this matter must be remanded in order to provide the Veteran with a medical opinion sufficiently detailed in order to ensure that the evaluation of the Veteran’s claim is fully formed. Barr v. Nicholson, 21 Vet. App. 303 (2007). Additionally, the Board notes that the June 2020 opinion also indicated that obesity was one of the factors that contributed to the Veteran’s claimed disabilities. Therefore, the medical opinion should also discuss the possibility of whether or not obesity served as a linking condition between any of the Veteran’s previously service-connected disabilities and the Veteran’s claimed hypertension and diabetes. See VAOPGCPREC 1-2017 (January 6, 2017). In light of the foregoing, the Board finds that a remand is required in order to retrieve addendum opinions addressing the above. The matters are REMANDED for the following action: Arrange to provide the Veteran with a VA examination in order to discuss the following: (a.) Is it at least as likely as not that the Veteran’s hypertension is proximately due to or aggravated by any of the Veteran’s previously service-connected disabilities? Why or why not? (b.) If the Veteran’s hypertension was aggravated by any of the Veteran’s previously service-connected disabilities, then estimate the baseline level of the Veteran’s hypertension but for the impact of the Veteran’s previously service-connected disabilities and explain why. (c.) Is it at least as likely as not that the Veteran’s diabetes is proximately due to or aggravated by any of the Veteran’s previously service-connected disabilities? Why or why not? (d.) If the Veteran’s diabetes was aggravated by any of the Veteran’s previously service-connected disabilities, then estimate the baseline level of the Veteran’s hypertension but for the impact of the Veteran’s previously service-connected disabilities and explain why. (e.) Is it at least as likely as not (50 percent or greater probability) that any of the Veteran’s service-connected disabilities caused the Veteran to become obese? Why or why not? (f.) Is it at least as likely as not (50 percent or greater probability) that the Veteran’s obesity was a substantial factor in the development of hypertension? Why or why not? (g.) Is it at least as likely as not (50 percent or greater probability) that the Veteran’s obesity was a substantial factor in the development of diabetes? Why or why not? (h.) Is it at least as likely as not (50 percent or greater probability) that the Veteran’s hypertension would not have occurred but for the Veteran’s obesity? Why or why not? (i.) Is it at least as likely as not (50 percent or greater probability) that the Veteran’s diabetes would not have occurred but for the Veteran’s obesity? Why or why not? DAVID L. WIGHT Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board D. Seaton 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.