Citation Nr: 21024500 Decision Date: 04/22/21 Archive Date: 04/22/21 DOCKET NO. 18-13 791 DATE: April 22, 2021 REMANDED Entitlement to service connection for hypertension is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from May 1984 to May 1987. This case comes before the Board of Veterans’ Appeals (Board) on appeal from an August 2017 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO). In October 2020, the Veteran testified at a hearing before the undersigned Veterans Law Judge. A transcript of the hearing is of record. Upon review, the Board finds that additional development is needed prior to adjudication of the claim. The Veteran has not been afforded a VA examination in connection with her claim for service connection for hypertension. Although she was not diagnosed with hypertension in service, May 1984 and February 1987 service treatment records show elevated blood pressure readings of 140/100 and 132/100, respectively. In a March 1987 service treatment record from Berlin, Germany, a medical provider noted that the Veteran had a family history of hypertension. Additionally, the Veteran asserts that at the end of her assignment in Berlin, Germany in 1987, the medical provider completing her physical found her blood pressure to be extremely high and that she was not permitted to leave Germany until her blood pressure lowered, which took approximately two weeks. She contends that within a year of her discharge from service, she was diagnosed with hypertension and has taken medication to control it since that time. See December 2017 Notice of Disagreement; October 2020 hearing testimony. The Veteran’s post-service medical records document a diagnosis of hypertension. See e.g. June 2011 VA treatment record. Therefore, the Board finds that a VA examination is needed to determine the nature and etiology of any hypertension that may be present. The matter is REMANDED for the following action: 1. The AOJ should request that the Veteran provide the names and addresses of any and all healthcare providers who have provided treatment for hypertension. After acquiring this information and obtaining any necessary authorization, the AOJ should obtain and associate these records with the claims file. The AOJ should also secure any outstanding VA treatment records, to include any records dated since June 2017. 2. After completing the foregoing development, the Veteran should be afforded a VA examination to determine the nature and etiology of any hypertension that may be present. Any and all studies, tests, and evaluations deemed necessary by the examiner should be performed. The examiner is requested to review all pertinent records associated with the claims file, including the Veteran’s service treatment records, post-service medical records, and lay statements. It should be noted that the Veteran is competent to attest to matters of which she has first-hand knowledge, including observable symptomatology. If there is a medical basis to support or doubt the history provided by the Veteran, the examiner should provide a fully reasoned explanation. The examiner should opine as to whether it is at least as likely as not that the Veteran has hypertension that manifested in service or within one year thereafter or that is otherwise causally or etiologically related to her military service, to include any elevated blood pressure readings documented in her service treatment records (e.g. May 1984 and February 1987 service treatment records that show blood pressure readings of 140/100 and 132/100, respectively). A clear rationale for all opinions would be helpful and a discussion of the facts and medical principles involved would be of considerable assistance to the Board. Because it is important “that each disability be viewed in relation to its history,” 38 C.F.R. § 4.1, copies of all pertinent records in the appellant’s claims file, or in the alternative, the claims file, must be made available to the examiner of review. 3. After completing these actions, the AOJ should conduct any other development as may be indicated. JENNIFER HWA Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board T. J. Williams, Associate 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.