Citation Nr: 21024517 Decision Date: 04/23/21 Archive Date: 04/23/21 DOCKET NO. 13-03 609A DATE: April 23, 2021 REMANDED Entitlement to service connection for hypertension is remanded. REASONS FOR REMAND The Veteran served on active duty from April 1966 to April 1970. In April 2020, the Board remanded this case for additional development to include obtaining private treatment records. An April 15, 2020 letter requested that the Veteran complete a VA Form 21-4142 so that private treatment records could be obtained on the Veteran’s behalf. The Veteran and representative did not respond to the April 15, 2020, letter. An April 5, 2019, letter also requested that the Veteran complete a VA Form 21-4142 so that private treatment records could be obtained on the Veteran’s behalf. The Veteran and representative did not respond to the April 5, 2019, letter. The duty to assist is not a one-way street. If a Veteran wishes help, he cannot passively wait for it in those circumstances where he may or should have information that is essential in obtaining the putative evidence. Wood v. Derwinski, 1 Vet. App. 190 (1991). The Board finds that the Veteran was provided an opportunity to submit additional treatment records or authorization for VA to obtain any outstanding records and was afforded a VA examination. Therefore, there has been substantial compliance with the April 2020 remand requests. Stegall v. West, 11 Vet. App. 268 (1998). Entitlement to service connection for hypertension The Board requested a medical opinion which addressed whether hypertension was the result of service, to include herbicide agent exposure, and whether hypertension was caused or aggravated by any service-connected disability. An October 2020 VA examiner opined that hypertension was not the result of service, presumed herbicide agent exposure, or a service-connected disability. The examiner explained that: (1) there was no medical evidence to support a diagnosis of or treatment for hypertension during service; (2) the Veteran's hypertension was most likely an idiopathic; and (3) there was no medical pathophysiologic relationship between prostate cancer and/or erectile dysfunction causing or leading to hypertension. The examiner noted that “hypertension that has no identifiable cause, most commonly affecting 95% of the patients with hypertension.” The Board finds the opinion incomplete. The VA examiner did not explain why, in the Veteran’s particular case, an idiopathic etiology was more likely than conceded herbicide agent exposure. When VA provides an examination or obtains an opinion, the examination or opinion must be adequate. Barr v. Nicholson, 21 Vet. App. 303 (2007). Therefore, a VA examination to address the nature and etiology of hypertension is necessary. Additionally, the Board notes that a January 27, 2021 rating decision established service connection for diabetes mellitus and assigned a 20 percent rating, effective September 29, 2020. Service-connected diabetes mellitus was not considered in a addressing secondary theory of entitlement. The matter is 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. All attempts to obtain records must be documented in the claims folder. 2. Then, schedule the Veteran for a VA examination to obtain a medical opinion to determine the etiology of the hypertension. The examiner must review the claims file and should note that review in the report. The examiner must opine whether: (a.) Opine whether it is at least as likely as not (50 percent or greater probability) that hypertension was caused by any event, injury, or disease during service, to include by presumed exposure to herbicide agents during service. The examiner is advised that herbicide agent exposure is conceded. The examiner is further advised that a negative opinion cannot be based exclusively on the: (1) absence of medical records, or (2) fact that VA has not recognized hypertension as presumptive diseases related to herbicide exposure. The examiner should review medical research in determining the likelihood that hypertension is related to herbicide agent exposure during service. (b.) Opine whether it is at least as likely as not (50 percent or greater probability) that hypertension manifested within one year following separation from service. (c.) Opine whether it is at least as likely as not (50 percent or greater probability) that hypertension was caused by any service-connected disability or treatment for any service-connected disability, to specifically include diabetes mellitus and prostate cancer. (d.) Opine whether it is at least as likely as not (50 percent or greater probability) that hypertension has been aggravated (increased in severity beyond the normal progress of the disorder) by any service-connected disability or treatment for any service-connected disability, to specifically include diabetes mellitus and prostate cancer. (e.) The examiner should consider the Veteran’s lay assertions and provide a complete rationale for each opinion with references to the record, diagnostic tests, and medical literature or research. Harvey P. Roberts Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board E.O., 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.