Citation Nr: 21024736 Decision Date: 04/26/21 Archive Date: 04/26/21 DOCKET NO. 16-30 677 DATE: April 26, 2021 ORDER Service connection for epitaxis (nosebleeds) due to hypertension is granted. FINDING OF FACT Resolving all reasonable doubt in the Veteran’s favor, the nosebleeds are due to or caused by the Veteran’s service-connected hypertension. CONCLUSION OF LAW The criteria for entitlement to service connection for nosebleeds due to hypertension have been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.303, 3.310. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served in the United States Army from December 1967 to December 1970 with service in the Republic of Vietnam. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a May 2011 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). In July 2019, the Board remanded this matter for additional development and consideration. The issue has now been returned to the Board for further appellate consideration. As is further discussed below, the Board finds that there has been substantial compliance with the directives of the prior remand. See Stegall v. West, 11 Vet. App. 268 (1998). 1. Entitlement to service connection for nosebleeds due to hypertension. First, the Board must also consider all reasonably raised theories even if not specifically raised by the claimant. See Douglas v. Derwinski, 2 Vet. App. 435 (1992) (evidence reasonably raising a service-connection theory not specifically raised by the claimant must be considered in adjudicating a claim). However, here the Veteran has consistently claimed his nosebleeds are secondary to his service-connected hypertension. See July 2010 VA Form 21-4138 Statement in Support of Claim; February 2011 VA Form 21-4138 Statement in Support of Claim; December 2012 VA Form 21-4138 Notice of Disagreement; see July 2016 VA Form 646 Statement of Accredited Representative; June 2019 Appellate Brief; September 2020 Appellate Brief. Determining, “whether a theory is reasonably raised generally depends on the evidence that is in the record before the agency.” Robinson v. Peake, 21 Vet. App. 545, 552-53 (2008), aff'd sub nom. Robinson v. Shinseki, 557 F.3d 1355 (Fed. Cir. 2009). Thus, the Board is not obliged to "assume the impossible task of inventing and rejecting every conceivable argument in order to produce a valid decision." Id. at 553; see also Healey v. McDonough, No. 18-6970, 2021 U.S. App. Vet. App. (2021). As the evidence of record reflects, the Veteran and his representative contend the only theory of entitlement is that of service connection on a secondary basis due to his service-connected hypertension, the Board finds no other theories of entitlement are reasonably raised by the evidence of record. Secondary Service Connection Service connection may be granted for a disability that is proximately due to or the result of a service-connected disease or injury. 38 C.F.R. § 3.310(a). To prevail under a theory of secondary service connection, there must be: (1) evidence of a current disorder; (2) evidence of a service-connected disability; and (3) medical nexus evidence establishing a connection between the service-connected disability and the current disorder. See Wallin v. West, 11 Vet. App. 509, 512 (1998). When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, VA shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107; see also Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). A. Current Disability The Board finds that the Veteran has a current diagnosis of nosebleeds. See January 2020 VA Sinusitis/Rhinitis and other conditions of the Nose and Throat, Larynx and Pharynx Disabilities Benefits Questionnaire (DBQ). Thus, the first element of service connection is met. B. Service-Connected Disability As to the second element of secondary service connection, the record reflects the Veteran is currently in receipt of service connection for his hypertension. See June 2016 Rating Decision. Therefore, this element is also met. C. Nexus Turning to the third element of secondary service connection, whether there is a nexus between the service-connected disability and the disabilities for which benefits are sought, the Board finds that the March 2011 VA examination supports a finding of service-connection on a secondary basis. See March 2011 Hypertension Examination. Specifically, where the examiner notes the Veteran has a history of nosebleeds related to hypertension. Id. at 5. In December 2020 the Veteran presented to a VA Sinusitis/Rhinitis and other conditions of the Nose and Throat, Larynx and Pharynx examination in compliance with the Board’s July 2019 remand. See December 2020 Sinusitis/Rhinitis and other conditions of the Nose and Throat, Larynx and Pharynx DBQ. The examiner found the Veteran’s nosebleeds less likely than not proximally due to or aggravated beyond its natural progression by his service-connected hypertension associated with posttraumatic stress disorder (PTSD). See December 2020 Sinusitis/Rhinitis and other conditions of the Nose and Throat, Larynx and Pharynx DBQ. However, the examiner failed to provide a rationale for the opinion proffered, and, as such, the Board finds the opinion inadequate as it is conclusory. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008); Stefl v. Nicholson, 21 Vet. App. 120, 124 (2007). As such, the Veteran’s claim of entitlement to service connection for nosebleeds is granted. See 38 U.S.C. § 5107(b) (2012); 38 C.F.R. § 3.102 (2018); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). YVETTE R. WHITE Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board David B. Scheirich, 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.