Citation Nr: 21026963 Decision Date: 05/04/21 Archive Date: 05/04/21 DOCKET NO. 16-28 229 DATE: May 4, 2021 ORDER Entitlement to service connection for hypertension is granted. FINDING OF FACT Hypertension is caused or aggravated by the Veteran's service-connected back disability. CONCLUSION OF LAW The criteria for service connection for hypertension have been met. 38 U.S.C. §§ 101, 106, 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.310. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Army from July 1990 to March 1994. This appeal comes before the Board of Veterans' Appeals (Board) from a July 2012 rating decision of a Department of Veterans Affairs (VA) Regional Office (RO). In his June 2016 VA Form 9, the Veteran requested the opportunity to present testimony at a hearing before the Board. In an April 2019 statement, he requested to withdraw his hearing request. Accordingly, his hearing request is withdrawn. 38 C.F.R. § 20.704 (e). Entitlement to service connection for hypertension is granted. In order to establish service connection for a claimed disorder, the following must be shown: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Service connection may be established on a secondary basis for a disability which is proximately due to or the result of service-connected disease or injury. 38 C.F.R. § 3.310(a). Establishing service connection on a secondary basis requires evidence sufficient to show (1) that a current disability exists and (2) that the current disability was either (a) proximately caused by or (b) proximately aggravated by a service-connected disability. Allen v. Brown, 7 Vet. App. 439, 448 (1995) (en banc). Service connection for certain chronic diseases, including hypertension, may be presumed to have been incurred in service by showing that the disease manifested itself to a degree of 10 percent or more within one year from the date of separation from service. 38 U.S.C. §§ 1101 (3), 1112; 38 C.F.R. §§ 3.307 (a)(3), 3.309(a). Such a chronic disease is presumed under the law to have had its onset in service even though there is no evidence of that disease during the period of service. 38 C.F.R. §§ 3.307 (a). Alternatively, when a chronic disease is shown in service, sufficient to permit a finding of service connection, subsequent manifestations of the same chronic disease at any later date, however remote, are service connected, unless clearly attributable to intercurrent causes. 38 C.F.R. § 3.303 (b). To be "shown in service," the disease identity must be established, and the diagnosis must not be subject to legitimate question. Walker v. Shinseki, 708 F.3d 1331, 1335 (Fed. Cir. 2013); see also 38 C.F.R. § 3.303 (b). However, if a condition is not noted during service, then generally a showing of continuity of symptomatology after service is required for service connection, if the disability is one that is listed in 38 C.F.R. § 3.309(a). 38 C.F.R. § 3.303(b); see also Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013). When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, the Secretary shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107; 38 C.F.R. § 3.102; see also Gilbert v. Derwinski, 1 Vet. App. 49, 53 (1990). The Veteran is currently diagnosed with hypertension. See April 2016 VA Examination. The record also shows the Veteran is service connected for a back disability effective April 1994. Therefore, the Board finds that the appeal turns on whether the record contains competent and credible evidence that shows that the hypertension is caused or aggravated by his service-connected back disability. See 38 C.F.R. § 3.310; Wallin v. West, 11 Vet. App. 509, 512 (1998). A June 2003 VA examiner provided a positive nexus opinion between the Veteran's hypertension and his service-connected back disability. The Board finds this opinion the most probative evidence of record because it is provided after a review of the record on appeal and an examination of the Veteran as well as because it is supported by citation to evidence found in the record and controlling medical principles. See Owens v. Brown, 7 Vet. App. 429, 433 (1995). Tellingly, at this time, this opinion is also not contradicted by any other medical evidence of record. See Colvin v. Derwinski, 1 Vet. App. 171, 175 (1991) (VA may only consider independent medical evidence to support its findings and is not permitted to base decisions on its own unsubstantiated medical conclusions). Therefore, the Board finds that it is the most probative evidence of record. See Owens, supra. Under such circumstances and with granting the Veteran the benefit of any doubt in this matter, the Board concludes that secondary service connection for hypertension is warranted. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.310; Gilbert, supra. John J. Crowley Veterans Law Judge Board of Veterans' Appeals Attorney for the Board L. Holcombe, 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.