Citation Nr: 21027428 Decision Date: 05/05/21 Archive Date: 05/05/21 DOCKET NO. 16-39 483 DATE: May 5, 2021 REMANDED The appeal as to the claim of entitlement to service connection for hypertension, to include as secondary to service-connected disabilities, to include medications prescribed, is remanded. REASONS FOR REMAND The Veteran had active service in the United States Army from March 1964 to March 1966. His service was under honorable conditions. The matter is from a September 2014 rating decision. In October 2017, the Board issued a decision which, in pertinent part, denied the Veteran's claim seeking service connection for hypertension, to include as secondary to diabetes mellitus, type II. The Veteran appealed the denial to the United States Court of Appeals for Veterans Claims (Court). In August 2018, the Court granted a Joint Motion for Remand, which set aside this portion of the October 2017 Board decision and remanded the matter for further adjudication consistent with the Joint Motion. The Veteran contends that his current hypertension is secondary to his service-connected diabetes mellitus, type II disability, including medications prescribed for these disorders. A disability which is proximately due to or the result of a service-connected disease or injury shall be service connected. When service connection is thus established for a secondary condition, the secondary condition shall be considered a part of the original condition. 38 C.F.R. § 3.310(a) (2020). This includes any increase in severity of a nonservice-connected disease that is proximately due to or the result of a service-connected disability as set forth in 38 C.F.R. § 3.310(b). See also Allen v. Brown, 7 Vet. App. 439 (1995) (en banc). A claimant is also entitled to service connection on a secondary basis when it is shown that a service-connected disability aggravates a nonservice-connected disability. 38 C.F.R. § 3.310; Allen, 7 Vet. App. at 439. Post-service VA outpatient treatment records note diagnoses of hypertension and diabetes mellitus, type II, in 1999, to the present. The October 2020 and February 2021 VA examination reports include the examiners findings, that the Veteran's current hypertension was not aggravated by his service-connected diabetes mellitus, type II disability. The October 2020 and February 2021 VA opinions are inadequate to adjudicate the claim, as the examiners failed to provide any rationale to support their conclusion, that the Veteran's current hypertension was not aggravated by his service-connected diabetes mellitus, type II disability. In addition, the examiners failed to address the medications prescribed for the service-connected diabetes mellitus, type II, and peripheral neuropathy of the bilateral upper and lower extremity disabilities. Accordingly, another medical opinion is necessary to make a determination in this case. Barr v. Nicholson, 21 Vet. App. 303, 311 (2007). The matter is REMANDED for the following actions: 1. Undertake appropriate development to obtain any outstanding records pertinent to the Veteran's claim. If any requested records are unavailable, or the search for such records otherwise yields negative results, that fact should clearly be documented in the record and the Veteran so notified in accordance with 38 C.F.R. § 3.159(e). All steps taken to attempt to obtain the above records should clearly be documented in the record. 2. Obtain a medical opinion from an appropriate VA examiner to determine the etiology of the Veteran's current hypertension. The Veteran need not appear for an examination unless deemed necessary by the physician assigned to offer an opinion. Following review of the record, the physician should state a medical opinion with respect to hypertension present during the period of the claim, as to whether it is at least as likely as not (i.e., at least 50 percent probable) that the current hypertension disorder was caused or permanently worsened by the service-connected diabetes mellitus, type II disability, to include medications prescribed for the service-connected diabetes mellitus, type II, and peripheral neuropathy of the bilateral upper and lower extremity disabilities. If the physician believes that a hypertension disorder was permanently worsened by a service-connected disorder(s), to include medication prescribed for the service-connected disorder(s), the physician should attempt to identify the baseline level of disability that existed prior to the onset of aggravation and the extent of disability that is attributable to aggravation. A complete rationale must be provided for all opinions offered. If an opinion cannot be offered without resort to mere speculation, the examiner must fully explain why this is the case and identify what additional evidence, if any, would allow for a more definitive opinion. Another examination of the Veteran should only be performed if deemed necessary by the physician providing the opinions. 3. Then, the AOJ should readjudicate the issue on appeal. If the benefits sought on appeal are not granted to the Veteran's satisfaction, he and his representative should be provided a supplemental statement of the case and an appropriate period for response before the case is returned to the Board for further appellate action B. MULLINS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Sara Schinnerer, 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.