Citation Nr: 21028224 Decision Date: 05/10/21 Archive Date: 05/10/21 DOCKET NO. 10-38 089 DATE: May 10, 2021 REMANDED Entitlement to service connection for the cause of the Veteran's death is remanded. REASONS FOR REMAND The Veteran served on active duty from August 1976 to July 2003. His awards include the Army Commendation Medal. He passed away and the appellant is his surviving spouse. This matter initially came before the Board of Veterans' Appeals (Board) from a July 2009 rating decision. In April 2015, the Board remanded this matter for further development. In March 2017, the Board denied the claim of service connection for the cause of the Veteran's death. The appellant appealed the Board's decision to the United States Court of Appeals for Veterans Claims (Court). In February 2018, the Court set aside the Board's March 2017 decision and remanded to the Board the issue of entitlement to service connection for the cause of the Veteran's death for readjudication in compliance with directives specified in a February 2018 Joint Motion filed by counsel for the appellant and VA. In June 2018 and April 2020, the Board remanded this matter for further development. Entitlement to service connection for the cause of the Veteran's death is remanded. The Board is cognizant of the fact that this matter has been in adjudicative status for years and has already been remanded multiple times in the past. Nevertheless, as explained in more detail below, the Board finds that it is necessary to obtain a medical opinion that addresses a new contention raised by the appellant's representative. Consequently, the Board wishes to assure the appellant that it would not be remanding this matter again unless it was essential for a full and fair adjudication of her claim. In April 2020, the Board remanded the issue on appeal to obtain a new medical opinion based on additional medical information that had been associated with the record. A new VA medical opinion was provided in May 2020, which substantially complied with the Board's remand instructions. Subsequently, the appellant's representative submitted an appellate brief in April 2021 containing a new theory of service connection. The representative reported that the Veteran had several service-connected musculoskeletal disabilities that resulted in chronic pain at the time of his death. The representative further contended that chronic pain can lead to elevated blood pressure and hypertension. The representative cited medical articles that correlated chronic pain to an increase in blood pressure, and the representative requested that the matter on appeal be remanded for further development if necessary. Since the appellant's representative has raised a new theory of entitlement with supporting medical literature (i.e., that the Veteran's service-connected musculoskeletal disabilities caused an increase in blood pressure which ultimately contributed to his death) and a medical opinion has not yet been obtained that addresses this contention, the Board will grant the representative's request and remand the matter on appeal to obtain an appropriate medical opinion. The matter is REMANDED for the following action: Obtain an addendum opinion from an appropriate clinician regarding whether the Veteran's fatal hypertension was at least as likely as not (1) proximately due or the result of the Veteran's service-connected musculoskeletal disabilities (to include pain associated with these disabilities); OR (2) aggravated beyond its natural progression by the service-connected musculoskeletal disabilities (to include pain associated with these disabilities). The clinician must provide reasons for each opinion given. In this regard, the clinician must address the medical literature the Veteran's representative mentioned in the April 2021 appellate brief. Brian J. Elwood Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board S. Imam, 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.