Citation Nr: 21028232 Decision Date: 05/10/21 Archive Date: 05/10/21 DOCKET NO. 15-04 850 DATE: May 10, 2021 REMANDED Entitlement to service connection for hypertension, to include as due to asbestos exposure, and secondary to service-connected asbestosis with interstitial lung disease, is remanded. REASONS FOR REMAND The Veteran served on active duty with the United States Navy from March 1966 to December 1969. This matter initially came before the Board of Veterans' Appeals (Board) on appeal from a January 2012 rating decision. When this case was last before the Board in May 2018 it was remanded for further development. The Veteran died while this matter was in remand status. The appellant is the Veteran's surviving spouse and has been substituted for the Veteran with respect to the issue of entitlement to service connection for hypertension. The Board extends its sympathy to the appellant and is grateful for the Veteran's honorable service. The Board, however, finds that additional development is necessary prior to adjudicating this claim. The Veteran was afforded a VA examination in August 2018 pursuant to the May 2018 Board remand. The examiner was asked to opine if the Veteran's hypertension was at least as likely as not related to an in-service event, to include any asbestos exposure. The examiner who conducted the August 2018 examination opined that the Veteran's hypertension was less likely than not due to an in-service event or injury. The examiner reasoned that the Veteran's service treatment records were silent for in service treatment or diagnosis of hypertension. However, the examiner did not provide any opinion regarding whether the Veteran's hypertension was due to asbestos exposure. Furthermore, the Veteran stated that his high blood pressure contributed to his heart problems because of his breathing problems. See VA Form 9 received in January 2015. The Veteran was granted service connection for asbestosis with interstitial lung disease. Thus, as a theory of secondary service connection has been raised, the claim should also be addressed on this basis, to include obtaining a VA opinion addressing this theory of entitlement. Finally, the appellant submitted private medical treatment records in May 2019 regarding the Veteran's hypertension and other medical issues. As these were submitted subsequent to the VA examination, the examiner was not able to review and address them. In light of the above, a remand is necessary to obtain a new medical opinion as to whether the Veteran's hypertension was related to service or was caused or aggravated by his service-connected respiratory disability. Also, the evidence indicates that there may be outstanding relevant VA treatment records. The most recent VA treatment records in the claims file are from the Orlando Vista electronic records system and are dated to August 2018. Any VA treatment records are within VA's constructive possession, and must be obtained regardless of their relevance as long as they are sufficiently identified. Sullivan v. McDonald, 815 F.3d 786, 793 (Fed. Cir. 2016) (VA has a duty to assist in obtaining sufficiently identified VA medical records regardless of their relevance). See also Jones v. Wilkie, 918 F.3d 922 (Fed. Cir. 2019) (confirming the holding in Sullivan). A remand is required to allow VA to obtain them. This matter is REMANDED for the following action: 1. Obtain the Veteran's outstanding VA treatment records from the Orlando Vista electronic records system for the period from August 2018 through March 2019; and all such relevant records from any other sufficiently identified VA facility. 2. After all efforts have been exhausted to obtain and associate with the claims file any additional treatment records, obtain a VA opinion from an appropriate clinician to determine whether the Veteran's hypertension was related to service or was caused or aggravated by service-connected disability. The claims file, including a copy of this remand, must be made available to and reviewed by the clinician. After review of the claims file, the clinician is asked to provide a response to the following: (a.) Is it at least as likely as not that the Veteran's hypertension (1) began during service; (2) manifested within one year after discharge from service; OR (3) was related to an in-service injury or disease, including asbestos exposure? (b.) Is it at least as likely as not that the Veteran's hypertension was proximately due to or the result of his service-connected asbestosis with interstitial lung disease? (c.) Is it at least as likely as not that the Veteran's hypertension was aggravated (i.e., worsened beyond its natural progression) by his service-connected asbestosis with interstitial lung disease? Aggravation is defined as any increase in severity of a nonservice-connected disease or injury that is proximately due to or the result of a service-connected disease or injury, and not due to the natural progress of the nonservice-connected disease. The clinician is advised that a finding that the Veteran's hypertension was aggravated beyond the normal progression due to a service-connected disability does not require evidence of permanent worsening and may encompass any additional impairment in earning capacity resulting from an already service-connected condition. A complete rationale should be provided for all opinions. In providing his or her opinion, the clinician should address the Medical Treatment Record provided by the appellant in May 2019 and the Veteran's secondary service connection theory raised in his January 2015 VA Form 9. Brian J. Elwood Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board C. Townsend, 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.