Citation Nr: 21028544 Decision Date: 05/11/21 Archive Date: 05/11/21 DOCKET NO. 13-05 129 DATE: May 11, 2021 REMANDED Entitlement to service connection for hypertension is remanded. REASONS FOR REMAND The Veteran had active air service from December 1992 to January 1993. This case comes before the Board of Veterans' Appeals (Board) on appeal of a March 2014 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). In February 2015, the Board remanded the issue on appeal for additional development. In February 2018, this case was again before the Board at which time the issue on appeal was denied. The Veteran thereafter appealed the Board's decision to the United States Court of Appeals for Veterans Claims (Court). In a February 2019 memorandum decision, the Court set aside the Board's February 2018 decision and remanded the issue on appeal to the Board. In Board decisions dated October 2019, April 2020, June 2020, and January 2021, the issue on appeal was remanded for additional development. The case has now returned to the Board for further appellate action. The Board regrets additional delay but finds that another remand is warranted. As mentioned above, this case has been remanded several times. A culmination of those remands reveal that the VA medical opinions of record failed to address both the Veteran's relevant in-service blood pressure readings and his lay statements. In a January 2021 VA addendum opinion, a VA examiner opined that that Veteran's hypertension was less likely than not incurred in or caused by active service. The VA examiner reasoned that the Veteran's in-service blood pressure readings did not constitute hypertension per the current VA guidelines. The VA examiner also reasoned that the Veteran had no medical records documenting hypertension proximate to active duty. Based on the foregoing, the Board finds that the January 2021 VA addendum opinion is inadequate for adjudication purposes. In that regard, the VA examiner based part of her opinion on the absence of an in-service diagnosis of hypertension per VA guidelines. See Fountain v. McDonald, 27 Vet. App. 258, 272-75 (2015); Dalton v. Nicholson, 21 Vet. App. 23 (2007). The VA examiner also failed to opine as to whether the Veteran's post-service hypertension was an extension of, or otherwise associated with, his elevated blood pressure readings during service. Additionally, the VA examiner failed to comment on the Veteran's statement of continued symptoms of hypertension since his separation from active service. The Board notes that the Veteran is competent to report the observable symptoms of his hypertension. Layno v. Brown, 6 Vet. App. 465 (1994). Accordingly, as the January 2021 VA examiner failed to consider the Veteran's competent complaints of hypertension symptoms following service and partially based the opinion on the absence of evidence, a remand for a new VA opinion is warranted. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295 (2008); Barr v. Nicholson, 21 Vet. App. 303 (2007). The Board notes that this claim must be handled in an expeditious manner. See 38 U.S.C. §§ 5109B, 7112 (2018). This matter is REMANDED for the following actions: 1. Forward the claims file, to include a copy of this remand, to a VA examiner with the appropriate expertise, who has not previously rendered an opinion, for an addendum opinion regarding the nature and etiology of the Veteran's hypertension. The examiner must review the claims file a note that review in the report. Based on a review of the record, the examiner must provide an opinion as to whether it is at least as likely as not (50 percent probability or greater) that the Veteran's hypertension had its onset during service or is otherwise related to his service. In forming this opinion, the examiner must comment on the Veteran's statement regarding continuity of symptomatology since his separation from service. Further, the examiner is advised that the absence of an in-service diagnosis of hypertension, per VA guidance, does not in and of itself indicate that the Veteran's post-service diagnosis of hypertension is not related to his active service. 2. Then, readjudicate the claim. If a decision is adverse to the Veteran, issue a supplemental statement of the case and allow the appropriate time for response. Then, return the claim to the Board. Roya Bahrami Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board A. Byrd, 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.