Citation Nr: 21028568 Decision Date: 05/11/21 Archive Date: 05/11/21 DOCKET NO. 14-19 526 DATE: May 11, 2021 REMANDED Entitlement to service connection for hypertension, to include as due to herbicide exposure, or alternatively, as secondary to service-connected diabetes mellitus, type II, is remanded. REASONS FOR REMAND The Veteran served on active duty from August 1968 to August 1970. On appeal is a March 2012 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO) that denied service connection for hypertension, to include as due to herbicide exposure, or alternatively, as secondary to service-connected diabetes mellitus, type II. A videoconference Board hearing was held in this matter in October 2017 before the undersigned Veterans Law Judge, and a transcript of the proceedings is associated with the claims file. Following that hearing, the Board remanded for additional development, to include obtaining a new VA examination. When the matter returned to the Board, in a September 2019 decision, the Board denied service connection for hypertension, to include as due to herbicide exposure, or alternatively, as secondary to service-connected diabetes mellitus, type II. The Veteran appealed the Board's denial to the United States Court of Appeals for Veterans Claims (Court). In October 2020, the Veteran's representative and the VA General Counsel filed a joint motion for remand (JMR). The parties agreed that the Board erred when it failed to ensure substantial compliance with a prior remand order; failed to ensure that VA provide an adequate VA examination; and failed to provide an adequate statement of reasons or bases for its findings. The Court granted the JMR in November 2020, vacating the Board's September 2019 decision that denied service connection for hypertension, to include as due to herbicide exposure, or alternatively, as secondary to service-connected diabetes mellitus, type II, and remanded the claim for additional action. The case has now been returned to the Board. 1. Entitlement to service connection for hypertension, to include as due to herbicide exposure, or alternatively, as secondary to service-connected diabetes mellitus, type II is remanded. Although the Board sincerely regrets the additional delay imposed on this appeal, the Veteran's claim must be remanded consistent with the October 2020 JMR. First, remand is warranted to obtain a new medical examination that adequately addresses whether the Veteran's hypertension is directly related to service, whether his hypertension is due to herbicide exposure, and whether his hypertension was caused or aggravated by his service connected diabetes mellitus, type II. Second, remand is warranted for the VA examiner to specifically address two internet articles submitted by the Veteran in April 2014 that suggest a relationship between diabetes and high blood pressure. The matter is REMANDED for the following action: Schedule the Veteran for a VA examination by a medical professional with the appropriate expertise to determine the nature and etiology of the Veteran's hypertension. The examiner must review the claims file, must review this Remand, and must note that the review took place in the written report. Any necessary tests should be obtained. The examiner must provide thorough responses to each of the following: (a) Whether it is at least as likely as not (50 percent or greater probability) that the Veteran's diagnosed hypertension is directly related to active service. (b) Whether it is at least as likely as not (50 percent or greater probability) that the Veteran's diagnosed hypertension is due to exposure to herbicides. (c) Whether it is at least as likely as not (50 percent or greater probability) that the Veteran's diagnosed hypertension was caused by the Veteran's service-connected diabetes mellitus type II. When providing this opinion, the examiner must specifically comment on the two internet articles submitted by the Veteran in April 2014 that suggest a relationship between diabetes and high blood pressure. (d) Whether it is at least as likely as not (50 percent or greater probability) that the Veteran's diagnosed hypertension has been aggravated (permanently increased in severity beyond the natural progress of the disorder) by the Veteran's service-connected diabetes mellitus type II. When providing this opinion, the examiner must specifically comment on the two internet articles submitted by the Veteran in April 2014 that suggest a relationship between diabetes and high blood pressure. In addition, should the examiner determine that the medical evidence is not sufficient to support a determination of a baseline level of severity, the examiner must provide a thorough explanation as to why. All opinions offered must be accompanied by a clear rationale consistent with the evidence of record. If the examiner finds it impossible to provide any part of the requested opinions without resort to pure speculation, he or she should so indicate and provide a rationale as to why such a finding is made. Caroline B. Fleming Veterans Law Judge Board of Veterans' Appeals Attorney for the Board T. Jiggetts 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.