Citation Nr: 21029518 Decision Date: 05/13/21 Archive Date: 05/13/21 DOCKET NO. 16-36 140 DATE: May 13, 2021 ORDER Entitlement to service connection for cerebral hemorrhagic stroke, to include as secondary to service-connected disabilities, is granted. Entitlement to service connection for bilateral vision loss, to include as secondary to service-connected disabilities, is granted. FINDINGS OF FACT 1. Resolving all reasonable doubt in the Veteran's favor, it is at least as likely as not that his cerebral hemorrhagic stroke, to include as secondary to service-connected disabilities, is related to active duty service. 2. Resolving all reasonable doubt in the Veteran's favor, it is at least as likely as not that his bilateral vision loss, to include as secondary to service-connected disabilities, is related to active duty service. CONCLUSIONS OF LAW 1. The criteria for entitlement to service connection for cerebral hemorrhagic stroke, to include as secondary to service-connected disabilities, have been met. 38 U.S.C. §§ 1111, 5107(b); 38 C.F.R. §§ 3.303, 3.304, 3.310. 2. The criteria for entitlement to service connection for bilateral vision loss, to include as secondary to service-connected disabilities, have been met. 38 U.S.C. §§ 1111, 5107(b); 38 C.F.R. §§ 3.303, 3.304, 3.310. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty in the United States Army from December 1965 to December 1967. The Board of Veterans' Appeals (Board) remanded these matters in December 2018 to obtain updated medical records and medical opinions. The requested development has been completed, and the appeal has returned to the Board for further appellate consideration. The Board is now satisfied there was substantial compliance with the remand. See Stegall v. West, 11 Vet. App. 268 (1998). Service Connection Under the relevant laws and regulations, service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active service. 38 U.S.C. §§ 1110, 1131. Generally, the evidence must show: (1) the existence of a present disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service. Shedden v. Principi, 381 F.3d 1163, 1166-67 (Fed. Cir. 2004); Caluza v. Brown, 7 Vet. App. 498, 505 (1995). In addition to the regulations cited above, service connection is warranted for a disability which is aggravated by, proximately due to, or the result of a service-connected disease or injury. 38 C.F.R. § 3.310. Any additional impairment of earning capacity resulting from an already service-connected condition, regardless of whether or not the additional impairment is itself a separate disease or injury caused by the service-connected condition, should also be compensated. Allen v. Brown, Vet. App. 439 (1995). When service connection is thus established for a secondary condition, the secondary condition shall be considered a part of the original condition. Id. 1. Entitlement to service connection for cerebral hemorrhagic stroke, to include as secondary to service-connected disabilities 2. Entitlement to service connection for bilateral vision loss, to include as secondary to service-connected disabilities The Veteran contends that his cerebral hemorrhagic stroke and resulting bilateral vision loss were caused by his service-connected hypertension, diabetes, and coronary artery disease. After considering all the evidence of record, the Board determines that service connection is warranted for cerebral hemorrhagic stroke and bilateral vision loss. First, the Veteran suffered a stroke in December 2009 that resulted in bilateral field of vision loss. Hospitalization discharge papers note a diagnosis of left parietal lobe hemorrhage, suspected secondary to uncontrolled hypertension. Consistent with this, a November 2019 VA examiner opined that the Veterans bilateral visual field defects were caused by his stroke, which was caused by hypertension. The Board acknowledges the negative opinion of the September 2020 VA examiner. However, the examiner stated that nontraumatic intracerebral hemorrhage most commonly results from hypertensive damage to blood vessel walls¬¬ before stating that an opinion on aggravation cannot be made without resorting to speculation. However, after a 3-day hospitalization as a result of the stroke in December 2009, and numerous tests to rule out other etiologies for the stroke, the treating physicians determined the cause of the stroke was likely hypertension, for which the Veteran is service-connected. Ultimately, affording the Veteran the benefit of the doubt, the weight of the evidence supports service connection for cerebral hemorrhagic stroke and bilateral vision loss, to include as secondary to a service-connected disability. Thus, service connection should be granted. 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. B.T. KNOPE Veterans Law Judge Board of Veterans' Appeals Attorney for the Board K. Veltri, Associate Counsel