Citation Nr: 21031815 Decision Date: 05/24/21 Archive Date: 05/24/21 DOCKET NO. 15-31 162 DATE: May 24, 2021 REMANDED The service connection claim for hypertension is remanded. REASONS FOR REMAND The Veteran served on active duty from November 1987 to January 1992. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a May 2014 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) in Montgomery, Alabama. In March 2019, the Board denied the service connection claim for hypertension, and remanded the service connection claim for a respiratory system disability for additional development. Thereafter, the Veteran appealed the March 2019 Board decision to the United States Court of Appeals for Veterans Claims (Court). After the parties filed a joint motion for partial remand (JMPR), in a June 2020 Order, the Court vacated and remanded the portion of the Board's decision that denied service connection for hypertension. In October 2020, the Board remanded the appealed claims for hypertension and a respiratory system disability to the RO for additional developments, consistent with the June 2020 Court Order. In February 2021, the AOJ granted the service connection claim for a respiratory system disability. Thus, as the AOJ granted the full benefits that the Veteran sought, by filing a service connection claim for a respiratory system disability, this issue is no longer before the Board, on appeal. However, further, additional developments are still required before the Board can appropriately render a fully-informed decision on the service connection claim for hypertension. Consistent with the June 2020 Court Order, the Board remanded this claim for an addendum opinion on the Veteran's hypertension. In this October 2020 remand, the Board, in requesting for an addendum opinion (and a VA examination, if necessary) on the nexus between the Veteran's hypertension and his service, specifically instructed the VA examiner, among other directives, that the VA examiner was to specifically comment on the Veteran's elevated blood pressure readings during service, in April 1990 and November 1990. Accordingly, the Veteran was afforded a VA examination in January 2021. After this examination, a VA examiner opined that after "performing a physical exam and reviewing medical records dated" 1/5/1988; 11/1/90; 8/2/91; 7/15/2014; 7/27/2014; 11/28/2015; 3/7/2019, 10/26/2020, "it is less likely as not that the Veteran's current hypertension is service related, the Veteran did not have an official diagnosis of hypertension until after active duty." As the rationale for this opinion, the VA examiner reasoned, in pertinent part, that the "isolated documentation of high blood pressure does not meet the criteria to establish an official diagnosis of hypertension." However, the VA examiner did not consider all of the medical evidence from his service treatment records (STRs) and post-service treatment records. For example, the Veteran's STRs includes an April 1990 dental health record, which reflects an elevated blood pressure reading. Additionally, a November 1991 physical examination questionnaire form suggests that the Veteran reported having a history of high blood pressure, as the Veteran circled the word, "high blood pressure", with respect to the question asking, "have you had" any of the listed conditions since your last physical examination. Further, a February 1994 annual certificate of physical condition, which was issued approximately two years after his separation from service, also reflects an elevated blood pressure reading. Additionally, the October 2020 remand directed that the VA examiner "specifically comment upon the Veteran's elevated blood pressure readings during service", including the readings from April 1990 and November 1990 STRs. While the VA examiner merely mentioned the documents be reviewed, he did not specifically comment on the November 1990 STR, and he did not comment on the April 1990 STR. A remand by the Board confers on the Veteran or other claimant, as a matter of law, the right to substantial compliance with the remand order. Stegall v. West, 11 Vet. App. 268, 271 (1998). Therefore, a remand is required for compliance with the October 2020 Board remand, and specifically, obtaining a supplemental opinion on the nexus between the Veteran's service and his currently diagnosed hypertension. The matters are REMANDED for the following action: 1. Obtain a supplemental opinion for a clarification of the Veteran's hypertension. The VA examiner must review the claims file and must note that review in the report. A copy of this REMAND must be made available to the VA examiner. The VA examiner must undertake the following: a. Opine whether it is at least as likely as not (50 percent probability or greater) that the Veteran's hypertension was incurred in service, is the result of an in-service injury, illness, disease, or event; and/or is otherwise related the Veteran's active service. b. In rendering an opinion, the VA examiner must specifically address all evidence of high or elevated blood pressure readings in the Veteran's service treatment records and post-service treatment records, especially including the April 1990 and November 1990 treatment records, and the February 1994 annual certificate of physical condition. c. By addressing all evidence of elevated blood pressure readings in the Veteran's STRs, please explain whether these results, and/or any readings that reflect as evidence of high blood pressure during service were a precursor to the Veteran's currently diagnosed hypertension; or a contributory factor of the Veteran's currently diagnosed hypertension. d. A detailed explanation is requested for all opinions provided. If an opinion cannot be provided without resort to speculation, provide an explanation as to why this is so and note what, if any, additional evidence would permit such an opinion to be rendered. M. Tenner Veterans Law Judge Board of Veterans' Appeals Attorney for the Board V-N. Pratt 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.