Citation Nr: 21040540 Decision Date: 07/05/21 Archive Date: 07/05/21 DOCKET NO. 18-04 493 DATE: July 5, 2021 ORDER Service connection for hypertension is granted. FINDING OF FACT The preponderance of the evidence weighs in favor of a finding that the Veteran's hypertension is secondary to his service-connected posttraumatic stress disorder (PTSD). CONCLUSION OF LAW The criteria for entitlement to service connection for hypertension have been met. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.310. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from July 1988 to July 1992. This claim is on appeal to the Board of Veterans' Appeals (Board) from a September 2016 rating decision. In July 2019, the Veteran testified at a hearing before the Board. In March 2021, the Board sent the Veteran a letter notifying him that the Veterans Law Judge (VLJ) who conducted that hearing is no longer employed by the Board and offering him an opportunity to testify at an additional, optional Board hearing before a VLJ who would decide his claim. The Veteran did not respond to that letter and it was not returned as undeliverable; therefore, the Board will proceed with adjudication of his claim. In November 2019, the Board denied the Veteran's claim and he appealed that denial to the Court of Appeals for Veterans Claims (Court). In a September 2020 Joint Motion for Partial Remand, the parties agreed that vacatur and remand was warranted with respect to the denial of service connection for hypertension. As the Board is granting this claim in the instant decision, which represents a full grant of the benefit sought, any discussion of why the prior denial required vacatur and remand is moot. Service connection for hypertension Service connection may be established for a disability that is proximately due to, or results from, another disease or injury for which service connection has been granted, will be considered part of the original disorder. 38 C.F.R. § 3.310(a). Moreover, 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, will be service connected. 38 C.F.R. § 3.310(b). The Veteran is claiming his hypertension began during active duty service or that it is secondary to his service-connected PTSD. The record contains a June 2016 VA opinion which found the Veteran's hypertension was less likely than not (less than a 50 percent probability) caused by his PTSD reasoning that while PTSD may transiently increase one's blood pressure, there was no medical evidence that it causes blood pressure to be chronically elevated. The examiner also noted that hypertension was believed to be multifactorial in nature according to medical literature and that the Veteran's PTSD could not be the only cause for his hypertension. Another October 2017 VA opinion reflects that the Veteran's hypertension was "multifactorial in etiology, at least partially due to his PTSD," with genetic, obesity, and anxiety also contributing. Based on aforementioned opinions, the Board finds service connection is warranted on a secondary basis. Notably, while the June 2016 opinion reflects that there was no permanent worsening of the Veteran's hypertension which was due to his PTSD, the Court has held that "the 'permanent worsening' standard has no application in cases involving an incremental increase in disability of a non-service-connected condition proximately due to or the result of a service-connected disease or injury." Ward v. Wilkie, 31 Vet. App. 233 (2019); see also 38 C.F.R. § 3.310. Additionally, the October 2017 opinion acknowledges that the Veteran's hypertension was at least partially due to his PTSD as well as his anxiety, which is a symptom of his PTSD. Thus, the Board finds that the preponderance of the evidence weighs in favor of a finding that the Veteran's hypertension is secondary to his PTSD and, therefore, service connection is warranted. ROBERT C. SCHARNBERGER Veterans Law Judge Board of Veterans' Appeals Attorney for the Board O'Connell, Jessica L. 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.