Citation Nr: 21041107 Decision Date: 07/08/21 Archive Date: 07/08/21 DOCKET NO. 17-02 160 DATE: July 8, 2021 REMANDED The issue of service connection for hypertension is remanded REASONS FOR REMAND The Veteran had active duty service from October 1993 to July 1997 and May 2003 to July 2006. The latter period of service is characterized as non-qualifying for VA benefits. The issue of entitlement to service connection for hypertension is remanded. The matter is REMANDED for the following action: 1. BACKGROUND FOR THE RO ADJUDICATOR: In December 2018, the Board of Veterans' Appeals (Board), remanded the Veteran's claim and directed the Agency of Original Jurisdiction (AOJ), to gather medical records related to hypertension from non-VA medical providers. The Board also instructed the AOJ to obtain a VA examination to determine the etiology of the Veteran's hypertension. The Board cited the numerous elevated blood pressure readings in the Veteran's service treatment records (STRs) and evidence that the Veteran was placed on a cardiac monitor during active duty service. Following the Board's remand, the Veteran was asked to complete VA Form 21-4142 with regard to any non-VA medical providers. The Veteran was also scheduled for a VA examination on December 16, 2019. However, the Veteran failed to attend the examination. A treatment note from June 23, 2020 indicates that the Veteran was unreachable for a period of time and was last seen on April 2, 2018. A June 26, 2020 treatment record indicates that the Veteran called and stated that he was receiving care in a different city but had moved back into the area, the Veteran also provided a new phone number. The Veteran was unreachable for routine treatment around the time of the scheduled examination, but reappeared with a new phone number. Viewing this chronology in the light most favorable to the Veteran, the Board will grant the doubt to him and direct that his examination be rescheduled. The remand directives follow. 2. AOJ ACTIONS: a. Ask the Veteran to complete a VA Form 21-4142 for any non-VA medical providers for his hypertension. Make all reasonable efforts to obtain records cited by the Veteran. b. Schedule the Veteran for an examination by an appropriate clinician to determine whether hypertension (1) began during active service, (2) manifested within one year after discharge from service, or; (3) was noted during service with continuity of the same symptomatology since service. The examiner MUST specifically discuss the significance of any in-service records regarding the monitoring of the Veteran's blood pressure and cardiac symptoms. HOWEVER, THE EXAMINER IS ADVISED THAT HIS/HER SOLE FOCUS IS WHETHER THE VETERAN'S HYPERTENSION BEGAN OR WAS CAUSED BY ANY INCIDENT OF HIS FIRST PERIOD OF SERVICE. THE VETERAN'S SECOND PERIOD OF SERVICE IS NOT QUALIFYING FOR VA BENEFIT PURPOSES BECAUSE OF THE VETERAN'S OTHER THAN HONORABLE DISCHARGE. A complete explanation for the medical opinion is required. The examiner must identify and explain the relevance or significance, as appropriate, of any history, clinical findings, medical knowledge or literature, etc., relied upon in reaching the conclusion(s). If an opinion cannot be expressed without resort to speculation, the examiner should so indicate and discuss why an opinion is not possible, to include whether there is additional evidence that could enable an opinion to be provided, or whether the inability to provide the opinion is based on the limits of medical knowledge. The examiner must review the entire file, but his/her attention is drawn to the following: Date BP Reading(s) 10/29/1993 160/80 10/31/1993 178/85 11/1/1993 124/68 11/2/1993 178/85 11/23/1993 120/80, 142/110, 151/95 11/24/1993 160/80 11/26/1993 150/90 11/27/1993 130/70, 137/61 12/1/1993 116/52 11/27/1994 166/86, 157/81 2/7/1994 142/70 6/21/1994 130/80 9/1/1995 198/78 11/13/1995 138/82 11/8/1996 104/64 (Continued on next page) Readjudicate the issue on appeal. If the benefit sought on appeal remains denied, the Veteran should be provided a supplemental statement of the case (SSOC). An appropriate period of time should be allowed for response before the case is returned to the Board. Vito A. Clementi Veterans Law Judge Board of Veterans' Appeals Attorney for the Board J. Wozniak, 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.