Citation Nr: 21042562 Decision Date: 07/13/21 Archive Date: 07/13/21 DOCKET NO. 16-24 694A DATE: July 13, 2021 REMANDED Entitlement to service connection for hypertensive vascular disease is remanded. REASONS FOR REMAND The Veteran served active duty in the United States Army from October 1978 to October 1981. This matter comes before the Board of Veterans' Appeals (Board) from a January 2015 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO) in St. Petersburg, Florida. A hearing was held in this matter before the undersigned Veterans Law Judge (VLJ) in March 2019 and a copy of the transcript is in the record. The matter was previously remanded by the Board in an August 2019 decision for additional development and has now returned for further appellate review. The Board observes that the issues of entitlement to service connection for a migraine condition and for depression as secondary to a service-connected eye disability were also remanded in the August 2019 Board decision and were subsequently granted in a July 2020 rating decision. Accordingly, those matters are no longer in appellate status. 1. Entitlement to service connection for hypertensive vascular disease is remanded. Pursuant to the August 2019 Board remand, the Veteran received a VA examination regarding the nature and etiology of his claimed hypertensive vascular disease in December 2019. The December 2019 examiner diagnosed the Veteran with hypertension, but opined that the condition "would not have any relationship to his [service-connected] diplopia, tinnitus, or hearing loss." The examiner also stated that the baseline severity of the Veteran's hypertension was not aggravated by the disabilities that were service-connected at the time of the examination. The examiner noted that the Veteran experienced headaches as a symptom of his hypertension, but did not express an opinion regarding whether the Veteran's hypertension is etiologically related to his now service-connected migraine condition. At the time of the December 2019 examination, the Veteran was not service-connected for headaches, but has since been granted service-connection for a migraine condition. The record is silent for an opinion regarding whether the Veteran's service-connected migraine condition is etiologically related to his claimed hypertensive vascular disease. Accordingly, the Board finds that remand is warranted to obtain a new medical opinion. The matters are REMANDED for the following action: 1. Schedule the Veteran for a VA examination by an examiner with sufficient expertise to address the etiology claimed hypertensive vascular disease. The examiner should specifically note the Veteran's STRs which reflect that the Veteran sought treatment through sick call for chest pains and increased heart rate while on active duty. Following a review of the relevant records and lay statements, the examiner(s) should state an opinion with respect to whether the claimed conditions are at least as likely as not (a 50 percent probability or greater) either directly related to military service or proximately due to or aggravated by the Veteran's service-connected disabilities, to include his service-connected migraine condition. The examiner should state an opinion regarding whether the headaches associated with the Veteran's diagnosed hypertensive vascular disease are separate and distinct from or are etiologically related to his service-connected migraine condition. The examiner(s) must specifically address the Veteran's reports relative to the etiology of the claimed disabilities. If an examiner is unable to provide any required opinion, he or she should explain why. If an examiner cannot provide an opinion without resorting to mere speculation, he or she shall provide a complete explanation as to why this is so. T. REYNOLDS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board D. Gorum, 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.