Citation Nr: 22001908 Decision Date: 01/13/22 Archive Date: 01/13/22 DOCKET NO. 17-36 075A DATE: January 13, 2022 REMANDED Entitlement to service connection for posttraumatic stress disorder (PTSD) is remanded. Entitlement to service connection for major depressive disorder is remanded. Entitlement to service connection for hypertension is remanded. REASONS FOR REMAND The Veteran served on active duty in the United States Army from July 1968 to March 1971, including service in the Republic of Vietnam. The Veteran was scheduled for a Board hearing in September 2021, which was cancelled by the Veteran. Therefore, the hearing request is deemed withdrawn. 38 C.F.R. § 20.702(e). 1. Entitlement to service connection for PTSD and major depressive disorder are remanded. The Veteran seeks service connection for an acquired psychiatric disorder, to include PTSD and major depressive disorder. The Veteran is diagnosed with recurrent moderate major depressive disorder. The June 2015 VA examiner provided a negative nexus opinion and part of his reasoning included that the Veteran did not seek treatment until 2012. The Veteran's treatment records show ongoing treatment for his psychiatric conditions. While the Veteran has been provided a previous examination to address his mental health, to date, no VA medical opinion has been obtained to address specifically whether the Veteran's acquired psychiatric disorder is etiologically related to any of his service-connected disabilities. Further, the Veteran has not been afforded a VA examination and there is no etiological medical opinion of record taking into consideration the Veteran's lay statements, buddy statements, and additional treatment records since his June 2015 VA examination. Accordingly, to ensure that the Veteran's claim is afforded full consideration, the Board concludes that a remand is warranted in order to provide the Veteran with a VA examination to ascertain the nature, onset and etiology of the Veteran's psychiatric disorder on both a direct and secondary service connection basis. 2. Entitlement to service connection for hypertension is remanded. The Veteran seeks service connection for hypertension. In light of the Veteran's service in Vietnam and presumed Agent Orange exposure, as well as his contentions regarding his disabilities, the Board finds that remand for a VA examination and medical opinion is necessary. See Healey v. McDonough, 33 Vet. App. 312 (2021). Additionally, there is no opinion of record addressing whether the Veteran's hypertension was caused by his exposure to herbicide agents. It is also noted that the National Academies of Sciences, Engineering and Medicine (NAS) issued an update in 2018. In "The Veterans and Agent Orange: Update 11 (2018)," NAS upgraded hypertension from its previous classification in the category of "limited or suggestive" evidence of an association to Agent Orange to the category of "sufficient" evidence of an association. According to NAS, "[t]he sufficient category indicates that there is enough epidemiologic evidence to conclude that there is a positive association" between hypertension and herbicide exposure. In light of the foregoing, the Board finds that an opinion addressing whether there is a relationship between the Veteran's hypertension and exposure to herbicide agents should be obtained. Id. The matters are REMANDED for the following action: 1. Obtain any outstanding VA treatment records. 2. Schedule a VA examination (or telehealth interview, review of the record, etc. if an in-person examination is not feasible) to determine the onset, nature and etiology of any psychiatric disorder(s) found to be present. Based on a review of the file and the lay evidence regarding the onset of his psychiatric problems, the examiner should respond to the following: (a.) Identify all psychiatric disorder(s) found to be present. (b.) With respect to each diagnosed psychiatric disorder, opine whether it is at least as likely as not each disorder had its onset in service or is related to service. 3. Schedule a VA examination (or telehealth interview, review of the record, etc. if an in-person examination is not feasible) for his hypertension. The VA examiner should opine whether it is at least as likely as not that any identified disability had its onset in service or within the first post-service year. (a.) The examiner must also opine as to whether the Veteran's hypertension is related to service or is related to herbicide exposure in Vietnam. (b.) The examiner must also address whether there is any etiology relationship between the Veteran's hypertension and his service-connected disabilities. In reaching this determination, the VA examiner must specifically address the National Academies of Sciences, Engineering and Medicine (NAS) 2018 update regarding the relationship between herbicide exposure and hypertension. Joshua Castillo Acting Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Jordan, Jacquelynn 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.