Citation Nr: 22013395 Decision Date: 03/09/22 Archive Date: 03/09/22 DOCKET NO. 19-31 879 DATE: March 9, 2022 REMANDED Entitlement to service connection for hypertension, to include as secondary to service-connected disabilities is remanded. REASONS FOR REMAND The Veteran served in the United States Army from July 1966 to September 1967. This issue comes before the Board of Veterans' Appeals (Board) on appeal from a January 2019 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). The Veteran contends that his hypertension was caused or aggravated by his service-connected Parkinson's disease. See February 2021 Hearing Transcript. The Board notes that the Veteran was granted service connection for Parkinson's disease in January 2019. A veteran is entitled to VA disability compensation if there is a disability resulting from personal injury suffered or disease contracted in the line of duty in active service, or for aggravation of a preexisting injury suffered or disease contracted in the line of duty in active service. 38 U.S.C. § 1110, 1131 (2012). Generally, to establish a right to compensation for a present disability, a veteran must show: (1) a present disability; (2) an in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the present disability and the disease or injury incurred or aggravated during service, the so-called "nexus" requirement. Shedden v. Principi, 381 F.3d 1163, 1167 (Fed. Cir. 2004). Service connection may be also established on a secondary basis for a disability which is proximately due to or the result of service-connected disease or injury. 38 U.S.C. § 1110, 1131; 38 C.F.R. § 3.310(a). Establishing service connection on a secondary basis requires evidence sufficient to show (1) that a current disability exists and (2) that the current disability was either (a) proximately caused by or (b) proximately aggravated by a service-connected disability. Allen v. Brown, 7 Vet. App. 439, 448 (1995). In order to prevail on the issue of secondary service connection, the record must show: (1) evidence of a current disability; (2) evidence of a service-connected disability; and (3) medical nexus evidence establishing a connection between the service-connected disability and the current disability. Wallin v. West, 11 Vet. App. 509, 512 (1998); see also Allen, supra. This claim was denied based on a lack of clinical diagnosis for the Veteran's hypertension condition. However, the Veteran's medical treatment records include a clinical diagnosis and treatment for hypertension. The Board notes that the Veteran has not undergone a VA examination for hypertension. The Veteran underwent one VA examination for Parkinson's disease; however, an etiology opinion regarding the Veteran's hypertension disorder, to include if it was secondary to the recently service-connected Parkinson's disease, has not been rendered. See November 2018 VA Examination. At this time, there is insufficient medical evidence for the Board to decide this claim. As such, it must remand this matter to secure a VA medical opinion on the etiology of the Veteran's claimed hypertension disorder. McLendon v. Nicholson, 20 Vet. App. 79, 81(2006). The matter is REMANDED for the following action: 1. In remanding this matter, the Board makes no finding, implicit or otherwise, as to the credibility of the Veteran's assertions. Neither the Veteran's credibility nor any lack thereof should be presumed in this remand. 2. Obtain a VA medical opinion regarding the etiology of the Veteran's hypertension from a medical professional with appropriate expertise. The claims file must be forwarded and reviewed by the examiner. A notation should be made on the examination report that the claims file has been reviewed. Based on a review of the record, the examiner is to render the following opinions: (a.) Whether it is at least as likely as not (a 50 percent or greater probability) that the Veteran's hypertension is the result of active-duty service? (b.) If the answer to (a.) is negative, then whether it is at least as likely as not that the hypertension was caused by the Veteran's service-connected Parkinson's disease? (c.) If the answer to (b.) is negative, then whether it is at least as likely as not that the hypertension was aggravated beyond its natural progression by the Veteran's service-connected Parkinson's disease? Please explain in detail any opinion provided and the supporting rationale. The term "at least as likely as not" does not mean within the realm of medical possibility, but rather that the medical evidence both for and against a certain conclusion is so evenly divided that it is as medically sound to find in favor of such a conclusion as it is to find against it. "Aggravation" means any increase in severity of a nonservice-connected disease or injury that is proximately due to or the result of a service-connected disease, and not due to the natural progress of the nonservice-connected disease. If aggravation is found, the examiner should attempt to quantify the extent of additional disability resulting from the aggravation. In rendering the requested opinion, the examiner should note that the Veteran is competent to attest to matters of which he has first-hand knowledge, including observable symptomatology. If the examiner cannot provide an opinion without resorting to mere speculation, he or she shall provide a complete explanation for why an opinion cannot be rendered. In so doing, the examiner shall explain whether the inability to provide a more definitive opinion is the result of a need for additional information, or that he or she has exhausted the limits of current medical knowledge in providing an answer to that particular question(s). G. A. WASIK Veterans Law Judge Board of Veterans' Appeals Attorney for the Board V. Schmidt 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.