Citation Nr: 22017221
Decision Date: 03/24/22	Archive Date: 03/24/22

DOCKET NO. 17-41 264
DATE: March 24, 2022

REMANDED

Entitlement to service connection for hypertension, claimed as the result of herbicide agent exposure, is remanded.

REASONS FOR REMAND

The Veteran had active service from June 1968 to December 1969.  He served in the Republic of Vietnam.

Entitlement to service connection for hypertension, claimed as the result of herbicide agent exposure, is remanded.   

Unfortunately, another remand is required in this case.  Although the Board sincerely regrets the additional delay, it is necessary to ensure that there is a complete record upon which to decide the claim.  

In its December 2021 Remand instructions, the Board of Veterans' Appeals (Board) requested that the Veteran be afforded a Department of Veterans Affairs (VA) hypertension evaluation.  The Board directed that the examiner provide an opinion as to whether the diagnosed hypertension "is at least as likely as not (1) proximately due to a service-connected disability, including diabetes mellitus, type II, or (2) aggravated beyond its natural progression by a service-connected disability, including diabetes mellitus, type II."  

A December 2021 VA hypertension evaluation states that the examiner concluded that "the claimed condition is less likely than not (less than 50 percent probability) proximately due to or the result of the Veteran's service connected condition" as "he had the hypertension prior to the diabetes mellitus diagnosis, so less likely than not that his diabetes mellitus caused his hypertension."  He concluded further that the hypertension was not "at least as likely as not aggravated beyond its natural progression by" the service connected disabilities as "his blood pressure has been stable on his current regimen" and "there is no worsening of his blood pressure since the diagnosis of the chronic kidney disability."  The physician comment that "in my opinion, the 30 year smoking history is the cause of his hypertension."  The Board is unable to discern whether there was aggravation of the diagnosed hypertension prior to the Veteran going on his "his current regimen" and the diagnosis of the chronic kidney disorder.  Therefore, the evaluation is of essentially no probative value.  

 Accordingly, this matter is REMANDED for the following action:

Schedule the Veteran for a VA hypertension examination conducted by a medical doctor to assist in determining the nature and etiology of the diagnosed hypertension and any relationship to active service and the service connected disabilities.  The examiner must review the record and should note that review in the report.  A rationale for all opinions should be provided.  The examiner should:

(a)	Opine whether it is at least as likely as not (50 percent probability or greater) that the diagnosed hypertension had its onset during active service or is causally related to any incident of service. 

(b)	Opine whether it is at least as likely as not (50 percent probability or greater) that any hypertension is due to or the result of diabetes mellitus, aortic heart valve replacement residuals, and the other service-connected disabilities.

(c)	 Opine whether it at least as likely as not (50 percent probability or greater) that diagnosed hypertension has been aggravated (increased in severity beyond the natural progress of the disorder) by diabetes mellitus, aortic heart valve replacement residuals, and the other service-connected disabilities.  

 

 

J. T. HUTCHESON

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	H. Marsdale

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.