Citation Nr: 25003584 Decision Date: 03/14/25 Archive Date: 03/14/25 DOCKET NO. 19-05 479 DATE: March 14, 2025 REMANDED Service connection for hypertension is remanded. REASONS FOR REMAND The Veteran had active service in the United States Army from January 1985 to December 1991, to include service in Southwest Asia. He participated in Toxic Exposure Risk Activity ( TERA ) during active service. This matter comes before the Board of Veterans' Appeals (Board) from a November 2018 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). In October 2024, the Court of Appeals for Veterans Claims (Court) vacated and remanded an April 2024 Board decision that denied the claim of service connection for hypertension, pursuant to a Joint Motion for Remand. Specifically, the parties agreed that the February 2024 VA medical opinion was inadequate as it "inappropriately require[s] scientific consensus in order to establish a nexus" and "inappropriately rel[ies] on the lack of a hypertension diagnosis or symptomatology during service as dispositive of the matter of nexus." 1. Service connection for hypertension is remanded. As discussed above, the Board finds that the February 2024 VA medical opinion is inadequate for the reasons stated above, and as discussed in the August 2023 Board decision, the October 2018 VA examination is also inadequate. Thus, there are no adequate medical opinions of record. Therefore, the Board finds that a new VA medical opinion is warranted to address the nature and etiology of the Veteran's hypertension. Barr v. Nicholson, 21 Vet. App. 303, 312 (2007) (when VA undertakes to provide an examination or obtain a medical opinion, it must ensure that the examination or opinion is adequate). The matter is REMANDED for the following action: Obtain an addendum VA medical opinion regarding the Veteran's hypertension. Specifically, the examiner must opine whether it is at least as likely as not (likelihood is at least approximately balanced or nearly equal, if not higher) that hypertension was caused by the Veteran's service. The examiner must provide a complete rationale for his or her opinion(s) in the examination report. If any of the above requested opinions cannot be made without resort to speculation, the examiner must state this and provide a rationale for such conclusion. The examiner is advised that he or she may not solely rely on the absence of contemporaneous medical evidence and that it is only necessary for it to be "at least as likely as not" caused by the Veteran's service, rather than requiring a "scientific consensus." The medical opinion must support the conclusions reached with an analysis that is adequate to consider and weigh against other evidence of record; medical opinions must contain not only clear conclusions with supporting data, but also a reasoned medical explanation connecting the two. If an opinion cannot be expressed without resorting to speculation, explain 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 need for another examination is left to the discretion of the examiner offering the addendum opinion. Paulette Vance Burton Veterans Law Judge Board of Veterans' Appeals Attorney for the Board H.S. Yun 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.