12-08 136
12-08 136
| Board of Vet. App. | May 31, 2017Background
- Veteran served on active duty Feb 1979–Apr 1999 and appealed a November 2010 VA RO denial of service connection for hypertension to the Board. The claim was remanded previously (Dec 2013, Mar 2016) and returned following development.
- Service treatment records across >20 years show multiple blood pressure readings that were normal to borderline and no diagnosis or treatment for hypertension in service or at separation.
- Post-service records first document a hypertension diagnosis in Dec 2002 and show antihypertensive medication use by 2003; the Veteran has alternatively reported onset dates (1982; ~2000; ~2001) in various statements.
- VA obtained a February 2014 medical opinion after file review; the examiner confirmed hypertension but opined it was less likely than not related to service, citing in-service BP levels and post-service course.
- The Board found VA satisfied VCAA notice and the duty to assist, credited the VA examiner’s rationale, found the Veteran’s history inconsistent and less probative than contemporaneous records, and concluded the preponderance of evidence weighs against service connection.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Service connection for hypertension (direct) | Veteran asserts hypertension began in service (variously 1982) or within a year after discharge and was treated thereafter | VA contends records show no in-service diagnosis or treatment; first diagnosis in 2002; VA medical opinion finds no nexus to service | Denied — no in-service diagnosis or nexus; preponderance against claim |
| Presumptive service connection (manifestation within 1 year) | Veteran claims manifestations within one-year post-separation (on medications ~2000–2001) | VA notes diagnosis not documented until 2002 (3 years post-discharge), so presumption not met | Denied — failed to show manifestation to compensable degree within one year |
| Competency of lay evidence to establish nexus | Veteran’s lay statements assert service causation | VA argues etiology of hypertension is medically complex and lay assertions are not competent to establish nexus | Board gave greater weight to VA medical opinion; lay statements insufficient to overcome objective records |
| Adequacy of VA’s development (duty to assist) | Veteran implied further development needed | VA obtained records and a VA examiner; Board found duties satisfied | Held adequate — examination and file review were sufficient |
Key Cases Cited
- Scott v. McDonald, 789 F.3d 1375 (Fed. Cir. 2015) (VCAA notice requirements discussed)
- Green v. Derwinski, 1 Vet. App. 121 (1991) (duty to assist includes obtaining medical opinions when necessary)
- Holton v. Shinseki, 557 F.3d 1362 (Fed. Cir. 2009) (elements required for service connection and nexus)
- Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013) (continuity of symptom evidence for chronic disease claims)
- Davidson v. Shinseki, 581 F.3d 1313 (Fed. Cir. 2009) (limitations on lay competence for complex medical etiologies)
- Barr v. Nicholson, 21 Vet. App. 303 (2007) (prejudice standard for examination deficiencies)