Hypertension (high blood pressure) Board decisions

The Veteran's appeal is being remanded due to the need for a statement of the case on his PTSD rating and scheduling him for a Travel Board Hearing at the Houston, Texas RO.

The Veteran's depressive disorder is found to be secondary to his service-connected coronary artery disease and hypertension. The Veteran's service-connected residuals of shell fragment wounds to the right leg are not productive of complete paralysis of the internal popliteal tibial nerve; nor does it represent an exceptional disability picture. A separate disability rating of 10 percent, but no higher, is warranted for deep scars in the posterior popliteal fossa area of the right leg that cover an area in excess of 6 inches but not 12 inches. The Veteran's service-connected residuals of shell fragment wounds to the left leg are not productive of a severe muscle injury; nor does it represent an exceptional disability picture. A separate disability rating of 10 percent, but no higher, is warranted for deep scars on the posterior aspect of the left calf and knee areas that cover an area in excess of 6 inches but not 12 inches. The Veteran's service-connected coronary artery disease, status post three stents, is not productive of congestive heart failure, workload of greater than 3 METs but no great than 5 METs that results in dyspnea, fatigue, angina, dizziness, or syncope, or, left ventricular dysfunction with an ejection fraction of 30 to 50 percent; nor does it represent an exceptional disability picture. The Veteran's service-connected hypertension is consistent with diastolic pressure predominately 100 or more, requires continuous medication, and does not represent an exceptional disability picture.

The Veteran's hypertension is not service-connected as it did not manifest during or within one year after his military service, and there is no evidence of a nexus to his service-connected PTSD or diabetes. Hypertension was first diagnosed many years after separation from service.

The Veteran's hypertension was incurred during service and is related to his military service.,The Veteran's heart disorder, including congestive heart failure and cardiomyopathy, is likely secondary to his service-connected hypertension. The residuals of cerebrovascular accidents are also related to the Veteran's service-connected hypertension.

The Veteran's cause of death is listed as COPD, with CAD and hypertension as significant contributing conditions. The Board finds that the Veteran served in Vietnam during a period when herbicide exposure was presumed, and thus service connection for his coronary artery disease (CAD) is granted.

The Veteran's appeal is being remanded for additional development, including obtaining medical records and providing the Veteran with VA examinations to assess his PTSD, heart disability, hypertension, sleep apnea, and left wrist condition.

The Veteran's claims for increased ratings and service connection are denied. The effective date of the right elbow disorder is also denied.,Service connection has been established for diabetes mellitus, type II; however, an earlier effective date is not warranted.

The Veteran's appeal is being remanded for further action, including the appointment of an authorized representative and scheduling a Travel Board hearing.

The Board denied the Veteran's claims for service connection for hypertension and a skin condition, finding that there was no evidence of chronicity in service or at separation, and noting the lack of continuity of symptomatology since service. The Board also found that the Veteran did not meet the presumptive criteria for these conditions due to herbicide exposure.

The Veteran's hypertension is service connected as it began during his active duty and continued after retirement, with a reasonable doubt resolved in favor of the Veteran.

The Board finds that the Veteran's death was not caused by VA hospital care, medical or surgical treatment, and there is no evidence of any fault on the part of VA. The cause of death was a pulmonary embolism due to the femoral fracture.

The Board has determined that further development is needed to address the cause of death and DIC claims, including obtaining a medical opinion regarding the relationship between the Veteran's service-connected back disability and his death.

The Board denied reopening the claim of service connection for hypertension in September 2007. New evidence received since that decision does not relate to an unestablished fact necessary to substantiate the claim.

The Veteran's hypertension and coronary artery disease were not incurred during active military service, and the Board found no evidence of a direct connection to service.

The Board has reopened the Veteran's claims for service connection for deviated nasal septum and hypertension, but has remanded them to obtain additional medical records and to schedule VA examinations. The claim of service connection for sleep apnea is also being remanded.

The Board found no evidence of a chronic condition in service or within one year following separation, and the examiner's opinion was that hypertension did not exist prior to service. The Veteran's valvular heart disease is considered direct service connection as there is no indication it was incurred during service.

The Board has directed that the Veteran be provided a new VA examination by a physician to determine if his hypertension is caused or aggravated by his service-connected diabetes. The case will be remanded for this purpose.

The Veteran's service-connected disabilities do not meet the threshold level of severity for consideration of a total disability rating based on individual unemployability, and his claim is denied.

The Board has reopened the Veteran's claim of entitlement to service connection for hypertension and found that new evidence submitted since the December 1999 denial relates to an unestablished fact necessary to substantiate the claim, raising a reasonable possibility of substantiating the claim. The Veteran is now entitled to service connection for hypertension.

The Board has determined that a VA examination is necessary to determine the etiology of the Veteran's hepatitis B, sciatica, sleep apnea, diabetes mellitus, type II, hypertension, and psychiatric disorder (depression).