Back to BVA DecisionsGRANTEDSpecial Benefit NO SPECIAL BENEFIT Docket No. 17-38 283
HYPERTENSION
DONNIE R. HACHEY · 2026 · Case ID: 26004372
Summary
The Veteran served on active duty from October 1969 to October 1971. He appeals a May 2013 rating decision that denied service connection for hypertension, erectile dysfunction (ED), and a skin disability. The Board found that service connection for hypertension on a basis other than the PACT Act was warranted. This decision was based on the Veteran's undisputed hypertension, his documented exposure to herbicide agents in service, and a VA reviewing physician's opinion that the hypertension was at least as likely as not related to this exposure. For the skin disability, diagnosed as atopic dermatitis, the Board found service connection warranted. This was supported by the Veteran's documented exposure to herbicide agents, his testimony of a persistent skin condition since service, and a VA reviewing physician's opinion that the condition was at least as likely as not related to herbicide exposure and other toxic exposures during his deployments. The Board resolved doubt in the Veteran's favor for this claim. For ED, the Board granted service connection, finding it was at least as likely as not due to or a result of his service-connected type 2 diabetes, citing medical literature that links ED to long-standing diabetes. The Board found substantial compliance with its prior remand directives for these issues.
Rationale
Hypertension undisputed; Exposure to herbicide agents in service; VA physician found hypertension at least as likely as not related to herbicide exposure
Full Decision Text
Citation Nr: 26004372 Decision Date: 04/08/26 Archive Date: 04/08/26 DOCKET NO. 17-38 283 DATE: April 8, 2026 ORDER Entitlement to service connection for hypertension on a basis other than the Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics (PACT) Act of 2022 is granted. Entitlement to service connection for a skin disability, diagnosed as atopic dermatitis, is granted. Entitlement to service connection for erectile dysfunction (ED) is granted. FINDINGS OF FACT 1. VA received a formal claim for entitlement to service connection for hypertension on March 8, 2012. The claim remained pending until the Board granted service connection for hypertension pursuant to the PACT Act. In an implementing decision, the Agency of Original Jurisdiction (AOJ) assigned an effective date of August 10, 2022, but no earlier, for the award of service connection for hypertension. 2. The Veteran's hypertension is etiologically related to his time in active service. 3. The Veteran's skin disability is etiologically related to his time in active service. 4. The Veteran's ED is related to his service-connected type 2 diabetes. CONCLUSIONS OF LAW 1. The criteria to establish service connection for hypertension on a basis other than the PACT Act have been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. 2. The criteria to establish service connection for a skin disability, diagnosed as atopic dermatitis, have been met. 38 U.S.C. §§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303. 3. The criteria for entitlement to service connection for ED are met. 38 U.S.C. Code§§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.310. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from October 1969 to October 1971. He appeals a May 2013 rating decision by the Agency of Original Jurisdiction (AOJ) denying entitlement to service connection for hypertension, ED, and a skin disability. In a June 2024 decision, the Board granted service connection for hypertension "pursuant to the Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics Act of 2022 (PACT Act)" and remanded the issue of service connection for hypertension on a basis other than the PACT Act. In June 2024, the Board also remanded the issues of entitlement to service connection for ED and a skin disability to the AOJ for further action consistent with the Board's remand directives. The claims are back before the Board for further appellate proceedings. The Board finds there has been substantial compliance with its remand directives. See Stegall v. West, 11 Vet. App. 268, 271 (1998). Service Connection 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. 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 granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that a disease was incurred in service. 38 C.F.R. § 3.303(d). 1. Hypertension It is undisputed that the Veteran had hypertension before he filed his claim in 2012. See May 2013 VA examination report. Further, it is undisputed that the Veteran was exposed to herbicide agents during his service in the Republic of Vietnam. See, e.g., June 2024 Toxic Exposure Risk Activity (TERA) Memorandum. A VA reviewing physician found it was at least as likely as not that the Veteran's hypertension was related ). Service connection may be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that a disease was incurred in service. 38 C.F.R. § 3.303(d). 1. Hypertension It is undisputed that the Veteran had hypertension before he filed his claim in 2012. See May 2013 VA examination report. Further, it is undisputed that the Veteran was exposed to herbicide agents during his service in the Republic of Vietnam. See, e.g., June 2024 Toxic Exposure Risk Activity (TERA) Memorandum. A VA reviewing physician found it was at least as likely as not that the Veteran's hypertension was related to his exposure to herbicide agents in service. See August 2024 Dr. K.P. medical opinion. As the record contained evidence that the Veteran had hypertension before 2012, was exposed to herbicide agents in service, and a VA reviewing physician found the Veteran's hypertension was related to his exposure to herbicide agents in service, the Board finds, in this particular case, service connection for hypertension on a basis other than the PACT Act is warranted. See Lynch v. McDonough, 21 F.4th 776, 781-82 (Fed. Cir. 2021); 38 C.F.R. § 3.102. 2. Skin The first two Shedden elements are met and are not in dispute. The Veteran has atopic dermatitis. See, e.g. August 2024 VA medical opinion. Further, the Veteran was exposed to herbicide agents in service and has attested to having a skin condition in service that has continued ever since. See, e.g., June 2024 TERA Memorandum; August 2024 VA medical opinion. Therefore, the fundamental factual dispute in this appeal is whether the Veteran's skin disability began in or is attributable to service. A VA reviewing physician found it was at least as likely as not that the Veteran's atopic dermatitis was related to his exposure to herbicide agents in service. See August 2024 Dr. K.P. medical opinion. Specifically, he explained that medical literature shows that the Veteran's deployments and the synergistic combined effect of all TERAs could have increased the likelihood of the Veteran's skin disability. Id. Further, he acknowledged the Veteran's argument that he developed the skin condition in service and it continued to persist ever since. Id. Resolving doubt in the Veteran's favor, the Board finds the Veteran's skin disability is etiologically related to his time on active duty in this particular case. Therefore, entitlement to service connection for a skin disability, diagnosed as atopic dermatitis, is warranted. See Lynch v. McDonough, 21 F.4th 776, 781-82 (2021); 38 C.F.R. § 3.102. 3. ED A disability which is the result of a service-connected disease or injury shall be service-connected. See 38 U.S.C. § 1110; 38 C.F.R. § 3.310(a). In Spicer v. McDonough, the Federal Circuit held that § 1110 plainly requires compensation when a service-connected disease or injury is a "but-for cause of a present-day disability." Further, nothing in the statute limits § 1110 to onset or etiological causes of a worsening in functionality. 61 F.4th 1360 (Fed. Cir. 2023). Importantly, the Federal Circuit also invalidated 38 C.F.R. § 3.110(b) entitled "aggravation of nonservice-connected disabilities" as unlawful and inconsistent with 38 U.S.C. § 1110. Id. at 1366. Here, the Veteran has ED and is service connected for type 2 diabetes. See August 2024 VA medical opinion. Dr. K.P. found that the Veteran's ED was at least as likely as not "due to or the result of" the Veteran's diabetes. Id. According to Dr. K.P., "medical literature does note that [ED] is a known complication of long[-]standing diabetes." Id. Therefore, the Veteran's ED resulted from his diabetes and service connection is warranted. See Lynch v. McDonough, 21 F.4th 776, 781-82 (2021); 38 C.F.R. § 3.102. DONNIE R. HACHEY Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M. Salazar, Counsel The Board's decision in this case is binding only with respect to the instant matter decided. This decision is not " the Veteran's diabetes. Id. According to Dr. K.P., "medical literature does note that [ED] is a known complication of long[-]standing diabetes." Id. Therefore, the Veteran's ED resulted from his diabetes and service connection is warranted. See Lynch v. McDonough, 21 F.4th 776, 781-82 (2021); 38 C.F.R. § 3.102. DONNIE R. HACHEY Veterans Law Judge Board of Veterans' Appeals Attorney for the Board M. Salazar, Counsel 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.