HYPERTENSION

J. PARKER · 2025 · Case ID: A25110534

DENIED

Summary

The veteran, who served from July 1961 to January 1969, appeals the denial of service connection for hypertension. The veteran contended that hypertension was due to herbicide exposure in Vietnam or other toxic exposures, or secondary to type 2 diabetes mellitus. The Board acknowledged favorable findings from the Regional Office regarding a current hypertension diagnosis and potential TERA exposure, but found the persuasive weight of the evidence against service connection. The Board noted the Veteran's service on the USS Oriskany and presence in Vietnam, but found the evidence insufficient to establish Vietnam service or herbicide exposure, citing a VA research summary that concluded no eligible offshore water service. Service treatment records showed no hypertension or cardiovascular issues during service, and symptoms did not manifest continuously or within one year of separation. The Board found the current diagnosis in 1997, decades after service, did not meet the criteria for presumptive service connection based on chronic or continuous symptoms. A VA examiner opined in June 2024 that hypertension was less likely than not related to service or toxic exposures, finding no medical evidence linking hypertension to ship engine noise, exhaust, fumes, asbestos, PFAS, or hazmat materials. While the Veteran cited literature on PFAS and hypertension, the Board found it inconclusive and speculative, not establishing causation. The Board also denied secondary service connection for hypertension due to diabetes, as diabetes itself was not service-connected. The Board concluded the evidence persuasively weighed against service connection for hypertension, making the benefit of the doubt doctrine inapplicable. Service connection for hypertension was denied.

Rationale

No in-service diagnosis or complaints of hypertension.; Hypertension manifested decades after service, not continuously or within one year of separation.; No direct nexus between hypertension and service or toxic exposures.; Secondary claim to diabetes denied as diabetes is not service-connected.

Special Benefit

NO SPECIAL BENEFIT

Diagnostic Code

7101

Docket No.

250908-572082

Full Decision Text

Citation Nr: A25110534
Decision Date: 12/29/25 Archive Date: 12/29/25

DOCKET NO. 250908-572082
DATE: December 29, 2025

ORDER

Service connection for hypertension is denied.

FINDINGS OF FACT

1. The evidence shows a current diagnosis of hypertension.

2. The evidence shows toxic exposures during service.

3. There was no cardiovascular injury, disease, or event during service, and no chronic symptoms of hypertension during service.

4. Symptoms of hypertension were not continuous after service separation and did not manifest to a compensable degree within one year of separation from service.

5. The current hypertension is not etiologically related to service, including as a result of toxic exposures.

6. There is no service-connected primary disability of diabetes mellitus, type 2 (diabetes), upon which secondary service connection for hypertension may be granted.

CONCLUSION OF LAW

The criteria for service connection for hypertension are not met. 38 U.S.C. §§ 1110, 1112, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309; PACT Act.

REASONS AND BASES FOR FINDINGS AND CONCLUSION

The Veteran, who is the appellant, served on active duty from July 1961 to January 1969.

This matter comes before the Board of Veterans' Appeals (Board) on appeal from a September 2024 Department of Veterans Affairs (VA) Regional Office (RO) rating decision.

By way of procedural history, the Veteran filed a claim for service connection for hypertension in August 2022, and a January 2023 rating decision denied service connection. The Veteran sought higher level review, and a May 2024 rating decision found duty to assist errors requiring further development. A subsequent September 2024 rating decision again denied service connection for hypertension. The Veteran filed a substantive appeal in September 2025.

In the September 2025 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Evidence Submission docket; therefore, the Board may only consider the evidence of record at the time of the September 2024 agency of original jurisdiction (AOJ) decision on appeal, as well as any evidence submitted by the Veteran with, or within 90 days from receipt of, the VA Form 10182. 38 C.F.R. § 20.303. If evidence was submitted either (1) during the period after the AOJ issued the decision on appeal and prior to the date the Board received the VA Form 10182, or (2) more than 90 days following the date the Board received the VA Form 10182, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.303, 20.801.

If the Veteran would like VA to consider any evidence that was submitted that the Board could not consider, the Veteran may file a Supplemental Claim (VA Form 20-0995) and submit or identify this evidence. 38 C.F.R. § 3.2501. If the evidence is new and relevant, VA will issue another decision on the claim, considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision.

This appeal has been advanced on the Board's docket. 38 U.S.C. § 7107(b).

Service Connection Legal Authority

Service connection may be granted for a disability resulting from disease or injury incurred in or aggravated by active military, naval, or air service. 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303(a). Service connection may be granted for any disease diagnosed after discharge, when all the evidence, including that pertinent to service, establishes that the disease was incurred in service. 38 C.F.R. § 3.303(d). As a general matter, service connection for a disability requires evidence of: (1) the existence of a current disability; (2) the existence of the disease or injury in service, and; (3) a relationship or nexus between the current disability and any injury or disease during service.

In order to establish presumptive service connection for a disease associated with exposure to certain herbicide agents, a veteran must show the following: (1) service in the Republic of Vietnam during the period beginning on January 9, 1962, and ending on May 7, 1975 (or was otherwise exposed to an herbicide agent during active service); (2) a current disability from a disease associated with exposure to
3.303(d). As a general matter, service connection for a disability requires evidence of: (1) the existence of a current disability; (2) the existence of the disease or injury in service, and; (3) a relationship or nexus between the current disability and any injury or disease during service.

In order to establish presumptive service connection for a disease associated with exposure to certain herbicide agents, a veteran must show the following: (1) service in the Republic of Vietnam during the period beginning on January 9, 1962, and ending on May 7, 1975 (or was otherwise exposed to an herbicide agent during active service); (2) a current disability from a disease associated with exposure to certain herbicide agents enumerated under 38 C.F.R. § 3.309(e); and (3) that the current disease process manifested to a degree of 10 percent or more within the specified time period prescribed in section 3.307(a)(6)(ii). 38 U.S.C. § 1116; 38 C.F.R. §§ 3.307(a)(6), 3.309(e).

On August 10, 2022, the PACT Act was signed into law expanding the scope of presumed in-service herbicide agent exposure for hypertension, among other diseases, for veterans that had service in the Republic of Vietnam as described above. The PACT Act, Pub. L. 117-168 (August 10, 2022).

The PACT Act provides that VA has an obligation to provide a VA examination for any service connection claim when there is evidence of a disability, evidence of participation in TERA, and such evidence is not sufficient to establish service connection for the disability. Section 303 implemented 38 U.S.C. § 1168 which requires a disability examination and medical opinion be requested for certain non-presumptive conditions involving TERAs.

In this case, the evidence shows a current diagnosis of hypertension, which is considered a "chronic disease" under 38 C.F.R. § 3.309(a). As such, the presumptive service connection provisions under 38 C.F.R. § 3.303(b) for service connection based on "chronic" symptoms in service and "continuous" symptoms since service are applicable to this matter. Walker v. Shinseki, 708 F.3d 1331 (Fed. Cir. 2013).

Where the evidence shows a "chronic disease" in service or "continuity of symptoms" after service, the disease shall be presumed to have been incurred in service. For the showing of "chronic" disease in service, there is required a combination of manifestations sufficient to identify the disease entity, and sufficient observation to establish chronicity at the time. With chronic disease as such in service, subsequent manifestations of the same chronic disease at any later date, however remote, are service connected, unless clearly attributable to intercurrent causes. If a condition noted during service is not shown to be chronic, then generally, a showing of "continuity of symptoms" after service is required for service connection. 38 C.F.R. § 3.303(b).

Additionally, where a veteran served 90 days or more of active service, and certain chronic diseases become manifest to a degree of 10 percent or more within one year after the date of separation from such service, such disease shall be presumed to have been incurred in service, even though there is no evidence of such disease during the period of service. While the disease need not be diagnosed within the presumption period, it must be shown, by acceptable lay or medical evidence, that there were characteristic manifestations of the disease to the required degree during that time. 38 U.S.C. §§ 1101, 1112, 1113, 1131, 1137; 38 C.F.R. §§ 3.307, 3.309(a).

To prevail under a theory of secondary service connection, the record must show (1) evidence of a current disability, (2) evidence of a service-connected disability, and (3) medical nexus evidence establishing a connection between the current disability and the service-connected disability. Wallin v. West, 11 Vet. App. 509, 512 (1998); Reiber v. Brown, 7 Vet. App. 513, 516-17 (1995). Any increase in the severity of a nonservice-connected disability that is proximately due to or the result of a service-connected disease or injury, and not due to the natural progress of the nonservice-connected disability, will be itself service connected. 38 C.F.R. § 3.310(b).

Service connection for hypertension is denied.

The Veteran appeals for service connection for hypertension, which he
service-connected disability, and (3) medical nexus evidence establishing a connection between the current disability and the service-connected disability. Wallin v. West, 11 Vet. App. 509, 512 (1998); Reiber v. Brown, 7 Vet. App. 513, 516-17 (1995). Any increase in the severity of a nonservice-connected disability that is proximately due to or the result of a service-connected disease or injury, and not due to the natural progress of the nonservice-connected disability, will be itself service connected. 38 C.F.R. § 3.310(b).

Service connection for hypertension is denied.

The Veteran appeals for service connection for hypertension, which he contends is due to exposure to herbicide agents in the Republic of Vietnam (Vietnam) or other TERA, or due to type 2 diabetes mellitus. See August 2022 VA Form 21-526EZ, January 2024 VA form 20-0996, and September 2025 VA Form 10182.

The September 2024 rating decision made favorable findings that there was a current diagnosis of hypertension (based on February 2022 VA treatment records), hypertension was a chronic disease that could be presumptively linked to service, and the Veteran had participated in a toxic exposure risk activity with the military occupational specialty of storekeeper. Under the AMA, the Board is bound by favorable findings made by the AOJ in the absence of evidence of clear and unmistakable error. 38?C.F.R. §?3.104(c). The record shows a current diagnosis of hypertension, and a May 2024 TERA Memorandum indicated possible exposure to ship engine noise, ship engine exhaust, fumes/smoke, asbestos, polyfluoroalkyl substances (PFAS), hazmat materials, and industrial hazardous material during service.

After a review of all evidence, lay and medical, the persuasive weight of the evidence is against a finding that the Veteran was exposed to herbicide agents during service such that the presumptive provisions found at 38 C.F.R. § 3.309(e) apply. The Veteran contends that while on the USS Oriskany he had service in Vietnam. Service personnel records confirm service on the USS Oriskany with a sea tour beginning in August 1968. The Veteran provided general information on the location of the USS Oriskany in 1968, including Vietnam. See September 2022 record.

However, a January 2022 VA research summary for all ships of service, including the USS Oriskany, concluded that there was not service in the eligible offshore water of Vietnam. See also logbooks. The Board finds that the record does not provide sufficient detailed information to establish service in Vietnam or to support a finding that the Veteran was exposed to herbicide agents.

After review of all the evidence, both lay and medical, the Board finds that the persuasive weight of the competent and probative evidence is against finding that a cardiovascular injury, disease, or event occurred during active service or that the symptoms of hypertension were "chronic" in service. Pursuant to Diagnostic Code 7101, Note 1, for VA rating purposes, the term hypertension means that the diastolic blood pressure is predominantly 90 millimeters (mm) or greater, and isolated systolic hypertension means that the systolic blood pressure is predominantly 160 mm or greater with diastolic blood pressure of less than 90 mm. 38 C.F.R. § 4.104.

Service treatment records show no relevant reports of injury, complaints, symptoms, or findings related to hypertension. See service treatment records April 1961 (indicating no heart or vascular issues and blood pressure of 130/60 at service entrance), July 1961 (indicating blood pressure of 118/82), and September 1964 (indicating no heart or vascular issues and blood pressure of 140/88 at reenlistment examination). A January 1969 Report of Medical Examination at service separation found no heart or vascular issues with a noted blood pressure of 122/80.

For these reasons, the lay and medical evidence generated contemporaneous to service, which shows no in-service cardiovascular injury or disease and no chronic symptoms of hypertension, is likely to accurately reflect the Veteran's physical condition, so is of probative value and provides evidence against a finding of cardiovascular symptoms during service. Accordingly, the criteria for presumptive service connection under 38 C.F.R. § 3.303(b) based on "chronic" symptoms in service are not met.

The Board next finds that the persuasive weight of the evidence shows that symptoms of hypertension were not continuous since active service, including not to a degree of 10 percent within one year of separation from active service. VA treatment records reflect a hypertension diagnosis as early as December 1997, approximately 28 years after separation from active service. The Veteran reports that he was first told he had high blood pressure in 1996. See June 2024 VA examination.

As the persuasive weight of the evidence demonstrates no "continuous" hypertension symptoms since active service, including to a compensable degree within the first post-service year, the criteria under 38 C.F.R. § 3.303(b) for presumptive service connection based on "continuous" symptoms or symptoms manifested to a degree of 10 percent within one year of service separation are not met. 38 C.F.R. §§ 3.307, 3.309.

The Board finds that the persuasive weight of the competent and probative evidence is against a finding that the current hypertension is directly related to service, including as a result of toxic exposures. A VA examiner in June 2024 opined that the current hypertension was less likely than not incurred in or caused by service. The VA examiner explained that hypertension is a condition where there is chronic increase in peripheral vascular resistance, which is indicated by elevated blood pressure readings, whereas in this case there were no records of hypertension in service, including at service separation.

The Veteran was also afforded a VA examination and opinion in June 2024 regarding the hypertension and toxic exposures. The examiner opined that the current hypertension was less likely than not related to toxic exposure risk activities. The examiner reasoned that there was no medical evidence to support hypertension being caused by exposures to ship engine noise, ship engine exhaust, fumes/smoke, asbestos, PFAS, hazmat materials, and industrial hazardous material.

The Veteran asserts that the June 2024 opinion did not consider relevant medical literature associating hypertension to PFAS. See September 2025 statement. While the Board has considered the medical literature provided by the Veteran in September 2025, the Board notes that the medical literature does not establish a causal link between PFAS exposure and hypertension. The meta-analysis referenced by the Veteran found a positive relationship between exposure to PFAS and increased risk of hypertension; however, the medical literature specifically states that additional research is needed to establish causation. The medical literature speaks only in terms of possibility, rather than some probability that is required to be probative for a nexus for direct service connection. See also July 2025 statement of private physician (indicating generally that people residing near airports have a higher incidence of hypertension). Medical evidence that is speculative, general, or inconclusive in nature cannot support a claim. See 38 C.F.R. § 3.102 (defining reasonable doubt and directing that VA adjudications are not to be based on "pure speculation or remote possibility"); Obert v. Brown, 5 Vet. App. 30, 33 (1993); see also Beausoleil v. Brown, 8 Vet. App. 459, 463 (1996); Libertine v. Brown, 9 Vet. App. 521, 523 (1996).

The June 2024 VA examiner had medical expertise and adequate information on which to base the medical opinions, relied on factually accurate assumptions that are consistent with the Board's findings of fact in this case, and provided adequate rationale based on accurate medical history and known medical principles. For these reasons, the Board assigns the June 2024 VA medical opinions probative value, weighing against a direct nexus between the hypertension and service, including the exposure to TERA during service.

With regard to the contention that service connection is warranted for hypertension due to diabetes, service connection for diabetes has not been established; therefore, the theory of service connection for hypertension as secondary to diabetes (38 C.F.R. § 3.310) must be denied as a matter of law because there is no primary service-connected disability upon which secondary service connection may be granted. See 38 C.F.R. § 3.310(a); Reiber v. Brown, 7 Vet. App. 513, 516-17 (1995
reasons, the Board assigns the June 2024 VA medical opinions probative value, weighing against a direct nexus between the hypertension and service, including the exposure to TERA during service.

For the above reasons, the evidence is neither evenly balanced nor approximately so with regard to whether service connection for the hypertension is warranted. Rather, the evidence persuasively weighs against service connection for hypertension, to include hypertension as directly incurred in service, on a presumptive basis, or on a secondary basis; therefore, the appeal must be denied. The benefit of the doubt doctrine, see 38 U.S.C. § 5107(b), is not for application as to this claim. Lynch v. McDonough, 21 F.4th at 781-82 (Fed. Cir. 2021) (en banc) (only when the evidence persuasively favors one side or another is the benefit of the doubt doctrine not for application).

J. PARKER

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board E. Beilsmith, Associate 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.

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