ANEURYSM ABDOMINAL AORTA

Summary

The Veteran, an Army Veteran who served from November 1964 to September 1967, appeals the denial of service connection for an aortic aneurysm secondary to his service-connected hypertension. The Veteran also sought a compensable rating for hypertension and colon cancer residuals, and a 10 percent evaluation based on multiple noncompensable service-connected disabilities. The Board found that while the Veteran had a current diagnosis of thoracic aortic aneurysm and is service-connected for hypertension, the medical evidence linking the two was conclusory and lacked probative weight. Specifically, a private physician's opinion stating a "high likelihood that Agent Orange contributed to the BP and the BP of course drove the aneurysm" was deemed insufficient due to a lack of rationale. The Board denied the aortic aneurysm claim as it was raised after the initial rating decision and could not be remanded due to no pre-decisional duty-to-assist error on that specific issue. The remaining claims for squamous cell cancer of the skin, benign prostatic hyperplasia, hypertension residuals, colon cancer residuals, and a 10 percent evaluation were remanded due to the Agency of Original Jurisdiction's failure to obtain identified private treatment records prior to the initial rating decision, constituting a pre-decisional duty-to-assist error.

Rationale

No medical evidence establishing a nexus between aortic aneurysm and hypertension.; Private physician opinion was conclusory and lacked rationale.; Claim raised after rating decision, no pre-decisional duty-to-assist error.

Full Decision Text

Citation Nr: A26040028
Decision Date: 04/29/26	Archive Date: 04/29/26

DOCKET NO. 250712-577915
DATE: April 29, 2026

ORDER

Entitlement to service connection for aortic aneurysm secondary to service-connected hypertension is denied.

REMANDED

Entitlement to service connection for squamous cell cancer of the skin is remanded.

Entitlement to service connection for benign prostatic hyperplasia is remanded.

Entitlement to a compensable rating for hypertension is remanded.

Entitlement to a compensable rating for colon cancer residuals is remanded.

Entitlement to a 10 percent evaluation based on multiple noncompensable service-connected disabilities is remanded.

FINDING OF FACT

The Veteran's aortic aneurysm is not secondary to his service-connected hypertension.

CONCLUSION OF LAW

The criteria for service connection for an aortic aneurysm secondary to service-connected hypertension are not met. 38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.310.

REASONS AND BASES FOR FINDING AND CONCLUSION

The Veteran served in the United States Army from November 1964 to September 1967.

This matter comes before the Board of Veterans' Appeals (Board) on appeal from a January 2025 rating decision by a Department of Veterans Affairs (VA) regional office, which is the Agency of Original Jurisdiction (AOJ).  

The Veteran elected the Board's Hearing docket. See July 2025 VA Form 10182, which was clarified via a September 2025 VA Form 10182.  This restricts the Board's review to the evidence of record at the time of the January 2025 rating decision and any evidence submitted by the Veteran or his representative at the hearing or within 90 days following the hearing. 38 C.F.R. § 20.302(a). The Veteran appeared for the hearing before a Veterans Law Judge in December 2025.

The Board notes that evidence was associated with the claims file during a period that is outside the applicable evidentiary window - between the January 2025 rating decision and the December 2025 Board hearing, or more than 90 days following the hearing. Therefore, as to the issue of entitlement to service connection for aortic aneurysm secondary to service-connected hypertension, the Board has not considered that evidence in its present decision. 38 C.F.R. § 20.300(a). 

If the Veteran would like VA to consider the additional evidence that the Board could not consider, the Veteran may file a supplemental claim (VA Form 20-0995) and identify the evidence for the AOJ's consideration. 38 C.F.R. § 3.2501. Specific instructions for filing a supplemental claim are included with this decision.

However, as the Veteran's remaining claims are being remanded, the AOJ will consider the claims in light of the entire claims file upon remand.

Entitlement to service connection for an aortic aneurysm secondary to service-connected hypertension. 

While no formal claim for entitlement to service connection for an aortic aneurysm, secondary to service-connected hypertension has been filed, in the September 2025 VA Form 10182 and in the December 2025 Board Hearing Transcript, the Veteran sought a compensable rating for his service-connected hypertension and reasonably raised a claim of entitlement to service connection for an aortic aneurysm as secondary to his service-connected hypertension. However, the Board has a duty to maximize benefits, and under Morgan v. Wilkie, schedular rating concepts, including secondary service connection, are critical components of the duty to maximize benefits well before reaching an extraschedular analysis. 31 Vet. App. 162 (2019). Accordingly, the Board will consider this reasonably raised issue.

Service connection on a secondary basis is warranted if there is (1) evidence of a current disability; (2) evidence of a service-connected disability; and (3) medical evidence establishing a nexus (i.e., link) between the current disability and the service-connected disability. Wallin v. West, 11 Vet. App. 509 (1998). A nexus is established when medical evidence shows that the current disability was either caused by or proximately aggravated by a service-connected disability. Allen v. Brown, 7 Vet. App. 439 (1995) (en banc).

The first element of service connection on a secondary basis is evidence of a current disability.  A July 2025 private treatment record reflects that the Veteran has a current diagnosis of a thoracic aortic aneurysm. Therefore, the first element has been established.

The second element of service connection on a secondary basis is evidence
 establishing a nexus (i.e., link) between the current disability and the service-connected disability. Wallin v. West, 11 Vet. App. 509 (1998). A nexus is established when medical evidence shows that the current disability was either caused by or proximately aggravated by a service-connected disability. Allen v. Brown, 7 Vet. App. 439 (1995) (en banc).

The first element of service connection on a secondary basis is evidence of a current disability.  A July 2025 private treatment record reflects that the Veteran has a current diagnosis of a thoracic aortic aneurysm. Therefore, the first element has been established.

The second element of service connection on a secondary basis is evidence of a service-connected disability. The Veteran is service connected for hypertension. See January 2025 Rating Decision Codesheet. Therefore, the second element has been established.

The third and final element of service connection on a secondary basis is medical evidence establishing a nexus (i.e., link) between the current disability and the service-connected disability. In December 2025, the Veteran submitted a July 2025 private treatment record which reflects that his physician noted there was a "[h]igh likelihood that Agent Orange contributed to the BP and the BP of course drove the aneurysm." No rationale for this opinion was given. However, "an unexplained conclusory opinion is entitled to no weight in a service-connection context." Horn v. Shinseki, 25 Vet. App. 231, 240 (U.S. 2012) (citing Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (2008)). "It is the fully articulated, sound reasoning for the conclusion . . . that contributes probative value to a medical opinion." Nieves-Rodriguez, 22 Vet. App. at 304. Therefore, the Board finds the July 2025 private opinion conclusory and without probative weight. 

Accordingly, without medical evidence establishing a medical nexus between the Veteran's aortic aneurysm and his service-connected hypertension, the Board cannot award service-connection for an aortic aneurysm secondary to service-connected hypertension at this time. 

Further, under the Appeals Modernization Act (AMA), the Board cannot refer this claim, and as it was initially raised after the rating decision on appeal, the claim cannot be remanded because the AOJ did not commit a duty-to-assist error prior to the rating decision on appeal. See 38 C.F.R. § 20.802(a). Rather, if the Veteran wishes to further pursue a claim for entitlement to service connection for an aortic aneurysm secondary to his service-connected hypertension, he should file a supplemental claim on the form prescribed by the Secretary. 38 C.F.R. § 3.151(a). Instructions for filing a supplemental claim are included with this decision. 

REASONS FOR REMAND

1. Entitlement to service connection for squamous cell cancer of the skin is remanded.

2. Entitlement to service connection for benign prostatic hyperplasia is remanded.

3. Entitlement to a compensable rating for hypertension is remanded.

4. Entitlement to a compensable rating for colon cancer residuals is remanded.

In the January 2025 rating decision, the AOJ found that new and relevant evidence had been submitted, the Veteran had current diagnoses of benign prostatic hyperplasia with lower urinary tract symptoms and squamous cell skin carcinoma, and the Veteran was exposed to herbicide agents during his service in the Republic of Vietnam. See October 2023 VA Male Reproductive Organ Conditions Examination; October 2023 VA Skin Diseases Examination; DD214; September 2023 VA Memorandum.  

In February 2024, the Veteran submitted a January 2024 general release for medical provider information and signed authorization, which identified relevant outstanding private treatment records for his skin cancer, colon cancer, hypertension, and his enlarged prostate gland. Although the AOJ requested authorization for the identified records in January 2024, a review of the claims file reflects that the AOJ never requested the identified and authorized private treatment records prior to the January 2025 rating decision on appeal. See January 2024 VA Form 20-0999; January 2024 Subsequent Development Letter. 

As these records were identified prior to the rating decision on appeal, fulfillment of the statutory duty-to-assist requires reasonable efforts are made to obtain relevant outstanding private treatment records. As no such efforts were made prior to the rating decision on appeal, the AOJ committed a predecisional duty-to-assist error. See 38 C.F.R. § 20.802(a). Accordingly, remand is required to allow VA to obtain authorization and request these records.

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5. Entitlement to
 claims file reflects that the AOJ never requested the identified and authorized private treatment records prior to the January 2025 rating decision on appeal. See January 2024 VA Form 20-0999; January 2024 Subsequent Development Letter. 

As these records were identified prior to the rating decision on appeal, fulfillment of the statutory duty-to-assist requires reasonable efforts are made to obtain relevant outstanding private treatment records. As no such efforts were made prior to the rating decision on appeal, the AOJ committed a predecisional duty-to-assist error. See 38 C.F.R. § 20.802(a). Accordingly, remand is required to allow VA to obtain authorization and request these records.

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5. Entitlement to a 10 percent evaluation based on multiple noncompensable service-connected disabilities is remanded.

Finally, because a decision on the remanded issues of entitlement to a compensable rating for hypertension and entitlement to a compensable rating for colon cancer residuals could significantly impact a decision on the issue of entitlement to a 10 percent evaluation based on multiple, noncompensable, service-connected disabilities, the issues are inextricably intertwined.  A remand of the claim for entitlement to a 10 percent evaluation based on multiple noncompensable service-connected disabilities is required.

The Board reminds the Veteran that the "duty to assist is not always a one-way street." A veteran is expected to cooperate in the efforts to adjudicate the claims, and his failure to do so would subject him to the risk of an adverse adjudication based on an incomplete and underdeveloped record. See Wood v. Derwinski, 1 Vet. App. 190, 193 (1991).

The matters are REMANDED for the following action:

1. Ask the Veteran to complete an updated VA Form 21-4142 for the previously identified physicians and facilities in the January 2024 general release for medical provider information. Make two requests for the authorized records from the authorized physicians and facilities, unless it is clear after the first request that a second request would be futile.

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2. After the above development, and any additionally indicated development, has been completed, readjudicate the issues on appeal, including the inextricably intertwined issue of entitlement to a 10 percent evaluation based on multiple noncompensable service-connected disabilities.

 

 

T. V. Casey

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	Maxey, Gloria J.

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.