HYPERTENSION

Summary

The Veteran served from June 2022 to October 2022. The Veteran appeals the denial of service connection for high blood pressure and a low back disability. Regarding high blood pressure, the Board found no current diagnosis or persistent symptoms, noting that service treatment records and post-service records did not reflect elevated blood pressure or hypertension. Blood pressure readings during service were not elevated, and the Veteran denied high blood pressure during periodic health assessments. The Board determined that the Veteran's vague assertion of increased blood pressure due to service stress was insufficient to meet the McLendon criteria for a pre-decisional VA examination, as there was no competent evidence of a current disability or indication of association with service. For the low back disability, the Board acknowledged current diagnoses of stenosis and arthropathy but found the evidence weighed against an in-service origin or relation. Service treatment records were absent of complaints or findings related to back pain, and the Veteran denied recurrent back pain during service. While the Veteran reported progressively worsening pain post-service, the Board found no medical evidence or opinion linking the current disability to service, nor evidence of continuity of symptomatology since service. The Board concluded that the Veteran's lay assertions were insufficient to establish the required elements for service connection for both conditions. Service connection for high blood pressure and the low back disability was denied.

Rationale

No current diagnosis of high blood pressure; Service treatment records negative for findings attributed to high blood pressure; Veteran's assertion of increased blood pressure due to service stress insufficient for McLendon criteria

Full Decision Text

Citation Nr: A26040138
Decision Date: 04/29/26	Archive Date: 04/29/26

DOCKET NO. 250202-511009
DATE: April 29, 2026

ORDER

Service connection for high blood pressure is denied.

Service connection for a low back disability is denied.

FINDINGS OF FACT

1. The evidence of record persuasively weighs against finding that the Veteran has had high blood pressure at any time during or approximate to the pendency of the claim.

2. The evidence of record persuasively weighs against finding that a low back disability began during active service or is otherwise related to an in-service injury or disease.

CONCLUSIONS OF LAW

1. The criteria for service connection for high blood pressure are not met.  38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309.

2. The criteria for service connection for a low back disability are not met.  38 U.S.C. §§ 1110, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.307, 3.309.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty from June 2022 to October 2022. 

The rating decision on appeal was issued in April 2024 and constitutes an initial decision; therefore, the modernized review system, also known as the Appeals Modernization Act (AMA), applies.  

In the February 2, 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 April 2024 agency of original jurisdiction (AOJ) decision on appeal, as well as any evidence submitted by the Veteran or representative 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. 

Specifically, the Board has considered evidence received prior to the April 17, 2024.  Any evidence submitted after April 17, 2024 is ineligible for review. 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 claims, considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision. 

The claims file contains a January 2026 Report of General Information in which the Veteran appears to request a withdrawal of these claims by telephone. The criteria for an oral withdrawal were not met; and in February 2026 the Board sought a written withdrawal that would satisfy the criteria of 38 C.F.R. § 20.205(b)(1). No such written withdrawal was obtained; so the Board will proceed to adjudicated the claims. 

Service Connection

Service connection may be granted for disability resulting from disease or injury incurred in or aggravated by active service.  38 U.S.C. §§ 1110, 5107; 38 C.F.R. § 3.303.  The three-element test for service connection requires evidence of: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury.  Shedden v. Principi, 381 F.3d 1163, 1166 -67 (Fed. Cir. 2004).

Certain chronic diseases will be presumed related to service, absent an intercurrent cause, if they were shown as chronic in service; or, if they manifested to a compensable degree within a presumptive period following separation from service; or, if they were noted in service (or within an applicable presumptive period) with continuity of symptomatology since service that is attributable to the chronic disease.  38 U.S.C. §§ 1101, 1112, 
 a disease or injury; and (3) a causal relationship between the current disability and the in-service disease or injury.  Shedden v. Principi, 381 F.3d 1163, 1166 -67 (Fed. Cir. 2004).

Certain chronic diseases will be presumed related to service, absent an intercurrent cause, if they were shown as chronic in service; or, if they manifested to a compensable degree within a presumptive period following separation from service; or, if they were noted in service (or within an applicable presumptive period) with continuity of symptomatology since service that is attributable to the chronic disease.  38 U.S.C. §§ 1101, 1112, 1113, 1137; 38 C.F.R. §§ 3.303, 3.307, 3.309.  Walker v. Shinseki, 708 F.3d 1331, 1338 (Fed. Cir. 2013).

Service connection for high blood pressure is denied.

The Veteran contends that the stress of his position in the military caused his blood pressure to increase. 

The question for the Board is whether the Veteran has a current disability that began during service or is at least as likely as not related to an in-service injury, event, or disease.

The Board concludes that the Veteran does not have a current diagnosis of high blood pressure and has not had one at any time during the pendency of the claim or recent to the filing of the claim.  Romanowsky v. Shinseki, 26 Vet. App. 289, 294 (2013); McClain v. Nicholson, 21 Vet. App. 319, 321 (2007).

The service treatment records fail to reflect any findings attributed to high blood pressure. Blood pressure readings taken during service, including in September 2022 were not elevated. The Veteran underwent Periodic Health Assessments (PHA) in February 2022 and in January 2023 (during National Guard service). The Veteran denied having high blood pressure and was not on medication. On the February 2022 PHA, the reviewing medical provider indicated the Veteran did not have a history of abnormal blood pressure since the last PHA. On the January 2023 PHA, the provider indicated there were no identified concerns needing referral. The Veteran stated that he had been in excellent health in the past month.  He denied exposure to burn pits; and he stated that he has never been deployed. 

Post service treatment records fail to reflect high blood pressure or any findings attributed to high blood pressure or hypertension.

The Board notes that the VA did not provide the Veteran with a VA examination for the purpose of determining the etiology of his alleged high blood pressure.  In light of the holding in McLendon v. Nicholson, 20 Vet. App. 79 (2006), a pre-decisional examination was not required.

McLendon provides that in disability compensation (service connection) claims, VA must provide a medical examination when there is (1) competent evidence of a current disability or persistent or recurrent symptoms of a disability, and (2) evidence establishing that an event, injury, or disease occurred in service or establishing certain diseases manifesting during an applicable presumptive period for which the claimant qualifies, and (3) an indication that the disability or persistent or recurrent symptoms of a disability may be associated with the Veteran's service or with another service-connected disability, but (4) insufficient competent medical evidence on file for the VA to make a decision on the claim.  

The McLendon criteria were not met in this case. Although the Veteran is competent to describe observable symptoms, he has only vaguely asserted that his blood pressure increased due to service.  There was no competent evidence of a current hypertension disability or persistent or recurrent symptoms of high blood pressure. The current medical records contain no findings or complaints of high blood pressure or any findings attributed to hypertension.  Third, the only evidence establishing that an event, injury, or disease occurred in service was the Veteran's vague assertion that his blood pressure had increased as a result of the stress of his position during service. The Board notes that according to the Veteran's DD Form 214, his MOS was as an intelligence officer. However, as noted above, the service treatment records contain no complaints or findings related to elevated blood pressure or hypertension. 

Finally, there was no indication that the Veteran's claimed high blood pressure may be associated with his active military service. The types of evidence that indicate that a current disability may be associated with military service include, but are not limited to, medical evidence that suggests a nexus but is too equivocal or lacking in specificity to support a decision on the merits, or credible evidence of continuity of symptomatology symptoms capable of lay observation. McLendon, 79 Vet.App. at 83 (quotations omitted).
 position during service. The Board notes that according to the Veteran's DD Form 214, his MOS was as an intelligence officer. However, as noted above, the service treatment records contain no complaints or findings related to elevated blood pressure or hypertension. 

Finally, there was no indication that the Veteran's claimed high blood pressure may be associated with his active military service. The types of evidence that indicate that a current disability may be associated with military service include, but are not limited to, medical evidence that suggests a nexus but is too equivocal or lacking in specificity to support a decision on the merits, or credible evidence of continuity of symptomatology symptoms capable of lay observation. McLendon, 79 Vet.App. at 83 (quotations omitted). The record contains no such evidence here. 

Though the threshold for this element is "low," McLendon, 79 Vet.App. at 83, the record must contain something other than a "conclusory generalized statement" to establish the element. Waters v. Shinseki, 601 F.3d 1274, 1278 (Fed. Cir. 2010). For these reasons, an examination prior to the rating decision on appeal was not required.

While the Veteran believes there is a current diagnosis of high blood pressure, he is not competent to provide a diagnosis in this case. The issue is medically complex, as it requires specialized medical education and the ability to interpret complicated diagnostic medical testing.  Jandreau v. Nicholson, 492 F.3d 1372, 1377, 1377 n.4 (Fed. Cir. 2007).  Consequently, the Board gives more probative weight to the competent medical evidence.

As the evidence persuasively weighs against the service connection claim for high blood pressure; the benefit of the doubt doctrine does not apply.  Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021) (only when the evidence persuasively favors one side or another is the benefit of the doubt doctrine not for application). Service connection for high blood pressure is denied.

Service connection for a low back disability is denied.

The Veteran contends that he was required to wear body armor every day for his position in the service, leading to severe lower back pain and tightness. 

The question for the Board is whether the Veteran has a current disability that began during service or is at least as likely as not related to an in-service injury, event, or disease.

The Board concludes that, while the Veteran has current diagnoses of stenosis of intervertebral foramina, and arthropathy of lumbar facet joint, the evidence of record persuasively weighs against finding that the Veteran's diagnoses of began during service or are otherwise related to an in-service injury, event, or disease. 

In a May 2025 correspondence, the Veteran stated that he has been dealing with back pain for a few years now and have been at the stage of dealing with the pain and managing it. He stated that in the last few months, he decided to take that next step and determine what might be the cause of his pain, as it had continued to get worse and had consumed many activities in his daily life.

Service treatment records fail to reflect any findings attributed to a back disability and there were no complaints of back pain or other symptoms. Service treatment records reflect that the Veteran denied back pain on October 7, 2022 (12 days before he was discharged). Service treatment records also include PHA reports conducted in February 2022 and in January 2023 (during National Guard service), which yielded normal findings. At that time, he denied having recurring muscle, joint, or low back pain. He stated that he had been in excellent health in the past month.  

Post service treatment records reflect that the Veteran sought treatment, in January 2025, for a two year history of progressively worsening lower back pain. He underwent an MRI that revealed stenosis of intervertebral foramina, and arthropathy of lumbar facet joint. 

The Board notes that the Veteran has a current disability (the first element of a service connection claim). However, elements two and three have not been met. There is no medical evidence of an in-service incurrence of a disease or injury; and there is no competent medical evidence linking the disability to service.  

The Board notes that the VA did not provide the Veteran with a VA examination for the purpose of determining the etiology of his back disability.  At the time that the AOJ rendered it April 2024 rating decision, a VA examination was not required pursuant to McLendon.

Regarding the first prong, the available medical records did not show a diagnosed back disorder, but the Veteran reported having severe low back pain and stiffness on his July 2023 service connection application. He is competent to report observable back pain and stiffness symptoms. For
 However, elements two and three have not been met. There is no medical evidence of an in-service incurrence of a disease or injury; and there is no competent medical evidence linking the disability to service.  

The Board notes that the VA did not provide the Veteran with a VA examination for the purpose of determining the etiology of his back disability.  At the time that the AOJ rendered it April 2024 rating decision, a VA examination was not required pursuant to McLendon.

Regarding the first prong, the available medical records did not show a diagnosed back disorder, but the Veteran reported having severe low back pain and stiffness on his July 2023 service connection application. He is competent to report observable back pain and stiffness symptoms. For the second prong, however, the Veteran's service treatment records were absent any complaints of back pain or other symptoms and did not show any back injuries or related clinical findings. The service treatment records also showed the Veteran denied having recurrent back pain. Regarding the third prong, there was no evidence that the claimed disability or symptoms "may be" associated with the Veteran's military service. Prior to the rating decision on appeal, there was no medical evidence or opinion that suggested a causal nexus and there was not a lay report of continued low back pain and stiffness since service separation. Thus, the McLendon criteria were not met.

Even if the Board were to conclude that the McLendon elements are currently satisfied, at the time of the April 2024 rating decision, they were not. Thus, the Board cannot find that a failure to schedule the Veteran for a VA examination constituted a pre-decisional duty to assist error.  

The Veteran believes that his current back disability is related to an in-service injury, event, or disease. He is not competent to provide a nexus opinion regarding this issue. The issue is medically complex, as it requires knowledge of internal lumbar spine pathology and the interpretation of complicated diagnostic medical testing. Therefore, it is outside the competence of the Veteran in this case because the record does not show that he has the medical training or credentials to make such a determination. Jandreau v. Nicholson, 492 F.3d 1372, 1377 n.4 (Fed. Cir. 2007); see also Kahana v. Shinseki, 24. Vet. App. 428 (2011). 

In the absence of (1) evidence of an in-service injury and (2) a nexus opinion linking the Veteran's current disability to service, the evidence persuasively weighs against the claim. 

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?

As the evidence persuasively weighs against the claim; the benefit of the doubt doctrine does not apply.  Consequently, the service connection claim for a low back disability is denied. Lynch v. McDonough, 21 F.4th 776 (Fed. Cir. 2021).

 

 

D. JOHNSON

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board	M. Prem, 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.