Citation Nr: 0002069 Decision Date: 01/27/00 Archive Date: 02/02/00 DOCKET NO. 98-10 437 ) DATE ) ) On appeal from the Department of Veterans Affairs Regional Office in San Juan, Puerto Rico THE ISSUE Entitlement to service connection for hypertension, claimed as secondary to medications prescribed for a service- connected left shoulder disability. REPRESENTATION Appellant represented by: Disabled American Veterans ATTORNEY FOR THE BOARD M. J. Bohanan, Counsel INTRODUCTION The veteran had active service from December 1980 to May 1981, with additional periods of active duty for training in the Reserves thereafter. This matter comes before the Board of Veterans' Appeals (Board) from a November 1997 rating decision of the Department of Veterans' Affairs (VA) Regional Office (RO) in San Juan, Puerto Rico which, in pertinent part, denied the veteran entitlement to service connection for hypertension as secondary to medications for a service-connected left shoulder disability. FINDING OF FACT The veteran has presented no competent medical evidence linking his hypertension to his service-connected humeral dislocation of the left shoulder, status post surgery secondary to recurrent dislocations. CONCLUSION OF LAW The veteran's claim of entitlement to service connection for hypertension as secondary to service-connected humeral dislocation of the left shoulder, status post surgery is not well grounded. 38 U.S.C.A. § 5107(a) (West 1991). REASONS AND BASES FOR FINDING AND CONCLUSION Service connection may be granted for a disability that is proximately due to or the result of a service-connected disability. When service connection is established for a secondary condition, the secondary condition is considered as part of the original condition. 38 C.F.R. § 3.310(a) (1999). A claim for secondary service connection, like all claims, must be well grounded. Reiber v. Brown, 7 Vet.App. 513, 516 (1995). The veteran has the initial burden of submitting evidence sufficient to justify a belief by a fair and impartial individual that his claim is well grounded. 38 U.S.C.A. § 5107(a) (West 1991). A well grounded claim is one that is plausible, capable of substantiation, or meritorious on its own. 38 U.S.C.A. § 5107(a); Murphy v. Derwinski, 1 Vet.App. 78, 81 (1990). In a case such as this, where the determinative issue involves a question of medical causation, i.e., whether the claimed condition is etiologically linked to a service-connected disability, competent medical evidence in support of the claim is required for the VA to find the claim well grounded. See Epps v. Gober, 126 F.3d 1464 (Fed. Cir. 1997). The veteran claims that medication prescribed for his service-connected humeral dislocation of the left shoulder, status post surgery, caused him to develop hypertension. Rating decisions of record confirm that the veteran is service-connected for humeral dislocation of the left shoulder, status post surgery, effective July 1997. Medical treatment records confirm that the veteran has received treatment for his left shoulder disability and that he currently manifests essential arterial hypertension. The record does not, however, demonstrate a relationship between the veteran's service-connected left shoulder disability or medications taken for same and his essential arterial hypertension. In September 1997, a VA examiner specifically opined that the veteran's hypertension was not related to any trauma to his shoulder or to the use of any specific medication. The veteran has not reported that there are outstanding records that demonstrate a connection between his hypertension and his service-connected humeral dislocation of the left shoulder, status post surgery. The Board notes that the veteran's contentions are the only evidence linking his hypertension with his service-connected left shoulder disability. The veteran, however, as a layperson with no medical training or expertise, and hence, his contentions by themselves do not constitute competent medical evidence of a nexus between his hypertension and his service-connected humeral dislocation of the left shoulder, status post surgery. See Espiritu v. Derwinski, 2 Vet.App. 492, 494-5 (1992). In the absence of competent medical evidence establishing the necessary link, the claim of entitlement to service connection for hypertension as secondary to service- connected humeral dislocation of the left shoulder, status post surgery, is not well grounded. The Board also notes that the veteran, through his representative, in his January 2000 informal hearing presentation, requested a remand on the basis that his September 1997 VA examination was inadequate because the examiner did not review his claims folder. However, because the veteran has failed to meet his initial burden of submitting evidence of a well-grounded claim for service connection, VA is under no duty to assist him in developing the facts pertinent to his claim. Epps v. Gober, 126 F.3d 1464, 1468 (Fed. Cir. 1997); see also Morton v. West, 12 Vet. App. 477 (1999). The Board is not aware of the existence of additional relevant evidence that could serve to make the veteran's claim well grounded. As such, there is no additional duty on the part of VA under 38 U.S.C.A. § 5103(a) (West 1991) to notify him of the evidence required to complete his application for service connection for the claimed disability. See McKnight v. Gober, 131 F.3d 1483, 1484-85 (Fed. Cir. 1997). That notwithstanding, the Board views its discussion as sufficient to inform the veteran of the elements necessary to well ground his claim and to explain why his current attempt fails. Regarding the underlying contention that certain M21-1 provisions require a full development by the RO prior to making a well-grounded determination, the Board notes that it is required to follow the precedent opinions of the Court. 38 U.S.C.A. § 7269; see also Tobler v. Derwinski, 2 Vet. App. 8, 14 (1991). Subsequent to the revisions to the M21-1 manual, in Meyer v. Brown, 9 Vet. App. 425 (1996), the Court held that the Board is not required to remand a claim for additional development, in accordance with 38 C.F.R. § 19.9, prior to determining that a claim is not well-grounded. In Epps v. Gober, 126 F.3d 1464 (Fed. Cir. 1997), cert. denied sub nom, Epps v. West, 118 S.Ct. 2348 (1998), the Federal Circuit upheld the Court's interpretation of 38 U.S.C.A. § 5107(a) and held that VA has no duty to assist the claimant in the absence of a well-grounded claim. Moreover, in the recent case of Morton, supra, the Court expressly rejected the argument that the provisions of the M21-1 manual require a duty to assist prior to the submission of a well-grounded claim. ORDER Entitlement to service connection for hypertension as secondary to medications prescribed for a service-connected left shoulder disability, is denied. CHRISTOPHER P. KISSEL Acting Member, Board of Veterans' Appeals