BVA9502163 DOCKET NO. 93-10 188 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in No. Little Rock, Arkansas THE ISSUE Entitlement to service connection for organic heart disease, including essential hypertension. REPRESENTATION Appellant represented by: Disabled American Veterans ATTORNEY FOR THE BOARD Melissa F. Marquez, Associate Counsel INTRODUCTION The appellant had active service from October 1961 to December 1963. This matter came before the Board of Veterans' Appeals (hereinafter Board) on appeal from a December 1991 rating decision of the North Little Rock, Arkansas, Regional Office (hereinafter RO), of the Department of Veterans Affairs (hereinafter VA), which denied entitlement to service connection for hypertension and heart disease. CONTENTIONS OF APPELLANT ON APPEAL The appellant contends, in essence, that he is entitled to service connection for hypertension and heart disease. He argues that he was treated for hypertension during active service which has continued to date, resulting in current arteriosclerotic heart disease. DECISION OF THE BOARD The Board, in accordance with the provisions of 38 U.S.C.A. § 7104 (West 1991), has reviewed and considered all of the evidence and material of record in the appellant's claims file. Based on its review of the relevant evidence in this matter, and for the following reasons and bases, it is the decision of the Board that the preponderance of the evidence is against allowance of the appellant's claims for entitlement to service connection for hypertension and heart disease. FINDINGS OF FACT 1. All available, relevant evidence necessary for disposition of the appeal has been obtained by the RO. 2. Essential hypertension was not present during service or within one year following separation thereof. Essential hypertension was initially medically demonstrated many years after separation from service, at a time too remote to be reasonably related thereto. 3. Elevated blood pressure readings in service were attributed to nerves; continuing elevated blood pressure ratings in the years immediately post-service have not been shown. 4. Heart disease was not present during service or within one year following separation thereof. Heart disease was initially medically demonstrated many years after separation from service, at a time too remote to be reasonably related thereto, and is not the result of a service-connected disability. 5. The appellant's heart disease and hypertension are unrelated to any in-service occurrence or event. CONCLUSIONS OF LAW 1. Hypertension was not incurred in or aggravated by service, nor can hypertension be presumed to have been so incurred. 38 U.S.C.A. §§ 1101, 1112, 1113, 1131, 1137, 5107 (West 1991); 38 C.F.R. §§ 3.303, 3.307, 3.309 (1993). 2. Arteriosclerotic heart disease was not due to injury or disease incurred in or aggravated by service, nor may heart disease be presumed to have been so incurred. 38 U.S.C.A. §§ 1101, 1112, 1113, 1131, 1137, 5107 (West 1991); 38 C.F.R. §§ 3.303, 3.307, 3.309 (1993). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS Initially, we find that the appellant's claim is well grounded within the meaning of 38 U.S.C.A. § 5107(a) (West 1991), in that he has presented a claim which is plausible. This being so, we must examine the record to determine whether the VA has a further obligation to assist in the development of facts pertinent to his claim. 38 U.S.C.A. § 5107(a) (West 1991). After reviewing the record, we are satisfied that all relevant facts have been properly developed and that no useful purpose would be served by remanding the case with instructions to provide additional assistance to the appellant. Service medical records appear complete, and it is not otherwise contended. Post-service medical reports of record include June 1976 treatment records from Saxton Lewis, M.D., Baptist Medical Center; inpatient treatment reports from Baptist Medical Center dated in January 1987 and October 1988; emergency room and inpatient treatment records from White River Hospital dated in October 1988; a May 1990 statement from Stone County Medical Center indicating emergency room treatment in 1987, 1988 and 1989; VA outpatient treatment (OPT) reports dated from August 1989 to April 1990; and an October 1992 statement from James E. Zini, D.O. In Dr. Zini's October 1992 statement, he indicates that the appellant was receiving treatment from a Dr. Beck for hypertension consisting prior to the mid 1980's, but that Dr. Beck was now deceased and any related records were reportedly unobtainable. Elsewhere, the veteran reports that he first saw Dr. Beck in the early 1970's. This is more than 1 year following separation from service. As such, the Board will not attempt to obtain such records. Furthermore, during April 1990 VA outpatient treatment, the appellant reported that he was recently awarded disability compensation from the Social Security Administration. While no documentation to such effect is currently associated with the claims folder, there is no indication and the appellant has not alleged that such award is based on additional relevant medical records not disclosed to or already obtained by the RO. The Board's duty to assist the appellant is not "a license for a fishing expedition," nor is it a "one-way street." See Gobber v. Derwinski, 2 Vet.App. 470, 472 (1992) (duty to assist does not extend to determinations of whether "there might be some unspecified information which could possibly support a claim."); Wood v. Derwinski, 1 Vet.App. 190, 193 (1991), reconsideration denied, 1 Vet.App. 406 (1991). Records of a current Social Security award would concern current impairment, not the origin of the disorders at issue in this appeal. In situations where it is not indicated how particular records might be useful, there is no need to obtain the records. See Holoway v. Brown, 4 Vet.App. 454 (1993). Therefore, the Board concludes that all relevant facts have been properly developed and that no useful purpose would be served by remanding the case with instructions to provide additional assistance to the appellant. Service connection may be granted for a chronic disability resulting from a disease or injury incurred in or aggravated by active peacetime service. 38 U.S.C.A. § 1131 (West 1991). Service connection may be shown directly or, for certain "chronic diseases," presumed, if the disease manifested to a degree of 10 percent or more within one year after the date of separation from service. 38 U.S.C.A. §§ 1101, 1112, 1113, 1137 (West 1991); 38 C.F.R. §§ 3.307, 3.309 (1993). Organic cardiovascular (heart) disease, including essential hypertension is such "chronic disease". If a disorder is not shown to be chronic during service, continuity of symptomatology after service is required to establish that a disorder is chronic. 38 C.F.R. § 3.303 (1993). Upon examination prior to entry into service, the appellant had no complaints, findings or diagnoses of hypertension or heart disease. At that time, the appellant's blood pressure was measured as 132/78. In May 1963, the appellant was treated for complaints of nose bleeds and headaches, with a blood pressure reading of 190/110. In June 1963, his blood pressure was measured as 160/70 and 180/96. At that time, the attending examiner ordered further testing. A chest x-ray in June 1963 revealed the heart to be of normal size and contour. In July 1963, the appellant's blood pressure was measured as 178/96, with no evidence of a murmur. The examiner further noted the presence of an inconsistent snapping in the heart as well as some arteriolar spasm in the appellant's eyes, and prescribed reserpine and phenobarbital. Subsequently, the appellant's blood pressure was measured as 166/90 in August 1963, and 160/92 in October 1963. The appellant was continued on the abovementioned medication at this time. On examination upon separation from service, the appellant's blood pressure was measured as 130/80, with a "history of hypertension due to nerves" noted by the examiner and the appellant. No other relevant complaints, findings, or diagnoses were found on such separation examination. The eyes were noted to be normal on examination. A chest x-ray revealed normal shape and size of the cardiac silhouette. Post-service medical reports of record reflect that in June 1976, the appellant was referred to Dr. Saxton by his personal physician, Dr. Beck, for a cardiovascular evaluation due to exertional chest pain. Prior to the examination, the appellant reported that he previously suffered a back and arm injury associated with a timber accident, and currently suffered from chest pain on exertion while cutting and hauling timber. Significantly, there was no recorded history of treatment of heart disease or hypertension. In conjunction with the appellant's history, Dr. Saxton noted that the appellant's blood pressure and ECG "have been normal," and that he was not currently using any hypertensive medications. Upon examination, the appellant's blood pressure was measured as 118/92 and 118/80. Furthermore, Dr. Saxton found no clinical heart enlargement, as well as no irregular rhythms and no gallop, rub or murmurs. However, due to the appellant's physically demanding employment, Dr. Saxton recommended a coronary arteriogram. That procedure revealed very mild non-occlusive disease, with a normal ventriculogram and ejection fraction. Dr. Saxton concluded that the appellant's exertional chest pain was probably skeletal in origin. Records further reflect that the appellant was treated in the White River Medical Center emergency room for complaints of chest pain in October 1988. At admission, his blood pressure was measured as 95/50. He was subsequently admitted with unstable ischemic syndrome characterized by severe chest pain and minimally elevated inferior systolic blood pressure. Following a cardiac catheterization indicating triple vessel coronary artery disease, the appellant was transferred to Baptist Medical Center for consideration of surgery. Inpatient treatment records from Baptist Medial Center indicate that the appellant specifically denied a history of or treatment for hypertension or heart disease. Subsequently, he underwent coronary artery bypass grafting surgery, recovered with no complications, and was discharged approximately a week later. VA outpatient and inpatient treatment reports dated from August 1989 to April 1990 indicate the appellant transferred his medical care to the VA for cardiac rehabilitation. In August 1989, his blood pressure was measured as 180/100. Upon admission to the cardiac rehabilitation program in April 1990, the appellant reported additional history of a second myocardial infarction in March 1989. Upon examination, the appellant was diagnosed with coronary artery disease, and controlled hypertension, with blood pressure readings at 135/80 and 175/90. An October 1992 statement from Dr. Zini indicated that he had rendered treatment to the appellant since the mid 1980's for mild to moderate hypertension, which had previously been treated by Dr. Beck. As Dr. Beck was currently deceased and his records were unobtainable, Dr. Zini stated he was unable to provide an accurate history of the appellant's current hypertension. He further stated that the appellant had subsequently suffered a myocardial infarction with bypass surgery due to arteriosclerotic heart disease. Upon review of the record, there is simply not enough objective clinical evidence to support a finding that the appellant incurred organic heart disease, including essential hypertension during service, or that he currently suffers from a chronic disability attributable to such service. While service medical records indicate isolated elevated blood pressure readings, the appellant's blood pressure upon separation from service was completely normal. There was a "history of hypertension due to nerves" indicated by the examiner. All pertinent clinical studies were normal at that time. In addition, there were no findings or diagnoses of chronic cardiovascular disease on such examination. Such clinical evidence clearly supports a finding that the appellant's elevated readings during service were merely acute and transitory. See Grivois v. Brown, 6 Vet.App. 136 (1994); Rabideau v. Derwinski, 2 Vet.App. 141 (1991). Furthermore, there is no objective clinical evidence of hypertension or heart disease within one year of separation from such service. 38 U.S.C.A. §§ 1101, 1112, 1113, 1137 (West 1991). Moreover, there is no clinical evidence of record indicating continuity of cardiac symptomatology following separation from service. The first clinical evidence of record, dated approximately 13 years after separation from service, indicated a previous history of normal blood pressure and ECG. The Board finds this reported history highly probative in the absence of clinical evidence to the contrary. This history was offered at the time the veteran was seeking treatment for chest pain, as opposed to histories offered now in the pursuit of compensation benefits. In addition, such records reflect only one slightly elevated blood pressure reading at that time with no diagnosis of or treatment for hypertension. The Board recognizes that the crux of the appellant's argument appears to be that his current arteriosclerotic heart disease is the direct result of hypertension which he contends began during his active service. While this theory is correct, the clinical evidence of record fails to demonstrate that the appellant incurred chronic essential hypertension during service. Thus, there is no basis to conclude that the hypertension and/or the heart disease is related to service. Therefore, it is concluded that chronic cardiovascular disease, including essential hypertension, was not present during service, or proximate thereto, nor has any such disorder attributable to such service been shown. 38 U.S.C.A. §§ 1101, 1112, 1113, 1131, 1137 (West 1991); 38 C.F.R. §§ 3.303, 3.307, 3.309 (1993). Since the preponderance of the evidence is against allowance of this claim, the benefit of the doubt doctrine is inapplicable. 38 U.S.C.A. § 5107(b) (West 1991). ORDER Entitlement to service connection for hypertension and heart disease is denied. ___________________________________ MICHAEL D. LYON Member, Board of Veterans' Appeals The Board of Veterans' Appeals Administrative Procedures Improvement Act, Pub. L. No. 103-271, § 6, 108 Stat. 740, ___ (1994), permits a proceeding instituted before the Board to be assigned to an individual member of the Board for a determination. This proceeding has been assigned to an individual member of the Board. NOTICE OF APPELLATE RIGHTS: Under 38 U.S.C.A. § 7266 (West 1991), a decision of the Board of Veterans' Appeals granting less than the complete benefit, or benefits, sought on appeal is appealable to the United States Court of Veterans Appeals within 120 days from the date of mailing of notice of the decision, provided that a Notice of Disagreement concerning an issue which was before the Board was filed with the agency of original jurisdiction on or after November 18, 1988. Veterans' Judicial Review Act, Pub. L. No. 100-687, § 402 (1988). The date which appears on the face of this decision constitutes the date of mailing and the copy of this decision which you have received is your notice of the action taken on your appeal by the Board of Veterans' Appeals.