Citation Nr: 18145018 Decision Date: 10/29/18 Archive Date: 10/25/18 DOCKET NO. 16-26 887 DATE: October 29, 2018 ORDER Entitlement to a compensable rating for hypertension is denied. FINDING OF FACT Throughout the Veteran’s hypertension has been manifested by diastolic pressures predominantly less than 100, systolic pressures predominantly less than 160, and a requirement of continuous medication for control of high blood pressure; a history of diastolic pressures or 100 or more is not shown. CONCLUSION OF LAW A compensable rating for hypertension is not warranted. 38 U.S.C. §§ 1155, 5107(b); 38 C.F.R. §§ 4.7, 4.31, 4.104, Diagnostic Code (Code) 7101. REASONS AND BASES FOR FINDING AND CONCLUSION The appellant is a Veteran who served on active duty from September 1994 to September 1999. This case is before the Board of Veterans’ Appeals (Board) on appeal from a Department of Veterans Affairs (VA) March 2015 rating decision, which granted service connection for hypertension, rated 0 percent, effective in September 2014. Entitlement to a compensable rating for hypertension Legal Criteria Disability evaluations are determined by application of VA’s Schedule for Rating Disabilities (Rating Schedule), 38 C.F.R. Part 4. The percentage ratings contained in the Rating Schedule represent, as far as can be practicably determined, the average impairment in earning capacity resulting from diseases and injuries incurred or aggravated during military service and their residual conditions in civil occupations. 38 U.S.C. § 1155; 38 C.F.R. § 4.1. Where there is a question as to which of two evaluations shall be applied, the higher evaluation will be assigned if the disability picture more nearly approximates the criteria for that rating. Otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7. The Board will consider whether separate ratings may be assigned for separate periods of time based on facts found, a practice known as “staged ratings.” Fenderson v. West, 12 Vet. App. 119, 126-27 (1999). The criteria for rating hypertension are found at 38 C.F.R. § 4.104, Code 7101. A 10 percent rating is warranted when diastolic pressures are predominantly 100 or more, or systolic pressures are predominantly 160 or more, or when there is a history of diastolic pressure predominantly 100 or more requiring continuous medication for control. A 20 percent rating is assigned when diastolic pressure is predominantly 110 or more, or systolic pressure is predominantly 200 or more. A 40 percent rating is assigned when diastolic pressure is predominantly 120 or more, and a maximum 60 percent rating is assigned when diastolic pressure is predominantly 130 or more. In every instance where the schedule does not provide for a 0 percent rating for a diagnostic code, a 0 percent rating shall be assigned when the requirements for a compensable rating are not met. 38 C.F.R. § 4.31. The evidence of record does not show that the Veteran’s hypertension is, or has been, manifested by diastolic pressures predominantly 100 or more or systolic pressures predominantly 160 or more, despite the need for continuous medication for blood pressure control from the time of his claim for service connection for hypertension in September 2014 and at various times before he filed his claim. In fact, in nearly every instance his diastolic and systolic pressures were well below the threshold criteria for a 10 percent rating under Code 7101. The Veteran’s service treatment records show that his blood pressure readings were: 138/88 in April 1994; 150/90 in April 1995; 169/79, 189/80, 130/86, and 115/79 in August 1996; 144/76 in April 1997; highest systolic of 153 and highest diastolic of 98 in June and July 1997; 152/72 in October 1997; 137/67 and 147/70 in November 1997; 161/92, 139/81, and 112/78 in January 1998; 139/83 and 150/86 in April 1998; 136/76 in June 1999; and 117/69 in July 1999. Pertinent VA medical records show the following blood pressure readings (after service but prior to the filing of his claim for service connection in September 2014): 140/90 in November 1999; 120/92 in July 2001; 124/80 in September 2001; 153/76 in October 2002; 120/80 in January 2003; 134/90 and 130/80 in February 2007; 126/84 in April 2008; 139/83 in April 2010; 147/93 in October 2010; 155/100 in January 2011; 138/80 in April 2012; 130/100 in April 2013; and 142/96 in September 2014. At various times during this period, the Veteran was placed on medication to control his blood pressure. For example, in February 2007 his blood pressure decreased after he took hydrochlorothiazide (hctz). In April 2008 and April 2010, it was noted that his elevated blood pressure had resolved and he was not on medication. However, in October 2010 a health care provider was considering adding medication (the elevated blood pressure was thought to be due to pain at that time), and by January 2011 medication to control blood pressure was prescribed. More than a year later, in April 2012, although he had a diagnosis of hypertension, it was noted that he was not on blood pressure medication. When he filed the instant claim, in September 2014, his blood pressure was again elevated and he agreed to be placed on medication (hctz/lisinopril) to control it. After the filing of the instant claim, in September 2014, the Veteran was afforded two VA examinations, when the highest blood pressure readings were 142/92 (in February 2015) and 140/92 (in June 2015). Subsequently, in a November 2015 statement, he claimed that his blood pressure was still elevated and continued to worsen. However, upon comparing blood pressure readings taken before, during, and after his VA examinations, the Board finds that the objective evidence does not reflect an increase in his disability; therefore, a new VA examination is not warranted. VA blood pressure readings since September 2014 have been: 138/84 in April 2015; 149/90 in October 2015; 135/89 in December 2015; 94/140 (highest) in April 2016; and 138/87 in March 2017. Private medical records show blood pressures of 130/86 in September 2014 and 124/88 and 140/90 in February 2015. During the appeal period, the Veteran continuously took daily medication (hctz) for hypertension. Regarding the functional impact of this condition, VA examiners have noted that the Veteran’s hypertension does not impact his ability to work and that he remains independent in his activities of daily living, even though his blood pressure was sub-optimally controlled. As the foregoing discussion shows, the Veteran’s blood pressure readings have fluctuated, but the evidence clearly demonstrates that the readings have not met the levels required for a 10 percent rating under Code 7101. Moreover, the evidence does not show that the hypertension causes occupational functional impairment. Based on the foregoing, the Board concludes that throughout, the preponderance of the evidence is against the award of a compensable schedular rating for hypertension under Code 7101, and there are no other diagnostic codes under which he would be more appropriately evaluated. The benefit-of-the-doubt rule does not apply; the appeal in this matter must be denied. 38 U.S.C. § 5107 (b). GEORGE R. SENYK Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD Debbie Breitbeil, Counsel