Citation Nr: 18146011 Decision Date: 10/30/18 Archive Date: 10/30/18 DOCKET NO. 17-07 264 DATE: October 30, 2018 ORDER An initial compensable rating for hypertension is denied. FINDING OF FACT The Veteran’s hypertension requires continuous medication for control, but it has not been manifested by diastolic pressure predominantly 100 or more, either now or historically; nor has it been manifested by systolic pressure predominantly 160 or more. CONCLUSION OF LAW The criteria for a compensable rating for hypertension have not been met. 38 U.S.C. § 1155 (2012); 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.104, Diagnostic Code 7101 (2017). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the U.S. Army from September 1982 to September 1984 and from December 1994 to December 2012. His decorations include the Combat Action Badge. This matter comes to the Board of Veterans’ Appeals (Board) on appeal from an October 2014 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO) in Winston-Salem, North Carolina. Entitlement to an initial compensable rating for hypertension. Disability evaluations are determined by comparing a Veteran’s symptoms with criteria set forth in VA’s Schedule for Rating Disabilities, which are based on average impairment in earning capacity. 38 U.S.C. § 1155; 38 C.F.R. Part 4. When a question arises as to which of two ratings applies under a particular diagnostic code, the higher of the two evaluations will be assigned if the disability more closely approximates the criteria for the higher rating. Otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7. The Veteran’s hypertension has been evaluated under Diagnostic Code 7101. 38 C.F.R. § 4.104. Under that diagnostic code, a 10 percent rating is warranted for hypertension manifested by diastolic pressure predominantly 100 or more, or; systolic pressure predominantly 160 or more; or for an individual with a history of diastolic pressure predominantly 100 or more who requires continuous medication for control. Diastolic pressure predominantly 110 or more or systolic pressure predominantly 200 or more is rated 20 percent disabling. Diastolic pressure predominantly 120 or more is rated 40 percent disabling. Diastolic pressure predominantly 130 or more is rated 60 percent disabling. Id. The Veteran’s entire history is reviewed when making disability evaluations. 38 C.F.R. § 4.1; Schafrath v. Derwinski, 1 Vet. App. 589 (1995). At the time of an initial rating, consideration of the appropriateness of a staged rating is also required. Fenderson v. West, 12 Vet. App. 119 (1999). Turning to the evidence of record, the Veteran was afforded a VA examination for hypertension in August 2014. The examiner indicated that the Veteran’s initial diagnosis was provided in August 2014 and was based on blood pressure readings of 140/70 and 145/75. As to the Veteran’s current readings, the examiner recorded readings of 145/75, 140/70, and 140/72 with an average of 141/72. The examiner indicated that the Veteran’s treatment plan included taking continuous medication and that there was no history of a diastolic blood pressure elevation to predominantly 100 or more. A September 2015 treatment note reflects a blood pressure reading of 127/84. A September 2016 treatment report from Myrtle Beach Outpatient Clinic reflects a blood pressure reading of 151/84. In December 2016, the Veteran underwent another VA examination for hypertension. The examination report contains blood pressure readings of 124/78, 132/82, and 132/78 with an average of 129/79. The examiner indicated that the Veteran’s treatment plan included taking continuous medication and that there was no history of a diastolic blood pressure elevation to predominantly 100 or more. In June 2017, the Veteran underwent a VA examination for heart conditions. The examination report reflects a blood pressure reading of 117/83, and the examiner indicated that the Veteran’s treatment plan for hypertension included taking continuous medication. An August 2018 treatment note from the Charleston VA Medical Center reflects a blood pressure reading of 115/72. The Veteran stated in his August 2015 notice of disagreement that he had been on Losartan for his hypertension since March 2012, when he suffered a heart attack and had a stent implanted in his heart. In a January 2017 written statement, he asserted that his entire military record showed a pattern of higher than normal blood pressure throughout his 20-year military career. He also asserted that his high blood pressure culminated in him having a heart attack in March 2012 and that he was now on high blood pressure medicine for the rest of his life. In light of the record, the Board finds that a compensable rating is not warranted. During the appeal period, the Veteran’s diastolic pressure has not been predominantly 100 or more. While the record reflects use of continuous medication for control the Veteran’s hypertension, he does not have a history of diastolic pressure predominantly 100 or more as required for a compensable rating. Nor has his hypertension been manifested by systolic pressure predominantly 160 or more. The Board acknowledges the Veteran’s statements to the effect that his service treatment records (STRs) reflect continuously high blood pressure. The Board has reviewed the STRS, however, and they do not establish a history of diastolic pressure of 100 or more. The Board also acknowledges the Veteran’s assertions that his high blood pressure culminated in a heart attack. The Board notes, however, that he has already been service connected for a heart disability and is in receipt of a separate rating therefor. The rating for that disability is not presently on appeal. As the preponderance of the evidence is against the claim for a compensable disability rating for the Veteran’s hypertension, the appeal must be denied. DAVID A. BRENNINGMEYER Acting Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD A. Smith, Associate Counsel