Citation Nr: 18157128 Decision Date: 12/11/18 Archive Date: 12/11/18 DOCKET NO. 16-57 020 DATE: December 11, 2018 ORDER Entitlement to a compensable rating for hypertension. FINDING OF FACT The Veteran's hypertension is not manifested by diastolic pressure of predominantly 100 or more-or a history thereof-or systolic pressure of predominantly 160 or more. CONCLUSION OF LAW The criteria for a compensable rating for hypertension have not been met. 38 U.S.C. §§ 1155, 5103A, 5107 (2012); 38 C.F.R. §§ 3.159, 4.1, 4.3, 4.7, 4.104, Diagnostic Code 7101 (2018).   INTRODUCTION The Veteran served on active duty from February 1978 to September 1998. This matter comes to the Board of Veterans’ Appeals (Board) on appeal from an October 2013 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO). The Veteran has raised a claim for service connection for headaches, as secondary to his service-connected hypertension. As this matter has not been developed for appellate review, it is not properly before the Board at this time and is referred to the Agency of Original Jurisdiction (AOJ) for appropriate action. REASONS AND BASES FOR FINDING AND CONCLUSIONS Pertinent Criteria Disability evaluations are determined by application of the criteria set forth in the VA's Schedule for Rating Disabilities, which is based on average impairment in earning capacity. 38 U.S.C. § 1155; 38 C.F.R. Part 4. An evaluation of the level of disability present must also include consideration of the functional impairment of the Veteran's ability to engage in ordinary activities, including employment. 38 C.F.R. § 4.10. When a question arises as to which of two ratings apply under a particular diagnostic code, the higher evaluation is assigned if the disability more closely approximates the criteria for the higher rating. 38 C.F.R. § 4.7. After careful consideration of the evidence, any reasonable doubt remaining is resolved in favor of the Veteran. 38 C.F.R. § 4.3. The Veteran's entire history is to be considered when making disability evaluations. See generally 38 C.F.R. § 4.1; Schafrath v. Derwinski, 1 Vet. App. 589 (1995). The Court has held that "staged" ratings are appropriate for any rating claim when the factual findings show distinct time periods where the service-connected disability exhibits symptoms that would warrant different ratings. See Hart v. Mansfield, 21 Vet. App. 505 (2007); Fenderson v. West, 12 Vet. App 119 (1999). The Veteran's service-connected hypertension is rated as noncompensable under the provisions of 38 C.F.R. § 4.104, Diagnostic Code (Code) 7101. This code provides for a 10 percent rating for diastolic pressure predominantly 100 or more, or; systolic pressure predominantly 160 or more, or; minimum evaluation for an individual with a history of diastolic pressure predominantly 100 or more who requires continuous medication for control. See 38 C.F.R. § 4.104, Diagnostic Code 7101. A 20 percent disability rating is warranted for diastolic pressure predominantly 110 or more, or systolic pressure predominantly 200 or more. A 40 percent disability rating for diastolic pressure predominantly 120 or more, while 60 percent rating is warranted for diastolic pressure predominantly 130 or more. Id. Facts and Discussion The Veteran’s service treatment records show that he was seen in December 1991 complaining of a skin rash. His blood pressure reading at that time was 154/106. Two additional readings were taken at that time showing readings of 160/100 and 150/88. The Veteran returned to the clinic on three separate occasions in December 1991 and January 1992 for blood pressure checks and the readings were all under 160 for systolic and under 100 for diastolic. These records additionally show that the Veteran was found to have high blood pressure at his retirement examination in April 1998. Multiple readings were taken over the course of three days in April 1998 with the following results: right arm-140/112, 138/98, 130/98, 102/70, 118/78 and 138/88; left arm-148/110, 140/102, 130/96, 108/62, 120/80 and 140/92. A May 1998 record shows that the Veteran was seen for follow up of recent blood pressure medication for new onset hypertension. He was assessed as having hypertension, stage I, controlled with medication. Post-service private treatment records from Dr. Hunter in 2008 and 2009 show readings of 150/94 in February 2008, 116/82 in April 2008, and 130/80 and 156/100 in April 2009. Additional post-service treatment records on file, including VA treatment records from 2009 to 2011, do not show systolic readings of 160 or over, or diastolic readings of 100 or over. A QTC examiner reported in April 2018 that the Veteran had been diagnosed as having hypertension in 1998 and began taking medication, Lisinopril, at that time. He did not have the Veteran’s medical records to review, but he did examine the Veteran. He reported that blood pressure readings were taken on three consecutive days, from March 21, 2018, to April 2, 2018, as follows: 121/89, 131/99 and 140/80. He remarked that there were no other pertinent findings related to the Veteran’s hypertension except for headaches. In sum, while the record demonstrates that the Veteran is required to take medication for control of his hypertension, neither the blood pressure readings taken in conjunction with the April 2018 QTC examination nor any post-service treatment record from the date of his October 2011 claim for an increase shows that diastolic pressure is predominantly 100 or more or systolic pressure is predominantly 160 or more. Given that the rating criteria also provide that a history of diastolic pressure predominantly 100 or more warrants a 10 percent rating with continuous medication, the Board has reviewed treatment records prior to October 2011 as well as the Veteran's service treatment records. In this regard, as noted, service treatment records show that at the time that the Veteran was found to have high blood pressure and was diagnosed as having stage I hypertension in April and May 2008, he only had one diastolic reading of 100 or over, i.e. 102. He also had two prior documented diastolic reading of 100 or over in December 1991, i.e. 106 and 100. Also, post-service medical records prior to the Veteran’s October 2011 claim show at least one diastolic reading of 100 in April 2009. However, such scant findings are not predominant, especially when considering the numerous blood pressure readings that are documented in the service treatment records as well as in post-service treatment records which show diastolic readings all below 100. Moreover, the basis of the Veteran’s claim for a compensable, 10 percent, rating for hypertension is that he has erectile dysfunction secondary to hypertension and he should therefore be assigned a 10 percent rating for that disability. See VA Form 9 received in June 2018. However, that represents a separate claim which the RO addressed in a May 2010 rating decision. In light of the foregoing, the criteria for a rating of 10 percent based on diastolic pressure of predominantly 100 or more, or a history of diastolic pressure of predominantly 100 or more with continuous medication, or systolic pressure predominantly 160 or more, are not met. 38 C.F.R. § 4.104, Diagnostic Code 7101. Accordingly, a compensable rating for hypertension is not warranted at any point during the duration of this appeal period. Kristin Haddock Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD A. Shawkey, Counsel