Citation Nr: 18159164 Decision Date: 12/18/18 Archive Date: 12/18/18 DOCKET NO. 16-46 927 DATE: December 18, 2018 ORDER An initial rating of 10 percent for hypertension since February 6, 2015, is granted. FINDING OF FACT The Veteran had a history of diastolic blood pressure readings at or greater than 100, had more recent diastolic blood pressure readings nearing 100 while taking blood pressure-lowering medication, and he took daily medication for control of his hypertension. CONCLUSION OF LAW The criteria for an initial rating of 10 percent, since February 6, 2015, for hypertension have been met. 38 U.S.C. §§ 1155, 5103, 5103A, 5107 (2012); 38 C.F.R. §§ 3.102, 3.159, 3.321, 3.326(a), 4.7, 4.14, 4.104, Diagnostic Code 7101 (2018). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from September 1983 to April 1990 and from January to June 2007. He also served in the Air National Guard of New York and as a Reservist in the Air Force. Entitlement to an initial compensable rating since February 6, 2015, for hypertension. Disability evaluations are determined by comparing the Veteran’s current symptomatology with the criteria set forth in the Schedule for Rating Disabilities. 38 U.S.C. § 1155 (2012); 38 C.F.R. Part 4 (2018). A 10 percent rating is warranted for hypertension with 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. A 20 percent rating is warranted for hypertension with diastolic pressure predominantly 110 or more, or; systolic pressure predominantly 200 or more. A 40 percent rating is warranted for hypertension with diastolic pressure predominantly 120 or more. Note (1) states: Hypertension or isolated systolic hypertension must be confirmed by readings taken two or more times on at least three different days. For purposes of this section, the term hypertension means that the diastolic blood pressure is predominantly 90mm. or greater, and isolated systolic hypertension means that the systolic blood pressure is predominantly 160mm. or greater with a diastolic blood pressure of less than 90mm. Note (2) states: Evaluate hypertension due to aortic insufficiency or hyperthyroidism, which is usually the isolated systolic type, as part of the condition causing it rather than by a separate evaluation. Note (3) states: Evaluate hypertension separately from hypertensive heart disease and other types of heart disease. 38 C.F.R. § 4.104, Diagnostic Code 7101 (2017). Where there is a question as to which of two disability evaluations shall be applied, the higher evaluation will be assigned if the disability picture more nearly approximates the criteria required for that evaluation. Otherwise, the lower evaluation will be assigned. 38 C.F.R. § 4.7. The evaluation of the same disability under several diagnostic codes, known as pyramiding, must be avoided. Separate ratings may be assigned for distinct disabilities resulting from the same injury so long as the symptomatology for one condition is not duplicative of or overlapping with the symptomatology of the other condition. 38 C.F.R. § 4.14; Esteban v. Brown, 6 Vet. App. 259, 262 (1994). Where, as here, the issue involves the assignment of an initial rating for a disability following the award of service connection for that disability, the entire history of the disability must be considered. See Fenderson v. West, 12 Vet. App. 119 (1999). December 2007 and January 2008 private treatment records and service treatment records indicate that the Veteran had diastolic blood pressure readings of greater than or equal to 100. In April 2015, the Veteran was afforded a VA examination. It was noted that he took daily prescription medication for his hypertension. Despite taking the daily medication, the Veteran’s diastolic blood pressure readings were 99, 93, and 91. In an April 2015 statement, May 2015 notice of disagreement (NOD), and September 2016 VA Form 9, the Veteran reported that he had been taking his daily blood pressure medication at his April 2015 VA examination and, therefore, his blood pressure readings were lower at the examination than they otherwise would have been. The Veteran had a history of diastolic blood pressure readings at or greater than 100, had more recent diastolic blood pressure readings nearing 100 while taking blood pressure-lowering medication, and he took daily medication for control of his hypertension. Therefore, the Board finds that his hypertension most closely approximated a 10 percent rating since February 6, 2015. 38 C.F.R. § 4.7. With respect to a rating higher than 10 percent, the record shows that the Veteran never evidenced diastolic pressure predominantly of 110 or more or systolic pressure predominantly of 200 or more. Thus, the criteria for a 20 percent rating have not been met or approximated at any point during the appeal. Inasmuch as the rating criteria for hypertension are successive, the criteria for a rating higher than 10 percent for hypertension have not been met. 38 C.F.R. § 4.3. Thomas H. O'Shay Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD J. E. Miller, Associate Counsel