Citation Nr: 20021418 Decision Date: 03/25/20 Archive Date: 03/25/20 DOCKET NO. 14-08 474 DATE: March 25, 2020 ORDER An initial compensable rating for hypertension is denied. FINDING OF FACT The Veteran’s hypertension required continuous medication, but the evidence does not show a history of diastolic pressure predominantly 100 or more or systolic pressure predominantly 160 or more. CONCLUSION OF LAW The criteria for a higher initial rating for hypertension have not been met. 38 U.S.C. § 1155; 38 C.F.R. § 4.104, Diagnostic Code (DC) 7101. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from April 1969 to November 1970. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a November 2012 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). The Board remanded this matter in July 2018 and requested development, to include requesting authorization for private treatment records from Dr. Calhoun from April 2012 to the present. A December 2018 letter requested that the Veteran complete a VA Form 21-4142(a) for such records. The record does not reflect that the Veteran responded. Otherwise, VA medical records and a VA examination were obtained per the prior Board directives. Increased Ratings Disability ratings are determined by applying the criteria set forth in the VA Schedule for Rating Disabilities, found in 38 C.F.R., Part 4. The percentage ratings are based on the average impairment of earning capacity as a result of a service-connected disability. 38 U.S.C. § 1155; 38 C.F.R. § 4.1. If two disability evaluations are potentially applicable, 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. All reasonable doubt as to the degree of the disability will be resolved in favor of the claimant. 38 C.F.R. § 4.3. In determining the propriety of an initial disability rating, the evidence since the effective date of the grant of service connection must be evaluated. Fenderson v. Brown, 12 Vet. App. 119, 126-27 (1999). In all cases, the Board must also consider staged ratings, which are appropriate when the evidence establishes that the claimed disability manifested symptoms that would warrant different ratings for distinct time periods. Hart v. Mansfield, 21 Vet. App. 505, 509-10 (2007). Entitlement to an initial compensable rating for hypertension The Veteran’s service-connected hypertension is currently rated as noncompensable under DC 7101. For the Veteran to be entitled to the minimum compensable rating of 10 percent, the evidence must show 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. 38 C.F.R. § 104, DC 7101. While the medical evidence of record reflects that the Veteran requires continuous medication for control of his hypertension, the evidence of record does not reflect a history of diastolic pressure predominantly 100 or more. The Veteran underwent a VA examination in October 2012. He took continuous medication for his hypertension. There was no history of diastolic BP elevation to predominantly 100 or more. His blood pressure readings at the examination were 130/82, 132/76, and 134/86. In his March 2014 Form 9, the Veteran indicated that his blood pressure readings were consistently in the range of more than 100 for diastolic pressure and more that 160 systolic pressure while on medication. He also asserted that in the past year, his blood pressure became harder to control regardless of medication. However, a review of the VA treatment records does not reflect a diastolic pressure of 100 or more nor a showing of systolic pressure predominantly 160 or more. These records reflect several examples of this. To illustrate this the Board notes that, for example, a blood pressure reading in October 2012 was 118/70, in March 2014 it was 141/79, in August 2014 it was 112/68, in January 2015 it was 115/77, in July 2015 it was 126/74, in April 2016 it was 112/74, in February 2017 it was 110/71, in August 2017 it was 126/72, and in August 2018 it was 124/72. Additionally, his blood pressure was regularly noted to be stable and controlled on medication. The Board finds these reading to have probative value and weight as there were taking during the course of regular medical visits and over a period of approximately six years. In September 2019, the Veteran’s blood pressure was stable, and he was advised to switch his medication. It is noted that in October 2019, he had blood pressure readings of 157/92, 165/98, and 177/98. He indicated that he had stopped taking medication because his treating physician had told him to stop taking some of his medication because his blood pressure was good in the 120’s systolic pressure. In October 2019, he was afforded another VA examination. His treatment plan included taking continuous medication for his hypertension and he reported that he had been doing well on his current medication. He did not have a history of diastolic blood pressure elevation to predominantly 100 or more. His blood pressure readings at the examination were 155/74, 149/74, and 149/75. After review of the competent and probative evidence, the Board finds that an initial compensable rating is not warranted. Here, with the exception of a few outliers, the Veteran’s diastolic and systolic pressures were below 100 and 160, respectively. The Board acknowledges the Veteran takes continuous medication to control his hypertension. However, the competent evidence of record weighs against a finding that the Veteran’s diastolic pressure is predominantly 100 or more, or systolic pressure is predominantly 160 or more. See MERRIAM-WEBSTER, Predominantly, available at https://www.merriam-webster.com/dictionary/predominantly (defining this word as, for the most part : mainly). In support, the Board notes that readings from 2012 through the most recent VA examination in 2019 does not reflect a history of diastolic pressure predominantly 100 or more. In light of the foregoing, the preponderance of the probative and competent evidence of record is against the Veteran’s claim and the reasonable doubt standard is not applicable. See 38 C.F.R. § 4.3. Therefore, the Board concludes a compensable rating is not warranted. Paul Sorisio Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board K. Cruz, Associate Counsel The Board’s decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.