Citation Nr: 20021720 Decision Date: 03/26/20 Archive Date: 03/26/20 DOCKET NO. 19-28 029 DATE: March 26, 2020 ORDER Entitlement to a disability rating in excess of 10 percent for hypertension is denied. FINDING OF FACT The Veteran’s diastolic blood pressure has predominately been less than 110 and his systolic blood pressure has predominately been less than 200. CONCLUSION OF LAW The criteria for a disability rating in excess of 10 percent for hypertension have not been met. 38 U.S.C. § 1155, 5107 (2012); 38 C.F.R. §§ 3.321, 4.1, 4.3, 4.7, 4.104, Diagnostic Code 7101 (2019). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from February 1997 to June 1999. This matter is before the Board of Veterans’ Appeals (Board) on appeal from a rating decision issued in July 2018 by a Department of Veterans Affairs (VA) Regional Office (RO). Entitlement to a disability rating in excess of 10 percent for service-connected hypertension The Veteran contends he is entitled to a rating in excess of 10 percent for his hypertension. Disability evaluations are determined by evaluating the extent to which a Veteran’s service-connected disability adversely affects his or her ability to function under the ordinary conditions of daily life, including employment, by comparing his or her symptomatology with the criteria set forth in the Schedule for Rating Disabilities. The percentage ratings represent as far as can practicably be determined the average impairment in earning capacity resulting from such diseases and injuries and the residual conditions in civilian occupations. Generally, the degree of disabilities specified are considered adequate to compensate for considerable loss of working time from exacerbation or illness proportionate to the severity of the several grades of disability. 38 U.S.C. § 1155; 38 C.F.R. § 4.1. Separate diagnostic codes identify the various disabilities and the criteria for specific ratings. If two disability evaluations are potentially applicable, the higher evaluation will be assigned to the disability picture that more nearly approximates the criteria required for that rating. Otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7. Any reasonable doubt regarding the degree of disability will be resolved in favor of the Veteran. 38 C.F.R. § 4.3. Under Diagnostic Code 7101, which lists the criteria for rating hypertension, a 10 percent evaluation is warranted where diastolic blood pressure is predominantly 100 or more, or systolic blood pressure is predominantly 160 or more, or when an individual with a history of diastolic blood pressure predominantly 100 or more requires continuous medication for control. A 20 percent evaluation is warranted where diastolic blood pressure is predominantly 110 or more, or systolic blood pressure is predominantly 200 or more. A 40 percent evaluation is warranted where diastolic pressure is predominantly 120 or more, and a 60 percent evaluation is warranted where diastolic blood pressure is predominantly 130 or more. 38 C.F.R. § 4.104. The Veteran has argued that his rating should be higher as he is on medication to control his hypertension and that his medication has been repeatedly adjusted upward to control the disorder. The rating schedule merely requires medication for continuous control and does not afford higher ratings when the medications are adjusted. Instead, higher ratings are applied when there are higher blood pressure readings, as described above. Moreover, adjustments in medication, without more, do not provide insight into the degree of functional impairment caused by a disability. The Board cannot construe this as an allegation of an exceptional disability picture. However, the Board may properly consider ameliorative effects of blood pressure medication in adjudicating claims for increased ratings for hypertension, because medication is specifically mentioned in Diagnostic Code 7101. See McCarroll v. McDonald, 28 Vet. App. 267, 276-77 (2016). The Veteran also contended in a statement on his VA Form 9 received in September 2019 that his physician has told him his hypertension also affects other parts of his body such as his heart, kidneys, hearing, vision, and possibly lead to mental conditions like anxiety and depression. The RO denied service connection for a heart disorder in the July 2018 rating decision on appeal. The Veteran did not identify that issue as one he wished to appeal on his June 2019 notice of disagreement. See 38 C.F.R. § 19.21 (2019) (requiring that issues be identified on the notice of disagreement form). An April 2018 VA examination report and a Disability Benefits Questionnaire completed in June 2018 by Dr. E.S., a non-VA physician, indicate that the Veteran had no “physical findings, complications, conditions, signs or symptoms” associated with his hypertension. While the Board acknowledges that the Veteran’s hypertension may affect other parts of the Veteran’s body, there are no such complications at this time. Thus, ratings for complications are not warranted. The Veteran last underwent a VA examination for hypertension in April 2018. At the April 2018 VA examination three blood pressure readings were taken and the Veteran’s average blood pressure reading was 127/86. Similarly, the DBQ completed by E.S. showed diastolic pressures below 110 and systolic pressures below 200. There were no blood pressure readings showing a diastolic blood pressure of 110 or more, or a systolic blood pressure of 200 or more. Similarly, VA treatment records associated with the claims file did not show a record of blood pressure readings where diastolic blood pressure is predominantly 110 or more or systolic blood pressure is predominantly 200 or more. Treatment records from several private providers, to include Straub Clinic and Hospital, Dr. R.P., Dr. H.C., and The Queens Medical Center were also associated with the claims file, but those records also did not show blood pressure readings where diastolic blood pressure is predominantly 110 or more or systolic blood pressure is predominantly 200 or more during the period of appeal. The Board has reviewed the private and VA treatment records as well as the April 2018 VA examination. The medical evidence of record indicates that the Veteran is treated with continuous blood pressure medication, but it does not show that the Veteran’s diastolic blood pressure is predominantly 110 or more, or systolic blood pressure is predominantly 200 or more. Therefore, a rating greater than 10 percent is not warranted. J. B. FREEMAN Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board A. Boal, 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.