Citation Nr: 20031186 Decision Date: 05/04/20 Archive Date: 05/04/20 DOCKET NO. 18-53 348 DATE: May 4, 2020 ORDER Entitlement to a compensable initial rating for hypertension prior to June 30, 2018, is denied. REMANDED Entitlement to a rating in excess of 40 percent for hypertension after June 30, 2018, is remanded. FINDING OF FACT Prior to June 30, 2018, the Veteran’s hypertension did not manifest a diastolic pressure predominantly 100 or more, systolic pressure predominantly 160 or more, or a history of diastolic pressure predominantly 100 or higher which required continuous medication for control. CONCLUSION OF LAW The criteria for entitlement to an initial compensable rating for hypertension prior to June 30, 2018, have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.104, Diagnostic Code 7101. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Air Force from January 2003 to July 2007, from January 2008 to July 2008, from October 2008 to April 2009, from July 2009 to April 2010 and from June 2010 to February 2012. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a September 2018 rating decision issued by the Department of Veteran Affairs (VA) Regional Office (RO). The Board acknowledges the Veteran’s October 2018 Rapid Appeals Management Program (RAMP) Election form. A November 2018 notification letter was mailed to the Veteran informing her that her request to participate in the program was not processed because she did not select a review lane. A copy of the new form was mailed along with the notification letter. However, no response was received by the Veteran. Therefore, the claim on appeal will continue within the legacy system. Entitlement to an initial compensable rating for hypertension prior to June 30, 2018. In an October 2016 rating decision, the Veteran was granted service connection for hypertension with a noncompensable rating effective March 23, 2016 under 38 C.F.R. § 4.104, Diagnostic Code 7101. A rating of 10 percent was not awarded because the evidence of record did not 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. The Veteran contends that she is entitled to a compensable rating for hypertension because her condition was worse than originally assessed. In a December 2016 statement, the Veteran wrote that she had uncontrolled hypertension that increased with time and age. She also stated that she did not report it more because she though it was a minor issue. Disability ratings are determined by the application of VA’s Schedule for Rating Disabilities (Schedule), which is based on the average impairment of earning capacity. Separate diagnostic codes identify the various disabilities. 38 U.S.C. § 1155; 38 C.F.R. Part 4. Pertinent regulations do not require that all cases show all findings specified by the Schedule, but that findings sufficient to identify the disease and the resulting disability and, above all, coordination of the rating with impairment of function will be expected in all cases. 38 C.F.R. § 4.21; see also Mauerhan v. Principi, 16 Vet. App. 436 (2002). When after careful consideration of all procurable and assembled data, a reasonable doubt arises regarding the degree of disability such doubt will be resolved in favor of the claimant. 38 C.F.R. § 4.3. Where there is a question as to which of two ratings shall be applied, the higher rating will be assigned if the disability picture more nearly approximates the criteria required for that rating. Otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7. The Board will consider whether separate ratings may be assigned for separate periods of time based on facts found, a practice known as “staged ratings,” in all claims for increased ratings. Fenderson v. West, 12 Vet. App. 119, 126-27 (1999); Hart v. Mansfield, 21 Vet. App. 505, 519 (2007). Under Diagnostic Code 7101, a 10 percent rating is warranted for diastolic pressure predominantly 100 or more; systolic pressure predominantly 160 or greater; or for an individual with a history of diastolic pressure predominantly 100 or greater who requires continuous medication for control. A 20 percent rating is warranted for diastolic pressure predominantly 110 or greater, or; systolic pressure predominantly 200 or greater. A 40 percent rating is warranted for diastolic pressure predominantly 120 or greater. A maximum 60 percent rating is warranted for diastolic pressure predominantly 130 or greater. The Board finds that the conclusion reached was accurate. The medical evidence prior to June 30, 2018, did not show a consistent history of hypertension with readings above 100. VA treatment records show the Veteran has been prescribed medications for hypertension. Recorded readings were as followed: March 2016 137/84; 140/87 February 2017 144/86 September 2017 150/115 October 2017 137/96 April 2018 132/83 At the September 2016 VA examination, the Veteran had blood pressure readings of 151/95, 155/95, and 137/84. The average of the three readings was 147/91. Thus, the blood pressure readings taken at the September 2016 VA examination included diastolic pressures below 100 and systolic pressures below 160. At the June 2018 VA examination, the Veteran had blood pressure readings of 186/130, 170/116, and 169/115. The average of the three readings was 175/120. It was not until this examination that the Veteran’s recorded blood pressure was predominantly elevated at or above 100. As such, the records do not show that the criteria for a compensable rating for hypertension were met at any time prior to June 30, 2018. In reaching this conclusion that Board has considered the hand written blood pressure readings recorded by the Veteran, but those readings also do not show more than an occasional diastolic reading above 100. Neither the Veteran nor his representative has raised any other issues with regard to the rating for the service-connected hypertension, nor have any other such issues been reasonably raised by the record. See Yancy v. McDonald, 27 Vet. App. 484, 495 (2016); Doucette v. Shulkin, 38 Vet. App. 366, 369-70 (2017). In summary, although the Veteran is on continuous medication for her hypertension, the evidence of record does not show a history of diastolic pressure predominantly of 100 or greater prior to June 30, 2018. As the preponderance of the evidence is against the assignment of a compensable rating, the benefit-of-the-doubt doctrine is not for application, and the claim must be denied. 38 U.S.C. § 5107(b); see also Gilbert v. Derwinski, 1 Vet. App. 49 (1990). REASONS FOR REMAND Entitlement to a rating in excess of 40 percent for hypertension after June 30, 2018. The Board is unable to determine if the Veteran is entitled to a higher rating after June 30, 2018, because medical treatment records from June 2018 to the present have not been associated with the record. Therefore, on remand, outstanding treatment records must be associated with the claims file. This matter is REMANDED for the following action: 1. Contact the Veteran for any necessary authorization to obtain medical treatment records. Allow the Veteran to submit any additional evidence in support of her claim. 2. Then, obtain the outstanding medical treatment records and associate them with the claims file, if any. 3. Thereafter, readjudicate the claim on appeal. MICHAEL MARTIN Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board T. Harris, Attorney Advisor 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.