Citation Nr: 20035948 Decision Date: 05/26/20 Archive Date: 05/26/20 DOCKET NO. 17-56 290A DATE: May 26, 2020 REMANDED Entitlement to an initial compensable rating for hypertension is remanded. REASONS FOR REMAND The Veteran had active duty service from June 1969 to April 1971, from March 2005 to August 2006, from February 2007 to September 2007, and from January 2008 to June 2010, to include service in Afghanistan and the Republic of Vietnam. His awards and decorations include the Bronze Star Medal and Combat Infantryman Badge. This matter comes before the Board of Veterans’ Appeals (Board) from an April 2013 rating decision of the Department of Veterans Affairs (VA) Regional Office (RO) that awarded service connection for hypertension and assigned an initial noncompensable (zero percent) rating effective July 29, 2011. The Veteran disagrees with the initial rating assigned. The Board notes that, in addition to the claim herein, the Veteran’s April 2014 Notice of Disagreement also included the additional claims for service for prostate cancer and erectile dysfunction. In his November 2017 substantive appeal, VA Form 9, however, only the Veteran’s hypertension claim was appealed to the Board. The Veteran’s hypertension is rated as noncompensable (zero percent) under the provisions of 38 C.F.R. § 4.104, Diagnostic Code 7101, which provides that a 10 percent rating is warranted for diastolic pressure predominantly 100 or more, or; systolic pressure predominantly 160 or more, or; 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 diastolic pressure predominantly 110 or more, or; systolic pressure predominantly 200 or more. A 40 percent rating is warranted for diastolic pressure predominantly 120 or more. A 60 percent rating is warranted for diastolic pressure predominantly 130 or more. The Veteran asserts that he has been prescribed continuous medication to control his hypertension which, without medication, would result in elevated levels. The Board confirms that the Veteran’s VA treatment records show continuous use medication to treat his hypertension. Of note, February 2011 blood pressure readings at the Lake Baldwin VA Clinic, not long after the Veteran’s separation from service, were elevated. As noted by a VA examiner the following August 2012, the Veteran was subsequently prescribed Diltiazem and Hydrochlorothiazide. The Board notes that, despite his use of continuous medication, all of his blood pressure readings at an VA examination were still slightly elevated at 174/101, 172/102, and 181/108. A VA examination again in August 2017 indicated elevated readings, particularly with systolic pressure which was, at most, 183. The Veteran’s representative wrote in May 2020 that the Veteran’s hypertension has increased in severity and therefore warrants an updated examination. While the Board notes that the above evidence suggests that the Veteran’s hypertension may warrant an increased rating of 10 percent under Diagnostic Code 7101, it has been nearly three years since the previous VA hypertension examination. Therefore, this matter should be remanded to determine the current nature and severity of his service-connected hypertension. The Board also notes for the record that additional VA treatment records through April 2019 have been added to the claims file since the last Statement of the Case in August 2017. While on remand, any additional VA treatment records dated since should also be obtained. The matter is therefore REMANDED for the following actions: 1. Obtain VA treatment records from April 2019 to the present. 2. Ask the Veteran to identify all outstanding treatment records relevant to his hypertension claim. All properly identified records should be obtained if the necessary authorization to obtain the records is provided by the Veteran. If any records are not available, or the Veteran identifies sources of treatment but does not provide authorization to obtain records, appropriate action should be taken (see 38 C.F.R. § 3.159(c)-(e)), to include notifying the Veteran of the unavailability of the records. There should be two attempts to obtain private treatment records. 3. After records development is completed, schedule the Veteran for a VA examination to determine the current symptoms, level of severity, and functional impairment associated with his service-connected hypertension. The claims file should be reviewed by the examiner. Scott Shoreman Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board R. Scarduzio, 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.