Citation Nr: 20054150 Decision Date: 08/14/20 Archive Date: 08/14/20 DOCKET NO. 16-24 079 DATE: August 14, 2020 ORDER Entitlement to a compensable rating for hypertension is denied. FINDING OF FACT Hypertension did not manifest by diastolic blood pressure that was predominantly 100 or more while the Veteran was on medication. CONCLUSION OF LAW The criteria for a compensable rating for hypertension are not met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.21, 4.1, 4.2, 4.3, 4.7, 4.104, Diagnostic Code (DC) 7101. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Coast Guard from September 1994 to November 1994, from February 2003 to January 2004, and from September 2005 to January 2009. This matter is before the Board of Veterans’ Appeals (Board) on appeal from a November 2014 rating decision by the Department of Veterans Affairs (VA) Regional Office (RO) in which the Veteran was granted service connection for hypertension at a noncompensable rating. In the July 2015 Notice of Disagreement (NOD), the Veteran sought an increased rating for his service-connected hypertension. In April 2016, the RO issued a statement of the case (SOC) denying an increased rating for hypertension because the Veteran did not meet the regulatory requirements for a higher rating. In May 2016, the Veteran timely filed his Form 9, Substantive Appeal, and declined the optional Board hearing. This case was previously before the Board in November 2018 in which the case was remanded for further development. In the Board’s November 2018 decision, the Board remanded the case directing the RO to obtain any outstanding medical records and afford the Veteran a VA examination to determine the current severity of his hypertension. In September 2019, additional medical records were associated with the claims file. Additionally, in September 2019, the Veteran was afforded a VA examination for his hypertension. Entitlement to an increase rating for hypertension in excess of 0 percent Disability ratings are determined by comparing the symptomatology manifested by a particular service-connected disability at issue with the criteria set forth in the VA Schedule for Rating Disabilities (Rating Schedule). See 38 U.S.C. § 1155; 38 C.F.R. Part 4. Disability ratings assess the ability of the body as a whole, or a body system or organ, to function under the ordinary conditions of daily life, to include employment. 38 C.F.R. § 4.10. The Rating Schedule is a guide intended to compensate, as far as can practicably be determined, the average impairment of earning capacity resulting from service-connected diseases and injuries and their residual conditions in civilian occupations. 38 U.S.C. § 1155; 38 C.F.R. §§ 3.21, 4.1. Where the question is which of the two evaluations shall be applied, the higher evaluation is assigned if the disability picture more nearly approximates the criteria for that rating. Otherwise the lower rating is assigned. 38 C.F.R. § 4.7. For VA purposes, hypertension or isolated systolic hypertension means that the diastolic blood pressure is predominantly 90 or more, or the systolic blood pressure is predominantly 160 or more with a diastolic blood pressure of less than 90. 38 C.F.R. § 4.104, Diagnostic Code (DC) 7101 at Note (1). For hypertension to be considered compensably disabling, the evidence must show that the diastolic blood pressure is predominantly 100 or more, or the systolic blood pressure is predominantly 160 or more, or show a 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. § 4.104, DC 7101. The Board may factor the ameliorative effects of blood pressure medication into its analysis of claims for increased ratings for hypertension because DC 7101 expressly mentions the effect of hypertension medications. See McCarroll v. McDonald, 28 Vet. App. 267, 276-77 (2016). The Veteran contends that his hypertension has worsened since 2014. The Veteran’s VA treatment records from February 2015 through December 2018 show the Veteran had 11 blood pressure readings while on medication for his hypertension. The blood pressure readings were: 136/89, 128/88, 118/76, 154/89, 134/84, 134/76, 124/62, 124/82, 122/78, 118/80, and 138/82. None of the readings had a diastolic pressure of 100 or more. 38 C.F.R. § 4.104, DC 7101. In September 2019, the Veteran underwent a VA examination for his hypertension. The VA examiner measured the Veteran’s blood pressure and obtained two readings: 144/93 and 149/96. The examiner’s report included the Veteran’s statement that he was taking medication to control his hypertension. The examiner reported that the Veteran’s last VA examination for hypertension was in September 2014, which recorded a blood pressure reading of 125/85. According to the VA examiner’s report, the Veteran does not meet the regulatory requirements for a compensable rating for hypertension. The examiner’s report based the Veteran’s functional impact solely on the Veteran’s statement that “he worries about having a heart attack or stroke if he was doing a job that caused him a significant amount of stress.” The examiner’s report did not find any basis for functional impact of the Veteran’s hypertension aside from the Veteran’s own words which are determined to be speculative. Given that neither the Veteran’s VA treatment records nor the September 2019 VA examination show the Veteran’s diastolic blood pressure as “predominantly” of 100 or more during the period on appeal or even during any identifiable stage of the period on appeal, the Veteran does not qualify for a compensable rating for his hypertension. Accordingly, while the Board is mindful of the Veteran’s opinion that the severity of his hypertension permits a compensable rating, the Board is without a basis to grant the Veteran’s claim on a schedular basis under the clear language of DC 7101. Moreover, the Board is without a basis in the record to refer the Veteran’s claim for an extraschedular consideration. See Thun v. Peake, 22 Vet. App. 111 (2008). Therefore, the Board is constrained to deny the Veteran’s claim for an increased rating for his hypertension. Cynthia M. Bruce Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. Agarwal, 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.