Citation Nr: 21062270 Decision Date: 10/06/21 Archive Date: 10/06/21 DOCKET NO. 16-52 229 DATE: October 6, 2021 ORDER A compensable rating for hypertension is denied. FINDING OF FACT The evidence of record fails to show the Veteran's systolic pressure predominantly at 160 mm or more, or diastolic pressure predominantly at 100 mm or more either currently or historically. CONCLUSION OF LAW The criteria for a compensable rating for hypertension have not been met. 38 U.S.C. § 1155; 38 C.F.R. § 4.104, DC 7101. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran honorably served on active duty from August 1988 to August 1991. In a June 2015 rating decision, the Regional Office (RO) granted service connection for hypertension evaluated as noncompensable. The Veteran appealed the assigned rating. In June 2021, the Veteran testified at a Board's hearing, a transcript of which is of record. As reflected in his October 2016 substantive appeal (VA Form 9) and reiterated at the June 2021 hearing, the Veteran believes that he is entitled to a compensable rating based on the required use of medication for control of his blood pressure. Hypertension is evaluated per VA schedule for rating cardiovascular disabilities under 38 C.F.R. § 4.104, Diagnostic Code (DC) 7101. Under DC 7101, a rating at 10 percent is assigned when the evidence shows diastolic pressure predominantly at 100 mm or more, or systolic blood pressure predominantly at 160 mm or more, or control of blood pressure requires a continuous use of medication and a medical history reflects a diastolic pressure of predominantly 100 or more. Id. Of note, the rating criteria for hypertension is successive, meaning that the criteria for a lower evaluation must be met before a higher rating may be considered. The regulations do not require every reading to meet the requisite thresholds, but the use of "predominantly" in the regulations means that the readings must more often than not be at or above those thresholds. The plain regulatory language sets forth the precise numeric thresholds for the average readings in systolic pressure at 160 mm or more, or in diastolic pressure at 100 mm or more, which may be considered in two ways. The Board considers the current average readings in systolic or diastolic pressure. In cases, like this, where the Veteran requires continuous use of medication for control, the Board alternatively considers whether the average readings historically (such as prior to use of medications) meet the regulatory threshold for diastolic pressure at 100 mm or more. As such, a 10 percent may be assigned based on historical, rather than current, blood pressure readings of diastolic pressure predominantly at 100 or more. However, the regulation states that a minimum evaluation of 10 percent is assigned for an individual requiring continuous medication for control with a history of diastolic pressure predominantly at 100 or more. Id. As such, contrary to the Veteran's belief, required continuous use of medication on its own is insufficient to assign a compensable rating and rather must be coupled with a history of diastolic pressure that was predominately at 100 or more. Otherwise, a noncompensable rating is assigned. See 38 C.F.R. § 4.31. In this case, the evidence of record fails to show that the Veteran's diastolic blood pressure, be it historically or more recently, has been at 100 or more at any time. His service treatment records reflect blood pressure readings of 116/72 in July 1988; 140/60 in October 1989; 110/60 in January 1990; 146/74, 132/74, 138/70, 138/72, 138/70, 130/68, 139/70, 154/70 in March 1990; 118/52 in October 1990; 110/60 in November 1990; 118/54 in December 1990; 145/62 in July 1991; and 108/64 upon separation in August 1991. An October 1994 VA examination report shows blood pressure of 100/70. The Veteran's private medical treatment records (received from Bastrop Regional Foot and Ankle) show blood pressure readings of 164/91 in March 2007 and 114/64 in March 2012. The Veteran's VA treatment records show readings of 148/75 in April 2009. His private medical treatment records (received from Family Health Center of Bastrop) show blood pressure readings of 138/82 in Mar 2011, 138/80 in April 2011, 155/74 in November 2014, and 176/80 in January 2015 when the Veteran was prescribed medication for control of his blood pressure. A February 2015 progress note reflects historical blood pressure of 170/88 in December 2014 and 176/80 January 2015 and current reading of 160/85 with continued prescription of Norvasc. A March 2015 Disability Benefits Questionnaire DBQ (received from the Veteran's primary care provider at Family Health Center of Bastrop) reflects readings of 188/88 and 180/99 in December 2012; 130/80 and 155/74 in November 2014; and 140/80 and 160/85 in February 2015. A May 2015 VA examination report reflects blood pressure readings of 150/74, 134/73, and 142/77. The Veteran's VA treatment records show readings of 161/84 in March 2015, 132/64 in March 2016, and 140/80 in June 2017. It follows that the record is devoid of any single diastolic pressure reading at 100 or more, let alone showing diastolic pressure predominately at 100 or more, which is a fundament legal requirement for a compensable rating for hypertension. Of note, the Veteran has not identified any occasions in which a diastolic reading of 100 or more has been recorded. The Board notes the Veteran's isolated systolic blood pressure readings of 170 shown in December 2014, 176 in January 2015, and 160 in February 2015. Of particular note, however, the February 2015 progress report reflects that, although the Veteran has not kept a blood pressure diary, he states that his typical readings show systolics in the 130-140 and diastolics in the 70-80 range. By implication, it cannot be said that the Veteran's systolic pressure is predominately at 160 or more, as required for a compensable rating. Ultimately, given that the legal criteria for a compensable rating for hypertension have not been met, the appeal is denied. MATTHEW W. BLACKWELDER Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Alex Bardin, 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.