Citation Nr: A21019474 Decision Date: 12/07/21 Archive Date: 12/07/21 DOCKET NO. 200522-88460 DATE: December 7, 2021 ORDER Entitlement to a 10 percent rating but no higher for hypertension is granted. Entitlement to an effective date prior to March 25, 2011 for service connection of hypertension is denied. FINDINGS OF FACT 1. Resolving reasonable doubt, during the period at issue the Veteran's hypertension demonstrated a history of diastolic pressure predominantly 100 or more who requires continuous medication for control. 2. The November 1996 rating decision is final; the earliest effective date the Veteran is entitled to is the date of the reopened claim on March 25, 2011. CONCLUSIONS OF LAW 1. The criteria for a rating of 10 percent but no higher have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1-4.7, 4.21, 4.31, 4.104, Diagnostic Code 7101. 2. The criteria for entitlement to an effective date prior to March 25, 2011 for service connection of hypertension have not been met. 38 U.S.C. §§ 5107, 5110; 38 C.F.R. §§ 3.102, 3.155, 3.159, 3.160, 3.400, 20.1104. REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served on active duty from November 1990 to November 1994. This matter comes before the Board of Veterans' Appeals (Board) on appeal from an April 2020 of the Department of Veterans Affairs (VA) Regional Office (RO). In the May 2020 VA Form 10182, Decision Review Request: Board Appeal, the Veteran elected the Direct Review docket. Therefore, the Board may only consider the evidence of record at the time of the agency of original jurisdiction (AOJ) decision on appeal. 38 C.F.R. § 20.301. Evidence was added to the claims file during a period of time when new evidence was not allowed. As the Board is deciding the claims of entitlement to a compensable rating for hypertension and entitlement to an effective date prior to March 25, 2011 for hypertension, it may not consider this evidence in its decision. 38 C.F.R. § 20.300. The Veteran may file a Supplemental Claim and submit or identify this evidence. 38 C.F.R. § 3.2501. If the evidence is new and relevant, VA will issue another decision on the claim, considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision. Increased Rating General Rating Principles 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. The Board will consider not only the criteria of the currently assigned diagnostic code, but also the criteria of other potentially applicable diagnostic codes. Rating Principles Hypertension The Veteran is currently service connected with a noncompensable for hypertension under diagnostic code 7101. Under diagnostic code 7101, a rating of 10 percent is warranted for 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. A rating of 20 percent is warranted for diastolic pressure predominantly 110 or more; or systolic pressure predominantly 200 or more. A rating of 40 percent is warranted for diastolic pressure predominantly 120 or more. A rating of 60 percent is warranted for diastolic pressure predominantly 130 or more. Note 1 of diagnostic code 7101 notes that hypertension or isolated systolic hypertension must be confirmed by readings taken two or more times on at least three different days. For purposes of this section, the term hypertension means that the diastolic blood pressure is predominantly 90mm. or greater, and isolated systolic hypertension means that the systolic blood pressure is predominantly 160mm. or greater with a diastolic blood pressure of less than 90mm. Note 2 of diagnostic code 7101 notes that hypertension due to aortic insufficiency or hyperthyroidism, which is usually the isolated systolic type, should be evaluated as part of the condition causing it rather than by a separate evaluation. Note 3: of diagnostic code 7101 notes that hypertension should be evaluated separately from hypertensive heart disease. 1. Entitlement to an initial compensable rating for hypertension. The Veteran contends that he is entitled to an initial compensable rating for his hypertension. May 2011 VA treatment records note blood pressure of 133/88. July 2011 VA treatment records note blood pressure of 133/88. The Veteran was afforded a VA examination for hypertension in September 2011. Blood pressure readings were 148/94, 167/100 and 193/110. The Veteran's treatment plan included continuous medication for hypertension or isolated systolic hypertension. October 2011 VA treatment records note blood pressure of 124/85. A November 2011 private opinion notes that the Veteran has been on anti-hypertension medication during military service. The cilician opines that the Veteran probably had sustained blood pressure because he was on anti-hypertensive medication. August 2012 VA treatment records note blood pressure of 144/88. February 2013 VA treatment records note blood pressure of 130/86. During an April 2014 VA examination for peripheral nerve conditions the Veteran's blood pressure was 140/90. May 2014 VA treatment records note blood pressure of 155/109. May 2015 VA treatment records note blood pressure of 138/92 and 132/89. June 2015 VA treatment records note that the Veteran's blood pressure was improved on several occasions, but elevated diastolic pressure was noted. The Veteran's blood pressure was 128/87. September 2015 VA treatment records note blood pressure of 122/86. March 2016 VA treatment records note blood pressure of 125/86. November 2016 VA treatment records show blood pressure of 128/91. The Veteran was noted to be out of his hypertension medication, triptan, and his blood pressure was noted as elevated. March 2017 VA treatment records note blood pressure of 129/81. April 2017 VA treatment records note blood pressure of 135/84. September 2017 VA treatment records note blood pressure of 138/88. January 2018 VA treatment records note blood pressure of 146/95. July 2018 VA treatment records note BP 142/96. August 2019 VA treatment records note blood pressure of 124/79. The Veteran was afforded a new VA examination in September 2019. The examiner noted that the Veteran was placed on blood pressure medication in 1993. The Veteran reported that he continues to take medication and reported having hypertensive crisis episodes that have sent him to the emergency room for treatment in 1996, 1997, 1998, 2005 and 2007. The examiner noted blood pressure readings of 140/92, 160/92 and 154/90. The Veteran's average blood pressure reading was 151/91. In connection with his VA examination the Veteran was asked to provide three days of blood pressure readings. Day #1 readings were 140/105, 140/101 and 140/98. Day #2 readings were 157/110, 154/115 and 150/105. Day #3 readings were 154/110, 157/112 and 158/114. The Veteran's private physician provided a hypertension disability benefits questionnaire in February 2020. The clinician notes that the Veteran's initial diagnosis of hypertension were confirmed by blood pressure readings of 150/91 in January 2016, 145/99 in March 2016 and 153/98 in July 2016. The clinician also noted blood pressure readings of 152/99 in June 2019, 148/99 in September 2019 and 146/100 in November 2019. December 2019 VA treatment records note 145/82 and 124/74. March 2020 VA treatment records note 134/87. April 2020 VA treatment records note 132/81. Ultimately, the evidence of record shows that the Veteran's diastolic pressure has predominantly been 99 or less and systolic pressure has been less than 160 during the entire period on appeal. However, the Board notes that the evidence suggests that the Veteran has been on continuous medication for control of his hypertension. Based on the Veteran's history of continuous medication and the Veteran's history of diastolic pressure near 99, the Board finds that a compensable rating of 10 percent is warranted. However, based on the Veteran's blood pressure readings, a rating in excess of 10 percent is not warranted. Entitlement to a rating of 10 percent but no higher is granted. Effective Date Legal Criteria The effective date of an award based on an original claim, a claim reopened after final adjudication, or a claim for increase of compensation, dependency and indemnity compensation, or pension, shall be fixed in accordance with the facts found, but shall not be earlier than the date of receipt of application thereof. 38 U.S.C. § 5110(a). 2. Entitlement to an effective date prior to March 25, 2011 for service connection of hypertension. The Veteran and his representative contend that the Veteran is entitled to an effective date of November 1994 for his service-connected hypertension. The Veteran applied for service connection for hypertension in November 1994. Subsequently a November 1996 rating decision denied the Veteran's claim. The November 1996 rating decision is final because no additional evidence was received within one year of the rating decision, and the Veteran did not appeal the rating decision. As the November 1996 rating decision is final, the earliest effective date the Veteran is entitled to is the date of the reopened claim. Here, that date is March 25, 2011, when the Veteran filed a new claim for entitlement to service connection for hypertension. As the Veteran's effective date is the date of his reopened claim, entitlement to an earlier effective date is not warranted. Entitlement to an effective date prior to March 25, 2011 is denied. Jennifer White Veterans Law Judge Board of Veterans' Appeals Attorney for the Board A. Wimbish, 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.