Citation Nr: A21020169 Decision Date: 12/17/21 Archive Date: 12/17/21 DOCKET NO. 210611-165742 DATE: December 17, 2021 ORDER Entitlement to a compensable disability rating for hypertension is denied. FINDING OF FACT During the appeal period, the Veteran's hypertension did not manifest in diastolic pressure predominantly 100 or more, or systolic pressure predominantly 160 or more. Also, the Veteran did not both have a history of diastolic pressure predominantly 100 or more and require continuous medication for control. CONCLUSION OF LAW The criteria for a compensable rating for service-connected hypertension have not 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. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active service from November 1968 to August 1970. This matter comes before the Board of Veterans' Appeals (Board) on appeal of a May 2021 rating decision. In the June 2021 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 supplemental claim decision on appeal which was issued on May 18, 2021. 38 C.F.R. § 20.301. Entitlement to a compensable disability rating for hypertension The Veteran contends that he is entitled to a higher rating for his service-connected hypertension due to recent blood pressure readings that are assertedly higher than prior readings and due to an increased difficulty of controlling his blood pressure with medication. Hypertension is rated pursuant to 38 C.F.R. § 4.104, Diagnostic Code (DC) 7101, for hypertensive vascular disease (hypertension and isolated systolic hypertension). Under DC 7101, a 10 percent rating is warranted for diastolic pressure predominantly 100 or more, or systolic pressure predominantly 160 or more, or; it is the minimum evaluation for an individual with a history of diastolic pressure predominantly 100 or more who requires continuous medication for control. The term "predominant" is not defined in the rating criteria. Merriam-Webster defines predominant to mean "being most frequent or common." See, e.g., "predominant," Merriam-Webster.com Online Dictionary, https://www.merriam-webster.com/dictionary/predominant. For the reasons that follow, the Veteran's hypertension has not more nearly approximated the criteria corresponding to a 10 percent rating. His blood pressure has been taken and recorded in many VA treatment records and in a VA examination during the period on appeal which dates back to January 2010. For the vast majority of that time, the Veteran has been on medication to control his blood pressure. However, his systolic blood pressure has, with a few exceptions, been consistently measured below 160 and his diastolic blood pressure has, with a few exceptions, been measured below 100. No blood pressure readings taken prior to May 2016 indicate a systolic blood pressure of 160 or higher, and, though beginning in May 2016, the Veteran's systolic blood pressure would sometimes register at or above 160, those measurements were always surrounded by other blood pressure measurements where the relevant reading was below that value. For instance, the May 2016 reading where the systolic pressure registers at 160 is accompanied by a systolic reading taken in the same month where it was measured at 152, and readings taken in the surrounding months of April 2016 and June 2016 document readings of 134 and 128 respectively. No further instances of systolic pressure at or above 160 are recorded, despite numerous readings being taken, until November 2017 when a single reading of 162 is surrounded by readings taken in the same month of 153 and 110. Similarly, while blood pressure readings in July and November of 2018 do indicate that the Veteran on at least 3 occasions in that period had a systolic blood pressure of 160 or above, the vast majority of the readings taken in those months and the months surrounding them indicate that his systolic pressure was much more frequently measured below the value of 160. It appears that few (or possibly no) readings of his systolic pressure in 2019 document a systolic reading at or above 160, and the evidence from 2020 is much the same as described in the years of 2016, 2017, and 2018, where a few instances of readings at or above 160 are recorded surrounded by many readings below 160. In his submission with his supplemental claim in 2021, he places much emphasis on a list of blood pressure readings that he asserts demonstrate the necessity for an increased rating, but here too, the evidence is clear that either one or a few elevated readings at or above 160 are surrounded by many readings demonstrating a value below 160. Diastolic readings at or above a value of 100 are even more rare. An exhaustive review of the record disclosed approximately 2 occasions where the Veteran's diastolic pressure was measured at or above this value, and these instances were separated by years and surrounded by myriad other readings where the diastolic value was lower than 100. There are a few intermittent readings that would meet the criteria for a higher rating, but the overwhelming majority of the readings surrounding those readings are lower than 160 for the Veteran's systolic blood pressure and lower than 100 for his diastolic pressure. Consequently, the Board finds that the Veteran's blood pressure readings are predominantly below the values required to meet the criteria for a compensable disability rating. Accordingly, the Veteran's hypertension did not manifest in diastolic pressure predominantly 100 or more, or systolic pressure predominantly 160 or more. Also, he did not have a history of diastolic pressure predominantly 100 or more and require continuous medication for control. There is no reasonable doubt to be resolved. His hypertension does not more nearly approximate the criteria corresponding to a 10 percent rating. As the criteria for a 10 percent rating under DC 7101 are not met, a compensable rating for the service-connected hypertension is warranted. See 38 C.F.R. § 4.31. THERESA M. CATINO Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Steven H. Johnston, 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.