Citation Nr: 21007504 Decision Date: 02/09/21 Archive Date: 02/09/21 DOCKET NO. 15-26 048 DATE: February 9, 2021 ORDER Entitlement to a 10 percent rating, but no higher, for hypertension is granted. FINDING OF FACT The Veteran requires continuous medication to control hypertension and keep her diastolic pressure below 100 and her systolic pressure below 160; however, her hypertension has not been manifested by diastolic pressure predominantly 100 or more, nor by systolic pressure predominantly 160 or more. CONCLUSION OF LAW The criteria for a 10 percent evaluation, but no higher, for hypertension have been met. 38 U.S.C. § 1155; 38 C.F.R. §§ 4.1-4.14, 4.104, Diagnostic Code 7101. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active duty service in the Air Force from March 1986 to June 1992 and the Army from September 1997 to July 2012. The Veteran testified at a videoconference hearing before the undersigned Veterans Law Judge in December 2018. A transcript of that proceeding is associated with the claims file. This matter comes to the Board of Veterans’ Appeals (Board) on appeal from a December 2012 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO). The matter was previously before the Board in May 2019, at which time it was remanded for development. Development was adequately performed, and the case was returned to the Board for appellate review. See Stegall v. West, 11 Vet. App. 268 (1998); D’Aries v. Peake, 22 Vet. App. 97 (2008). I. Duty to Assist Neither the Veteran nor her representative has raised any issues with the duty to notify or duty to assist. See Scott v. McDonald, 789 F.3d 1375, 1381 (Fed. Cir. 2015) (holding that “the Board’s obligation to read filings in a liberal manner does not require the Board... to search the record and address procedural arguments when the veteran fails to raise them before the Board.”); Dickens v. McDonald, 814 F.3d 1359, 1361 (Fed. Cir. 2016) (applying Scott to a duty to assist argument). II. Entitlement to an Initial Compensable Rating for Hypertension Disability ratings are determined by applying the criteria set forth in the VA Schedule for Rating Disabilities (Rating Schedule). 38 C.F.R. Part 4. The Rating Schedule is primarily a guide in the evaluation of disability resulting from all types of diseases and injuries encountered as a result of or incident to military service. The ratings are intended to compensate, as far as can practicably be determined, the average impairment of earning capacity resulting from such diseases and injuries and their residual conditions in civilian occupations. See 38 U.S.C. § 1155; 38 C.F.R. § 4.1. If two disability evaluations are potentially applicable, the higher evaluation will be assigned if the disability picture more nearly approximates the criteria for that rating; otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7. All reasonable doubt as to the degree of disability will be resolved in favor of the veteran. 38 C.F.R. § 4.3. In both initial rating claims and increased rating claims, the Board must discuss whether any “staged ratings” are warranted. Fenderson v. West, 12 Vet. App. 119 (1999); Hart v. Mansfield, 21 Vet. App. 505 (2007). The Veteran contends that she is entitled to a compensable evaluation for her service-connected hypertension. Service connection for hypertension was granted in a December 2012 rating decision. The RO granted a noncompensable rating effective August 1, 2012, one day following the Veteran’s separation from the military, pursuant to 38 C.F.R. § 4.104, Diagnostic Code 7101. Under Diagnostic Code 7101, a 10 percent rating is assigned where diastolic pressure is predominantly 100 or more, or; systolic pressure is 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 of the condition. A 20 percent rating is assigned when diastolic pressure is predominantly 110 or more or systolic pressure predominantly 200 or more. A 40 percent rating is assigned when diastolic pressure is predominantly 120 or more. A 60 percent rating is assigned when diastolic pressure is predominantly 130 or more. Since August 2012, the Veteran has not consistently had blood pressure readings that satisfy any of the above enumerated criteria. However, the medical evidence demonstrates that she has a history of diastolic blood pressure predominantly greater than 100 with the requirement of continuous medication. The medical record shows that the Veteran has required medication to control her hypertension since at least 2007. While there is little documentation of the Veteran’s blood pressure within the year prior to being prescribed medication for hypertension, service treatment records (STRs) document a diastolic pressure of 100 in 2002. STRs also document a diastolic pressure at 100 or greater on numerous occasions from 2008 to 2009, despite recently starting medication for hypertension. This evidence supports a finding that the Veteran has a history of diastolic pressure predominantly greater than 100 and requires continuous medication to control her hypertension. Accordingly, the Board finds that a 10 percent evaluation for hypertension is warranted. A rating in excess of 10 percent is not warranted because the evidence does not demonstrate a diastolic pressure predominantly at 110 or more or a systolic pressure predominantly at 200 or more. Notably, the Veteran’s blood pressure was measured at 144/76, 156/80, and 152/80 during a June 2012 VA examination. Additionally, a private treating physician indicated in a letter from September 2018 that the Veteran’s blood pressure was fairly well-controlled, despite needing to increase her medication dose due to recent elevations and having a gradual increase of her blood pressure over the prior two years. In January 2018, the Veteran’s blood pressure was 200/100. However, all other blood pressure readings in 2018 were below 100 for diastolic pressure and below 200 for systolic pressure. Similarly, a majority of the Veteran’s blood pressure readings in 2019 and 2020 were below 100 for diastolic pressure and below 200 for systolic pressure. It is noteworthy that the Veteran’s blood pressure was measured nearly every day from June to August 2019, during which her systolic pressure did not surpass 168 and her diastolic pressure did not surpass 93. Additionally, the Veteran’s blood pressure was measured at 162/88, 170/94, and 150/80 during a September 2019 VA examination and 171/84, 156/83, 132/79 during an October 2020 VA examination. Thus, despite the one reading of 200, there is no evidence that her blood pressure was predominantly 200 or more during the appeal period. Accordingly, an evaluation of 20 percent or higher is not warranted. For the above reasons, entitlement to a 10 percent evaluation, but no higher, for hypertension is granted. GAYLE STROMMEN Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board T. Beech, 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.