Citation Nr: 21008803 Decision Date: 02/18/21 Archive Date: 02/18/21 DOCKET NO. 17-34 208 DATE: February 18, 2021 ORDER Entitlement to an initial evaluation in excess of 10 percent for hypertension is denied. FINDING OF FACT The evidence of record does not show that the Veteran has been having diastolic pressure predominantly 110 or more, or systolic pressure predominantly 200 or more. CONCLUSION OF LAW The criteria for an initial evaluation in excess of 10 percent for hypertension have not been met. 38 U.S.C. §§ 1155, 5107 (2012); 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.104, Diagnostic Code 7101 (2019). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from November 1979 to November 1982. This case is before the Board of Veterans’ Appeals (Board) on appeal from a February 2014 rating decision by a Department of Veterans Affairs (VA) Regional Office. In January 2020, the Veteran testified at a videoconference hearing before the undersigned Veterans Law Judge. A transcript of the hearing has been associated with the electronic claims file. In August 2020, the Board remanded the matter for more development. Now the matter is returned to the Board. The Veteran is currently service-connected for hypertension with a 10 percent evaluation, and he is seeking a higher evaluation. A disability rating is determined by the application of VA’s Schedule for Rating Disabilities (Rating Schedule). See generally 38 C.F.R. Part 4. The percentage ratings contained in the Rating Schedule represent, as far as can practicably be determined, the average impairment in earning capacity resulting from diseases and injuries incurred or aggravated during military service and their residual conditions in civil occupations. See 38 U.S.C. § 1155 (2012); 38 C.F.R. § 4.1 (2019). Separate diagnostic codes identify the various disabilities. 38 C.F.R. § 4.27 (2019). Where there is a question as to which of two ratings to apply, VA will assign the higher rating if the disability picture more nearly approximates the criteria for that rating. 38 C.F.R. § 4.7 (2019). Otherwise, it will assign the lower rating. Id. Hypertension is evaluated under Diagnostic Code 7101. A 10 percent evaluation 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 20 percent evaluation is warranted for diastolic pressure predominantly 110 or more, or; systolic pressure predominantly 200 or more; a 40 percent evaluation is warranted for diastolic pressure predominantly 120 or more; and a maximum 60 percent is warranted for diastolic pressure predominantly 130 or more. 38 C.F.R. § 4.104, Diagnostic Code 7101 (2019). 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. The Veteran’s service treatment record shows the following blood pressure readings: 145/95 (September 1980); 108/64 (February 1982); 118/78 and 120/98 (April 1982); 142/102, 124/84, 154/90, and 126/94 (June 1982); 120/80 (July 1982); and 124/60 (August 1982). The records from 2014 to 2016 shows the following blood pressure readings: 126/84, 147/92, 153/87, 138/83, 132/83, 125/78, 129/79, and 125/78. See e.g., August 2014 Primary Care Note; June 2015 Mental Health Nursing Note; March 2016 Primary Care Nurse Note. On April 2017 VA examination for hypertension, the Veteran’s blood pressure readings were 140/90, 140/86, and 138/90 with an average blood pressure of 139/88. The examiner noted that the Veteran’s treatment plan includes taking continuous medication for hypertension. The examiner provided that the Veteran’s hypertension does not impact his ability to work. Other records from 2017 shows the following blood pressure readings: 153/92, 141/84, 161/85, 149/84, 139/84, and 139/83. See e.g., January 2017 Gastroenterology Evaluation Note; June and December 2017 Nursing Outpatient Notes. The blood pressure readings from 2018 were: 149/91, 159/83, 163/86, 150/74, and 172/88. See e.g., February and December 2018 Primary Care Notes; November 2018 Nursing Outpatient Note. The records from 2019 shows the following blood pressure readings: 14-day average of 165/77, 160/73, 145/77, 158/80, and 138/79. See e.g., January and June 2019 Primary Care Nursing Notes; December 2019 Primary Care Note. During the January 2020 hearing, the Veteran testified that his hypertension condition has gotten worse because the doctors have been experimenting with different types of high blood pressure medication to see if they could stabilize his blood pressure. He stated that his blood pressure has been as high as 210/110. On December 2020 VA examination for hypertension, the Veteran’s blood pressure readings were 160/84, 162/82, and 162/82. The Veteran reported that his blood pressure has been increasing as well as the dosage for Lisinopril. The Veteran stated that he began to take Amlodipine since a couple of years ago, but he still has elevated blood pressures from time to time. The Veteran denied visiting emergency room for blood pressure, stroke, or myocardial infarction. The examiner indicated that the Veteran’s hypertension condition requires continuous medication, but it does not impact his ability to work. Further, other records from 2020 shows the following blood pressure readings: 165/91, 151/77, 153/74, 140/72, 112/78, 163/71, and 143/75. See e.g., January 2020 Nursing Outpatient Note and Primary Care Nursing Note. During a December 2020 primary care telephone contact, the Veteran reported that he is taking the medication, but his blood pressures are higher than 140/90, and one day it was as high as 150/80s. As stated above, a next higher evaluation of 20 percent for hypertension under DC 7101 is not warranted unless diastolic pressure is predominantly 110 or more, or systolic pressure is predominantly 200 or more. The Board acknowledges the Veteran’s testimony of his blood pressure being as high as 210/110, but finds that the evidence of record does not show that he has been having diastolic pressure predominantly 110 or more, or systolic pressure predominantly 200 or more. Consequently, the Board finds that the Veteran’s entitlement to an initial evaluation in excess of 10 percent for hypertension is not warranted. 38 U.S.C. §§ 1155, 5107 (2012); 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.104, Diagnostic Code 7101 (2019). MICHAEL LANE Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board J. E. Kim, 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.