Citation Nr: 21010876 Decision Date: 02/25/21 Archive Date: 02/25/21 DOCKET NO. 14-34 478 DATE: February 25, 2021 ORDER Entitlement to an initial 10 percent disability rating, but no greater, for hypertension is granted. FINDING OF FACT The Veteran’s service-connected hypertension symptoms have shown to require continuous medication for control with a history of diastolic blood pressure predominantly 100 or more; but have not more nearly approximated predominant diastolic blood pressure of 110 or more, or systolic blood pressure of 200 or more. CONCLUSION OF LAW The criteria for an initial 10 percent, but no greater, disability rating for hypertension have been met. 38 U.S.C. § 1155; 38 C.F.R. §§ 4.1, 4.2, 4.3, 4.6, 4.7, 4.10, 4.21, 4.104, DC 7101. REASONS FOR FINDING AND CONCLUSION The Veteran served on active duty from October 1988 to September 2009. The Veteran served on active duty from March 1968 to October 1969. This matter comes before the Board of Veterans’ Appeals (Board) on appeal from a January 2010 rating decision by a Regional Office (RO) of the Department of Veterans Affairs (VA). This case was before the Board in April 2018 and December 2019, when it was remanded for further development. There has been substantial compliance with the December 2019 remand directives. Stegall v. West, 11 Vet. App. 268, 271 (1998). These matters are properly before the Board for adjudication. Entitlement to a compensable rating for hypertension. The Veteran contends a compensable disability rating is warranted for his service-connected hypertension. Disability ratings are determined by applying the criteria set forth in the VA’s Schedule for Rating Disabilities, which is based on the average impairment of earning capacity. Individual disabilities are assigned separate diagnostic codes. 38 U.S.C. § 1155; 38 C.F.R. § 4.1. The basis of disability evaluations is the ability of the body as a whole, or of the psyche, or of a system or organ of the body to function under the ordinary conditions of daily life including employment. 38 C.F.R. § 4.10. In determining the severity of a disability, the Board is required to consider the potential application of various other provisions of the regulations governing VA benefits, whether or not they were raised by the Veteran, as well as the entire history of the Veteran’s disability. 38 C.F.R. §§ 4.1, 4.2; Schafrath v. Derwinski, 1 Vet. App. 589, 595 (1991). If the disability more closely approximates the criteria for the higher of two ratings, the higher rating will be assigned; otherwise, the lower rating is assigned. 38 C.F.R. § 4.7. It is not expected that all cases will show all the findings specified; however, findings sufficiently characteristic to identify the disease and the disability therefrom and coordination of rating with impairment of function will be expected in all instances. 38 C.F.R. § 4.21. In deciding this appeal, the Board has considered whether separate ratings for different periods of time, based on the facts found, are warranted, a practice of assigning ratings referred to as “staged” ratings. See Fenderson v. West, 12 Vet. App. 119 (1999). In a January 2010 rating decision, the Veteran was awarded service-connection for hypertension, effective September 1, 2009. In this decision, the RO stated that a September 23, 2009 VA examination report guided its decision in assigning a noncompensable rating. Specifically, the RO noted that the Veteran had three blood pressure readings taken on September 23, 2009: 154/92, 148/90, and 152/94; three blood pressure readings on September 24, 2009: 146/98, 152/98, and 156/100; and three blood pressure readings on September 29, 2009: 162/98, 164/102, and 168/106. Unfortunately, the September 2009 VA examination report was not associated with the claims file. In an August 2010 statement, the Veteran disagreed with the assignment of a noncompensable rating for hypertension and argued that his hypertension worsened in October 2009 because he required lisinopril and hydrochlorothiazide to control his disability. The Veteran underwent a VA examination in January 2011. The examiner noted that the Veteran’s blood pressure was well controlled with medication and measured: 132/86, 120/80, and 128/86. The Board remanded this case in December 2019 in order to locate and associate the missing September 2009 report and the Veteran’s September 24 and 29, 2009 serial blood pressure assessments. The RO was informed that these records no longer exist. Notwithstanding the fact that the September 2009 blood pressure readings no longer exist, the RO cited and relied on these readings when granting service-connection for hypertension. Under 38 C.F.R. § 4.104, Diagnostic Code 7101, a 10 percent disability rating for hypertension is warranted when diastolic pressure is predominantly 100 or more or when continuous medication is shown necessary for control of hypertension with a history of diastolic blood pressure predominantly 100 or more, or when systolic pressure is predominantly 160 or more. A 20 percent evaluation is warranted where diastolic blood pressure is predominantly 110 or more, or systolic blood pressure is predominantly 200 or more. Based upon the January 2010 rating decision, the Veteran had three readings of diastolic pressure at 100 or more and three readings of systolic pressure at 160 or more within one year of his separation from service, that he took medication to control. As such, a 10 percent disability rating is warranted. An initial rating higher than 10 percent for the Veteran’s service-connected hypertension is not warranted. Based on private and VA treatment records, the Veteran’s blood pressure readings are as follows: 2010 2011 2012 2013 2014 2015 2016 2017 2018 156/98 126/84 120/80 118/80 114/73 126/76 130/82 132/83 111/67 138/90 120/84 140/80 116/76 112/76 128/74 128/84 112/80 130/84 120/86 138/80 118/82 126/73 128/80 110/70 113/76 120/70 130/88 130/78 138/82 124/80 134/86 122/80 116/72 120/80 110/78 120/90 127/69 134/92 118/74 134/80 130/80 126/74 142/94 140/82 The Board notes the most recent examination for the Veteran’s hypertension was the 2011 examination. The mere passage of time between the examination and the Board’s review does not, in and of itself, trigger a remand for another more contemporaneous examination. See Palczewski v. Nicholson, 21 Vet. App. 174 (2007) (holding that a remand was not required solely due to the passage of time since the most recent VA examination); VAOPGCPREC 11-95 (1995). There is no evidence, and the Veteran has not contended, that his hypertension disability has worsened since his 2011 VA examination. The preponderance of the evidence is against the Veteran’s claim for an initial rating higher than 10 percent for service-connected hypertension under DC 7101. The above-referenced blood pressure readings are sufficient for making an increased rating determination even considering the Veteran’s use of medication to control his blood pressure. See McCarroll v. McDonald, 28 Vet. App. 267. 276-77 (2016) (the Board may properly consider ameliorative effects of blood pressure medication in adjudicating claims for increased ratings for hypertension, because medication is specifically mentioned in DC 7101). While the Veteran contends that his hypertension warrants a higher rating, the evidence of record does not demonstrate findings of diastolic pressure of 110 or more, or systolic blood pressure predominantly of 200 or more at any time during the pendency of the Veteran’s appeal. An initial rating higher than 10 percent for the Veteran’s service-connected hypertension is not warranted. There is no reasonable doubt to be resolved as to this issue. 38 U.S.C. § 5107 (b); 38 C.F.R. §§ 4.3. Jennifer White Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board Mohammad Mahmoudi, 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.