Citation Nr: 21014729 Decision Date: 03/15/21 Archive Date: 03/15/21 DOCKET NO. 16-21 193 DATE: March 15, 2021 ORDER Entitlement to an initial compensable 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 an initial compensable rating for hypertension have not been met. 38 U.S.C. § 1155, 5107; 38 C.F.R. §§ 4.1, 4.3, 4.7, 4.10, 4.40, 4.45, 4.59, 4.71a, Diagnostic Code 7101. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Army from October 1981 through September 1992, December 1998 through April 2012, and April 2012 through January 2014. This matter comes to the Board of Veterans’ Appeals (Board) on appeal from a November 2014 rating decision issued by the Department of Veterans Affairs (VA) Regional Office (RO). The Veteran was granted service connection with a noncompensable rating, and subsequently filed a Notice of Disagreement seeking a higher disability rating. In November 2020, the Veteran appeared before a VLJ by way of a virtual hearing with their representative in order to clarify their request for a higher initial disability rating. The Board has limited the discussion below to the relevant evidence required to support its finding of fact and conclusion of law, as well as to the specific contentions regarding the case as raised directly by the Veteran and those reasonably raised by the record. See Scott v. McDonald, 789 F.3d 1375, 1381 (Fed. Cir. 2015); Robinson v. Peake, 21 Vet. App. 545 552 (2008). Entitlement to an initial compensable rating for hypertension is denied. The Veteran contends that he is entitled to a higher rating because of his long history of taking medication to control his hypertension and he believes if he was off his medication, he would have much higher blood pressure readings. 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. 38 C.F.R. § 4.104, Diagnostic Code (DC) 7101. A 20 percent rating is warranted for diastolic pressure predominantly 110 or more, or systolic pressure predominantly 200 or more. Id. 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. Also worth noting, because Diagnostic Code 7101 contemplates the effects of medication in the rating criteria, it is not error to consider such effects in determining the appropriate rating. See McCarroll v. McDonald, 28 Vet. App. 267, 273 (2016) (holding that Diagnostic Code 7101 “contemplates the effects of medication” and rejecting “the appellant’s arguments that the Board erred when it failed to consider whether he would be entitled to a compensable rating if he were not taking medication”). In this case, the medical evidence confirms the Veteran has been on blood pressure medication to control his hypertension since 2008 while on active duty and his blood pressure is well controlled on such medication. Thus, there is no basis to award a compensable rating at this time. In particular, treatment records from April 2014 show blood pressure readings of 130/84, 122/88, and 124/85. A February 2015 treatment record shows a blood pressure reading of 128/86. In August 2016, a record shows a blood pressure reading of 130/81, and in August 2017, his blood pressure was measured at 126/83. In February 2019, a VA outpatient treatment record shows a blood pressure reading of 130/77. There is one elevated reading in the VA outpatient treatment records dated in May 2015. The Veteran briefly stopped taking his blood pressure medication after a physician recommended the Veteran stop since he was on a low dosage to see how it would affect his blood pressure. During that time, the Veteran had a blood pressure reading of 156/104 and was immediately told to begin taking his blood pressure medication again. In short, since service, while on blood pressure medication, the Veteran’s hypertension is predominately well-controlled with diastolic pressure less than 100, and systolic pressure less than 160. While there has been one isolated reading of 156/104, this was for a very specific purpose. In May 2015, the Veteran’s physician had recommended he briefly stop taking his medications to see if they were required. Once he resumed his medication regimen, his blood pressure readings, once again, returned to a controlled level, to include a February 2019 reading of 130/77. This one isolated finding cannot be considered “predominantly” occurring for purposes of an increased rating. The Board has considered the Veteran’s argument that his hypertension should be considered at the severity if he were not taking his medication. Again, however, DC 7101 “contemplates the effects of medication” and, therefore, the fact that the Veteran’s hypertension is well-controlled on medication is part of the consideration of the rating criteria here. See McCarroll, 28 Vet.App. at 273. In any case, the Board has considered the severity of his hypertension when he was “off” his medication but finds the one, isolated blood pressure reading to be different than the “predominant” blood pressure readings of record. As the criteria for a 10 percent rating under DC 7101 are not met, a noncompensable rating is warranted. See 38 C.F.R. § 4.31. Shereen M. Marcus Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board D. Boivin, 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.