Citation Nr: 21022529 Decision Date: 04/16/21 Archive Date: 04/16/21 DOCKET NO. 15-15 912 DATE: April 16, 2021 ORDER Entitlement to a rating in excess of 10 percent for hypertension is denied. FINDING OF FACT Throughout the appeal period, the Veteran’s diastolic blood pressure has been predominately less than 110 and her systolic blood pressure has never met or exceeded 200. CONCLUSION OF LAW The criteria for a rating in excess of 10 percent for hypertension are not met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1-4.7, 4.21, 4.104, Diagnostic Code (DC) 7101. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Navy from October 1994 to October 1998. This matter comes before the Board of Veterans’ Appeals (Board) from an August 2014 rating decision by a Department of Veterans Affairs (VA) Regional Office (RO). In April 2018, the Veteran testified before the undersigned Veterans Law Judge at a Board hearing. In July 2018, the Board remanded the matter to obtain the Veteran’s VA treatment records created since June 2015 and to obtain an examination to determine the current severity of her service-connected hypertension. In March 2019, a CAPRI document, containing the Veteran’s VA treatment records since June 2, 2015, was uploaded to the claims file. In April 2019, the Veteran underwent a C&P examination for her hypertension. Thus, the Board finds there has been substantial compliance with its prior remand directives. The Veteran asserts that her hypertension has worsened since it was first rated at 10 percent, as evidenced by the fact that her prescription medication to treat the hypertension has increased. See April 2018 Hearing Transcript at 3-6, 8-9; April 2015 VA Form 9; October 2014 Correspondence/Notice of Disagreement. The Veteran’s service-connected hypertension is currently rated at 10 percent under DC 7101, 38 C.F.R. § 4.104, for hypertensive vascular disease. As the rating criteria in DC 7101 specifically contemplate hypertension, no other DC may be used to rate her hypertension. See Copeland v. McDonald, 27 Vet. App. 333, 337 (2015) (when a condition is specifically listed in the rating schedule, it may not be rated by analogy and should be rated under the diagnostic code that specifically pertains to it). Under DC 7101, a 60 percent rating is warranted for diastolic pressure predominately 130 or more. A 40 percent rating is warranted for diastolic pressure predominately 120 or more. A 20 percent rating is warranted for diastolic pressure predominately 110 or more, or systolic pressure predominately 200 or more. A 10 percent rating is warranted for diastolic pressure predominately 100 or more, systolic pressure predominately 160 or more, or for an individual with a history of diastolic pressure predominately 100 or more who requires continuous medication for control. As the term “predominant” is not defined in the rating criteria, the Board will adopt the common dictionary definition of the term. 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. In rating hypertension under DC 7101, the Board may consider blood pressure readings taken while a veteran is using medication. See McCarroll v. McDonald, 28 Vet. App. 267, 271 (2016) (holding that DC 7101 contemplates the effects of medication and therefore Jones v. Shinseki, 26 Vet. App. 56 (2012), does not apply). In other words, the rating criteria already considers the ameliorative effects of antihypertensive medication. See id. In addition, DC 7101, Note (1) requires multiple blood pressure readings to be taken over multiple days to confirm the existence of hypertension. That requirement is not applicable to increased rating claims. See Gill v. Shinseki, 26 Vet. App. 386, 391 (2013). The period on appeal, including the one-year lookback, is from July 17, 2013. See July 17, 2014 VA Form 21-526EZ. An October 23, 2013 VA treatment note indicates blood pressure readings of 153/110 and 146/110. An October 29, 2013 VA treatment note indicates blood pressure readings of 139/104, 134/97, 133/97, and 142/103. A January 21, 2014 VA treatment note indicates blood pressure readings of 122/85, 119/83, and 121/85. A February 18, 2014 VA treatment note indicates blood pressure readings of 137/96, 131/95, and 132/100. A March 10, 2014 VA treatment note indicates blood pressure readings of 124/89 and 118/85. A May 30, 2014 VA treatment note indicates a blood pressure reading of 119/79. An August 22, 2014 C&P examination notes blood pressure readings of 138/90, 136/88, 132/84, and an average reading of 135/87. A January 8, 2015 VA treatment note indicates blood pressure readings of 144/104 were taken three times. A June 2, 2015 VA treatment note indicates blood pressure readings of 154/110 and 141/103. A July 23, 2015 VA treatment note indicates blood pressure readings of 129/92, 132/96, and 125/95. A July 7, 2016 VA treatment note indicates blood pressure readings of 127/84. A June 30, 2017 VA treatment note indicates blood pressure readings of 145/92, 132/91, and 145/96. An August 2, 2017 VA treatment note indicates blood pressure readings of 118/80 and 130/82. A June 29, 2018 VA treatment note indicates blood pressure readings of 125/85 and 142/91. An April 2, 2019 C&P examination notes blood pressure readings of 138/96, 132/94, and 136/94, and an average reading of 136/94. The Veteran testified at the April 2018 Board hearing that she takes her own blood pressure readings at home, but did not keep a log of those readings. See Hearing Transcript at 8. To warrant the next higher rating of 20 percent under DC 7101, 38 C.F.R. § 4.104, the Veteran’s diastolic blood pressure (second number) would need to be predominately 110 or more, or systolic blood pressure (first number) would need to be predominately 200 or more. As detailed above, out of 37 blood pressure readings taken throughout the appeal period, the Veteran manifested a diastolic blood pressure of at least 110 on 3 readings and a systolic blood pressure of at least 200 on no readings. Three readings out of 37 would not meet the common meaning of the term “predominant.” See, e.g., “predominant,” Merriam-Webster.com Online Dictionary, https://www.merriam-webster.com/dictionary/predominant (defining “predominant” as “being most frequent or common”). While the Board notes the Veteran’s assertion that her increase in hypertensive medication evidences an increase in her disability, the rating criteria of DC 7101 does not include such a factor when evaluating hypertension. Moreover, the Veteran is already in receipt of a 10 percent rating, which considers the need for continuous medication. In addition, the Board notes the Veteran’s representative’s argument that an examiner should estimate what her blood pressure readings would be without the benefit of medication. See Hearing Transcript at 7. The rating criteria, however, already compensate for the ameliorative effects of antihypertensive medication, so this inquiry is not warranted. See McCarroll, 28 Vet. App. at 271. Thus, throughout the appeal period, as the Veteran’s diastolic blood pressure has been predominately less than 110 and systolic blood pressure has never met or exceeded 200, a rating in excess of 10 percent for hypertension under DC 7101 is not warranted. S. BUSH Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board D. deBruyn, 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.