Citation Nr: 21025030 Decision Date: 04/27/21 Archive Date: 04/27/21 DOCKET NO. 15-22 558 DATE: April 27, 2021 ORDER An increased disability rating greater than 10 percent for hypertension is denied. FINDING OF FACT The Veteran’s hypertension has not been manifested by diastolic pressure predominantly 110 or more or systolic pressure predominantly 200 or more during the appellate period. CONCLUSION OF LAW The criteria for an increased disability rating greater than 10 percent for hypertension have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. § 4.104, Diagnostic Code 7101. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty in the United States Army from May 1977 to November 1983. He currently has a combined disability rating of 40 percent with special monthly compensation based on loss of use of a creative organ. Neither the Veteran nor his representative has raised any issues with VA’s duty to notify or VA’s 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.”); see also Dickens v. McDonald, 814 F.3d 1359, 1361 (Fed. Cir. 2016). Thus, the Board need not discuss any potential issues in this regard. In the June 2015 VA Form 9, Substantive Appeal, the Veteran requested a Board hearing. On September 4, 2018, VA sent the Veteran initial notice that his hearing was scheduled for October 19, 2018. On October 12, 2018, VA sent a reminder notice that the Veteran’s hearing was scheduled for October 19, 2018. The Veteran failed to report for his scheduled hearing. On November 2, 2018, within 15 days of the scheduled hearing, the Veteran submitted a statement indicating that he did not attend the October 19, 2018 hearing because he did not receive the October 12, 2018 notice letter until after the hearing time had passed, due to mailing delays caused by the United States Postal Service. He requested to have his hearing rescheduled. The undersigned has considered this request, but finds it to be without merit. While it may be true that the Veteran did not received the October 12, 2018 notice letter until after the scheduled date and time of the October 19, 2018 Board hearing, this letter was merely a reminder. There is no allegation or evidence to indicate that the Veteran did not receive the initial September 4, 2018 notice letter indicating that the Veteran was scheduled for a Board hearing on October 19, 2018. Accordingly, the Board finds that the Veteran was on notice of his scheduled hearing date, regardless of the timeliness of the receipt of the October 12, 2018 reminder notice letter, and given so, he has not presented good cause for his failure to report for the scheduled Board hearing. See 38 C.F.R. § 20.603 (formerly 20.704). Following the November 2018 Board remand, the Veteran did not request a post-remand Board hearing. See Quinn v. Wilkie, 31 Vet. App. 284 (2019). Accordingly, the Veteran’s November 2018 motion for a new hearing is denied, and the Board shall proceed with a decision on the merits. Hypertension The Veteran contends that his service-connected hypertension is more severe than indicated by his current 10 percent disability rating. Disability ratings are determined by applying the criteria set forth in the VA Schedule for Rating Disabilities, found in 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. 38 U.S.C. § 1155; 38 C.F.R. § 4.1. Where there is a question as to which of two evaluations shall be applied, 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 benefit of the doubt will be resolved in the Veteran’s favor. 38 C.F.R. § 4.3. The Veteran’s hypertension is currently rated at 10 percent. Under Diagnostic Code 7101, a 10 percent evaluation is warranted for hypertension with diastolic pressure predominantly 100 or more, or systolic pressure predominantly 160 or more, or for an individual with a history of diastolic pressures predominantly 100 or more who requires continuous medication for control. The next higher 20 percent evaluation contemplates hypertension with diastolic pressure predominantly 110 or more, or systolic pressure predominantly 200 or more. A 40 percent disability rating requires diastolic pressure predominantly 120 or more. A 60 percent disability rating requires diastolic pressure predominantly 130 or more. At the outset, it is noted that all the evidence in the Veteran’s claims file has been reviewed. Although the Board has an obligation to provide adequate reasons and bases supporting this decision, there is no requirement that every item of evidence submitted by the Veteran or obtained on his behalf be discussed in detail. Rather, the Board’s analysis below will focus specifically on what evidence is needed to substantiate the Veteran’s claim and what the evidence in the claims file shows, or fails to show, with respect to the claim. See Gonzales v. West, 218 F.3d 1378 (Fed. Cir. 2000) and Timberlake v. Gober, 14 Vet. App. 122 (2000). The Veteran was granted service connection for hypertension in December 1983 and assigned a 10 percent disability rating. He was granted a higher 20 percent rating in a June 2006 rating decision, but it was reduced back to 10 percent in an unappealed September 2009 rating decision. He submitted a claim for an increased rating in January 2012. In the August 2012 rating decision on appeal, the Regional Office (RO) denied an increased rating of 20 percent based upon the lack of evidence of hypertension manifested by diastolic pressure predominantly 110 or more or systolic pressure predominantly 200 or more. In relationship to his hypertension claim, the Veteran was afforded a VA examination in March 2012. The charted blood pressure readings were 140/89 (from date of examination), 145/90 (from December 2011), and 146/89 (from December 2011). Another VA examination was conducted in August 2013. The August 2013 VA examiner noted blood pressure readings at that time of 135/85, 135/79, and 140/89 (systolic blood pressure number/diastolic blood pressure number). Thus, the Veteran had a high systolic reading of 140 and a low of 135 with a high diastolic reading of 89 and a low of 79. The examiner noted that the Veteran took medication needed to control his hypertension, specifically Hydrochlorothiazide, Losartan, and Amlodipine Besylate. During the time prior to the August 2013 examination, the Veteran’s hypertension was noted as being under moderate control, with hypertension readings of 139/89, 131/86 and 129/86. See VA medical records dated from January 2010 to May 2011. He also had blood pressure readings of 137/75, 134/84, 147/92, 126/80, and 146/99. See VA medical records from December 2011 to June 2013. A list of active outpatient medications reveals that the Veteran was taking Amlodipine Besylate and Hydrochlorothiazide for his high blood pressure during this time. Post-August 2013 VA examination, the Veteran had high blood pressure readings in April 2016 and October 2016 that were high at 160/88 and 160/92. Repeated readings revealed lower systolic readings of 148 and 153 respectively, with diastolic readings of 88 and 95. Thereafter, VA medical records reveal the highest systolic reading of 143 with a diastolic reading of 87 in 2017; and 138 systolic over 84 diastolic in 2018. Blood pressure readings in 2019 were found to be 131/77, 145/78 and 139/75. See medical records dated from 2015 to 2019. The only abnormal blood pressure reading found by the Board in the VA medical records dated in November 2019 reflect the Veteran’s blood pressure as 155/97. The examiner noted at that time that while the Veteran’s blood pressure was elevated, he had not taken his blood pressure medication that morning. The Veteran was reported to be asymptomatic; and told his examiner that he monitored his blood pressure at home, and that his readings at home averaged in the 120’s over 70’s. VA Records dated in May 2020 reflect that the Veteran continues to take medication for his hypertension; and the overall records have generally indicated that his hypertension is under good control. Considering the pertinent facts above, the Board finds that at no point during the appeal period, has the Veteran’s hypertension warranted a disability rating greater than 10 percent. At no time during the appeal period was the Veteran’s diastolic pressure predominantly 110 or more. Similarly, at no time during the appeal period was his systolic pressure predominantly 200 or more. Indeed, the Board notes no findings of either a diastolic number of 110 or more or a systolic number of 200 or more of record during the appellate period. Although not argued by the Veteran, the Board recognizes for the record the contention that may be made that a veteran’s current hypertension medication keeps his blood pressure down and that the medical evidence would likely reflect higher blood pressure readings if the veteran were to stop taking his medicine. Even assuming that this is true, an increased disability rating would not be warranted in this situation. In Jones v. Shinseki, 26 Vet. App. 56 (2012), the United States Court of Appeals for Veterans Claims (Court) held that, when assigning a disability rating, the Board may not consider the ameliorative effects of medication where those effects are not explicitly contemplated by the rating criteria. “Thus, if [the applicable diagnostic code (DC)] does not specifically contemplate the effects of medication, the Board is required pursuant to Jones to discount the ameliorative effects of medication when evaluating [the disability]. Conversely, if [the applicable DC] does specifically contemplate the effects of medication, then Jones is inapplicable.” See McCarroll v. McDonald, 28 Vet. App. 267, 271 (2016) (en banc). The Court in McCarroll explicitly addressed whether DC 7101 contemplates the effects of medication and concluded that it did. Id. Since DC 7101 explicitly contemplates the effects of blood pressure medication, the Veteran cannot support any increased rating claim by asserting that his medication prevents his blood pressure readings from being high enough to qualify for a higher rating. Therefore, after considering the available medical records and VA examinations, the Board finds that the evidence does not support a rating greater than 10 percent at any time during the appeal period. Consideration has been given to the April 2013 lay statement from the Veteran’s friend, but it does not contain relevant evidence to support a higher rating for the Veteran’s service-connected hypertension, and thus, it is of no probative value in this appeal. As the preponderance of the evidence is against the claim, the benefit of the doubt rule does not apply. Gilbert v. Derwinski, 1 Vet. App. 49, 58 (1991). The Veteran’s claim for a disability rating greater than 10 percent for hypertension is denied. M. GALANTE Acting Veterans Law Judge Board of Veterans’ Appeals Attorney for the Board P. Talpins 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.