Citation Nr: 21028058 Decision Date: 05/10/21 Archive Date: 05/10/21 DOCKET NO. 17-63 834 DATE: May 10, 2021 ORDER Entitlement to a 10 percent rating, but not higher, for hypertension is granted. FINDINGS OF FACT 1. The Veteran's hypertension has been continuously treated with medication since service and he has a history of diastolic pressure predominantly 100 or greater during service and after separation. 2. During the appeal period, the Veteran's hypertension did not manifest in diastolic pressure predominantly 110 or more, or systolic pressure predominantly 200 or more. CONCLUSION OF LAW The criteria for a rating of 10 percent, but not higher, for hypertension have been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.14.7, 4.21, 4.104, Diagnostic Code 7101. REASONS AND BASES FOR FINDINGS AND CONCLUSION The Veteran served on active duty from August 1984 to September 2005. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a December 2016 rating decision of the Department of Veterans Affairs (VA) agency of original jurisdiction (AOJ). The Veteran testified before the Board at a February 2021 virtual hearing; a transcript of the hearing is associated with the claims file. Duty to Notify and Assist VA has a duty to notify and assist claimants in substantiating a claim for VA benefits. 38 U.S.C. §§ 5100, 5102, 5103, 5103A, 5107, 5126; 38 C.F.R. §§ 3.102, 3.159, 3.326(a). These duties have been satisfied in this case. The AOJ associated the Veteran's service records and VAMC treatment records with the claims file. No other relevant records have been identified and are outstanding. Appropriate and necessary examinations were afforded the Veteran in December 2016 and March 2021. They are adequate for evaluation, as they include needed findings to permit application of the Rating Schedule and identification of current disability. VA has accordingly satisfied its duty to assist with the procurement of relevant records. 38 U.S.C. § 5103A; 38 C.F.R. § 3.159(c). Neither the Veteran nor his representative have raised any issues with the duty to notify or duty to assist. See Scott v. McDonald, 789 F.3d 1375, 1381 (Fed. Cir. 2015); Dickens v. McDonald, 814 F.3d 1359, 1361 (Fed. Cir. 2016). Entitlement to a compensable rating for hypertension The Veteran contends that he is entitled to a higher rating because he has a history of diastolic pressure predominantly 100 or more that requires continuous medication. Disability evaluations are determined by comparing a veteran's present symptomatology with criteria set forth in VA's Schedule for Rating Disabilities (Rating Schedule), which is based on average impairment in earning capacity. 38 U.S.C. § 1155; 38 C.F.R. Part 4. When a question arises as to which of two ratings apply under a particular diagnostic code (Code), the higher evaluation is assigned if the disability more closely approximates the criteria for the higher rating. 38 C.F.R. § 4.7. After careful consideration of the evidence, any reasonable doubt remaining is resolved in favor of the veteran. 38 C.F.R. § 4.3. The veteran's entire history is reviewed when making disability ratings. See generally 38 C.F.R. § 4.1; Schafrath v. Derwinski, 1 Vet. App. 589 (1991). Where entitlement to compensation has already been established and an increase in the disability rating is at issue, the present level of disability is of primary concern. "Although a rating specialist is directed to review the recorded history of a disability in order to make a more accurate evaluation, the regulations do not give past medical reports precedence over current findings." Francisco v. Brown, 7 Vet. App. 55, 58 (1994) (citation omitted). VA accordingly concentrates on the evidence that establishes the state of the veteran's disability in the period one year before the veteran files his claim through the date VA makes a final decision on the claim. Hart v. Mansfield, 21 Vet. App. 505, 509 (2007). Hypertension is rated pursuant to 38 C.F.R. § 4.104, Code 7101, for hypertensive vascular disease (hypertension and isolated systolic hypertension). Under Code 7101, a 10 percent rating is warranted for diastolic pressure predominantly 100 or more, or systolic pressure predominantly 160 or more. 10 percent is also the minimum evaluation for an individual with a history of diastolic pressure predominantly 100 or more who requires continuous medication for control. A 20 percent rating is warranted for diastolic pressure predominantly 110 or more, or systolic pressure predominantly 200 or more. 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. As discussed below, the evidence documents a history of diastolic pressure predominantly 100 or more that requires continuous medication for control, corresponding to the criteria for a 10 percent rating under DC 7101. An August 1991 service treatment record (STR) noted diastolic readings of 100 and 110. Two days later, an STR listed multiple diastolic results greater than 100. July 1994 and February 1995 STRs noted diastolic pressure of 100. A February 2004 STR listed diastolic pressure of 101; an April 2004 STR noted diastolic pressure of 103. Following separation from service, a November 2006 VA medical center (VAMC) record reported diastolic pressure of 104. In a November 2007 VA examination, two of the three recorded diastolic readings were greater than 100. At the February 2021 hearing, the Veteran testified that he was diagnosed with hypertension in service and prescribed medication; he stated that he has taken medication for the condition to the present. During the appeal period, the Veteran's systolic pressure in VAMC records and in VA examinations was never 200 or greater. The Veteran's diastolic pressure was similarly never 110 or greater in those records for that period. The Veteran reported in an October 2017 VAMC primary care record that "his highest blood pressure at home is been [sic] in the 150s over 109 range." At the February 2021 hearing, the Veteran confirmed that his blood pressure readings during the appeal period "stayed around" "140/90s" in 2017. He additionally testified that at the time of the hearing his blood pressure "still is like over 130, usually right around 90." The Veteran reported at the hearing that his highest systolic readings had been "close to 200" but did not exceed 200. The Board notes the Veteran's testimony at the February 2021 hearing that at times VAMC clinicians would have him wait after a high reading before taking his blood pressure again. The Board notes that the VAMC records consistently indicated that blood pressure was "Re-checked if equal to or greater than 135/85." There were no initial systolic or diastolic pressures of more than 200 or 110 (respectively), however. The Veteran's hypertension has been continuously treated with medication since service and he has a history of diastolic pressure of 100 or greater at multiple points throughout service and after separation. The Board accordingly finds that a 10 percent rating is appropriate for hypertension. A higher 20 percent rating is not warranted, however, because the Veteran's systolic and diastolic pressure have always been less than 200 and 160, respectively. WILLIAM H. DONNELLY Veterans Law Judge Board of Veterans' Appeals Attorney for the Board W. Ripplinger, 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.