Citation Nr: 21031297 Decision Date: 05/21/21 Archive Date: 05/21/21 DOCKET NO. 15-14 878 DATE: May 21, 2021 ORDER Entitlement to a rating in excess of 10 percent for hypertension is denied. FINDING OF FACT 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 disability rating in excess of 10 percent for service-connected hypertension have not been met. 38 U.S.C. §§ 1155, 5107 (2018); 38 C.F.R. §§ 4.7, 4.104, Diagnostic Code 7101 (2020). REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran had active service from December 1984 to December 2000. This case comes before the Board of Veterans' Appeals (Board) on appeal from an August 2008 rating decision issued by a Department of Veterans Affairs (VA) Regional Office (RO). The Veteran testified at a hearing before the undersigned Veterans Law Judge in December 2018. A transcript of that hearing has been added to the record. This case was previously before the Board in April 2019, at which time the issue on appeal was remanded for additional development. The case has now been returned to the Board for further appellate action. Increased Rating Hypertension The Veteran has asserted that he should have a higher rating for his hypertension as his symptoms are worse than those contemplated by the currently assigned ratings. Specifically, the Veteran has reported that his hypertension causes him to experience nose bleeds, headaches, blurry vision, lightheadedness, and chest pain among other issues. The Veteran also has reported that his hypertension has caused him to quit his part time job of coaching. The Veteran's spouse submitted a statement in support of the Veteran's claim. In her statement, she reported that the Veteran must take naps often due to his hypertension and that it causes him to not feel well during the day. At a July 2008 VA examination, the Veteran reported that his blood pressure was well-controlled with medication. The Veteran reported experiencing headaches secondary to his blood pressure, but also reported that he felt the headaches were related to his sinus problems and reflux. The Veteran denied chest pain, shortness of breath, paroxysmal nocturnal dyspnea, orthopnea, palpitations, weakness, and syncopal episodes. He did report dizziness on and off, but reported it occurred in conjunction with his reflux. The Veteran's blood pressure readings at that examination were 120/82, 118/78, and 110/76. The examiner ultimately concluded that the Veteran had hypertension that was well-controlled with medication. At an October 2016 VA examination, the Veteran denied any recent symptomatic, elevated blood pressure readings. He reported that he had no recent emergency room or urgent care visits. The Veteran reported that he exercised five days per week. The examiner noted that the Veteran was maintained on medication to control his hypertension. The examiner cited to blood pressure readings from January 1997, June 1999, and August 1999 that were used to establish the Veteran's diagnosis of hypertension, and based on those readings, the examiner found that the Veteran did not have a history of diastolic blood pressure elevation to predominantly 100 or more. The examiner noted the Veteran's most current blood pressure readings to be as follows: 108/64 and 127/71 in September 2016, and 119/66 in October 2016. The Veteran's average blood pressure reading was noted to be 118/67. The examiner found that the Veteran did not have any other physical findings, complications, conditions, signs, or symptoms related to his hypertension. The examiner found that the Veteran's hypertension did not impact his ability to work. At his December 2018 hearing the Veteran testified that his current blood pressure medications work to control the blood pressure, but that side effects of the medications include chest pain and headaches. He testified that his symptoms had worsened since his most recent VA examination. At an October 2019 VA examination, the Veteran reported that his hypertension had increased in severity. He reported experiencing frequent headaches and nosebleeds, both of which he attributed to his hypertension. The Veteran was noted to be on medication to control his hypertension. The Veteran's blood pressure readings at the time of the examination were as follows: 120/70, 120/68, and 120/70. His average blood pressure reading was noted to be 120/69. The examiner found that the Veteran did not have any other pertinent physical findings, complications, conditions, signs, or symptoms related to his hypertension. The examiner found that the Veteran's hypertension did not impact his ability to work. A review of the record shows that the Veteran receives treatment for hypertension at the VA Medical Center. A review of the VA Medical Center treatment notes shows that the Veteran had his blood pressure taken approximately 216 times from March 2007 through October 2020. A review of those blood pressure readings does not show an instance where the Veteran was recorded to have a diastolic blood pressure reading of 110 or more, or a systolic blood pressure reading os 200 or more. Further, there is no indication from the treatment notes of record that the Veteran has been found to have symptoms of headaches or chest pain associated with his hypertension, or the medication used for treatment of such. The Board finds that the Veteran is not entitled to a rating in excess of 10 percent for hypertension. Specifically, the evidence does not show that the Veteran's diastolic pressure was predominantly 110 or more, or that his systolic blood was predominantly 200 or more. In fact, the Veteran's record contains blood pressure readings on a nearly monthly basis for the entire course of the appeal, and there is no indication from the treatment records or the VA examination reports that the Veteran has had diastolic pressure recorded at 110 or more, or systolic pressure recorded at 200 or more. Further, while the Board acknowledges that the Veteran has reported additional symptoms such as headaches and chest pain as a result of his hypertension medication, the record does not show that those symptoms have been determined to be related to his hypertension. In fact, the Veteran has reported headaches associated with both his sinus problems and his reflux; and he specifically has denied chest pain at VA examinations. Additionally, both the October 2016 and October 2019 VA examiners specifically found that the Veteran did not have additional pertinent physical findings, complications, conditions, signs, or symptoms related to his hypertension. 38 C.F.R. § 4.104, Diagnostic Code 7101. Consideration has been given to assigning staged ratings. However, at no time during the period in question has the disability warranted a higher schedular rating than that assigned. Hart v. Mansfield, 21 Vet. App. 505 (2007). Accordingly, the Board finds that the preponderance of the evidence is against the claim and entitlement to a rating in excess of 10 percent for hypertension is not warranted. 38 U.S.C. § 5107 (b) (2018); Gilbert v. Derwinski, 1 Vet. App. 49 (1990). Kristin Haddock Veterans Law Judge Board of Veterans' Appeals Attorney for the Board D. Andrew Ledman II 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.