Citation Nr: 21032854 Decision Date: 05/28/21 Archive Date: 05/28/21 DOCKET NO. 16-11 734 DATE: May 28, 2021 ORDER Entitlement to a rating in excess of 10 percent for hypertension is denied. INTRODUCTION The Veteran served on active duty from April 1973 to March 1977. This matter comes before the Board of Veterans' Appeals (Board) on appeal from a rating decision by a Department of Veterans Affairs (VA) Regional Office (RO). In August 2018, the Veteran testified at a hearing before the undersigned Veterans Law Judge. A transcript of this hearing has been associated with the claims file. This appeal was most recently remanded in September 2020. After the issuance of a November 2020 supplemental statement of the case, the appeal has been remitted to the Board for further appellate review. FINDING OF FACT 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 disability rating in excess of 10 percent for service-connected hypertension have not been met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 4.1-4.7, 4.21, 4.104, Diagnostic Code 7101. REASONS AND BASES FOR FINDING AND CONCLUSION Preliminarily, the Board observes that, prior to the September 2020 remand, VA had inadvertently conflated the Veteran's claim of entitlement to service connection for headaches, to include as secondary to hypertension, with his claim of entitlement to an increased rating for hypertension. In the September 2020 remand, the Board referred the issue of entitlement to service connection for headaches. In an October 2020 rating decision, service connection for headaches was granted and assigned a separate rating. Consequently, headaches will not be considered as part of the Veteran's hypertension rating. In the September 2020 remand, the Board directed the RO to provide the Veteran with a VA examination in order to ascertain the severity of the Veteran's disability. In November 2020, the Veteran underwent the requested examination, and then the RO re-adjudicated the Veteran's claim. After the issuance of a November 2020 supplemental statement of the case, the appeal was remitted to the Board for further appellate review. The Board finds that the RO substantially complied with the September 2020 remand directives and, thus, another remand is not required. Throughout the pendency of this appeal, the Veteran's hypertension has been assigned a 10 percent rating. Hypertension is rated under Diagnostic Code 7101, which provides for a 10 percent rating where diastolic pressure is predominantly 100 or more, or systolic pressure is predominantly 160 or more, and a minimum of 10 percent is also assigned when continuous medication is shown necessary for the control of hypertension and there is a history of diastolic blood pressure of predominantly 100 or more. 38 C.F.R. § 4.104. A 20 percent rating requires diastolic pressure of predominantly 110 or systolic pressure of predominantly 200 or more. Where there is a diastolic pressure of predominantly 120 or more, a 40 percent rating will be assigned. The highest rating of 60 percent requires diastolic pressure of predominantly 130 or more. During the pendency of this appeal, the Veteran has undergone several VA examinations: January 2012, December 2015, November 2019, October 2020, and November 2020. These examinations consistently demonstrate that the Veteran has been prescribed medication to control his hypertension. The January 2012 VA examiner obtained the following blood pressure measurements: 150/102, 158/106, and 144/97. The December 2015 VA examiner indicated that the Veteran's blood pressure was 142/84 on June 23, 2015, and then obtained two additional readings, 153/97 and 155/95. The November 2019 and October 2020 VA examiners utilized blood pressure readings from March 2019, which are as follows: 154/90, 147/96, and 144/88. During the November 2020 VA examination, the examiner obtained the following blood pressure readings: 146/86, 151/92, and 182/110. The examiner also observed that the Veteran's blood pressure was 183/127 and 172/104 on June 23, 2014 and was 159/100 on June 23, 2015. In consideration of this evidence, the Board finds that the Veteran's hypertension has not been productive of diastolic pressure predominantly 110 or more, or systolic pressure predominantly 200 or more. The assigned 10 percent rating contemplates the Veteran's level of blood pressure, his history of high blood pressure, and the need for continuous medication. The Board notes it may not deny entitlement to a higher rating on the basis of relief provided by medication when those effects are not specifically contemplated by the rating criteria. Jones v. Shinseki, 26 Vet. App. 56, 62-63 (2012). However, VA has contemplated the effects of medication as a factor to be considered when rating hypertension under Diagnostic Code 7101. Thus, any ameliorative effects of the Veteran's blood pressure medication were not discounted in arriving at this decision. See McCarroll v. McDonald, 28 Vet. App. 267, 271-73 (2016) (holding that Jones does not apply to Diagnostic Code 7101). Accordingly, the criteria for a disability rating higher than 10 percent for hypertension have not been met. As the preponderance of the evidence is against the claim, the benefit-of-the doubt doctrine is not applicable, and a higher initial rating is not warranted. See 38 U.S.C. § 5107(b); 38 C.F.R. §§ 3.102, 4.3. T. REYNOLDS Veterans Law Judge Board of Veterans' Appeals Attorney for the Board Sean G. Pflugner, 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.