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How Does the VA Rate Hypertension?

How Does the VA Rate Hypertension?

What is Hypertension?

High blood pressure, or hypertension, occurs when blood is circulating on the walls of arteries at pressures higher than normal. According to the VA, hypertension is defined as a diastolic blood pressure predominantly measured at 90mm. Included under hypertension schedular ratings, VA also rates isolated systolic hypertension; this is defined as systolic blood pressure predominantly measured at 160mm or more, with a diastolic blood pressure of 90mm or below.

 Are there health concerns associated with hypertension?

 Hypertension does not always exhibit symptoms, and they may take years to emerge; however, if left untreated for an extended period of time, serious health concerns may arise. VA warns that prolonged high blood pressure may result in:

  • Hypertrophy, or the thickening of the walls of the heart;
  • Cardiac dilation, or an enlarged heart;
  • Arteriosclerosis, or hardening of the arteries.

How Does VA Rate Hypertension?

In order to receive VA disability compensation for hypertension, you must demonstrate that your hypertension is service-connected.  In addition, your diagnosis must be supported by evidence proving that two or more blood pressure readings were performed on three different days. This rule is in place to ensure that a diagnosis of hypertension is not based solely on “readings taken on a single, perhaps unrepresentative, day.”

Under 38 CFR 4.104 diagnostic code 7101, hypertension ratings are assigned at 10%, 20%, 40%, or 60%. Veterans that qualify for VA benefits and whose tests reveal the following blood pressure levels, may qualify for the corresponding disability ratings:

  • Diastolic pressure predominantly 130 or more – 60%;
  • Diastolic pressure predominantly 120 or more – 40%;
  • Diastolic pressure predominantly 110 or more OR systolic pressure predominantly 200 or more – 20%;
  • Diastolic pressure predominantly 100 or more;
    • OR systolic pressure 160 or more;
    • OR if a person has a non-compensable blood pressure reading, but has a history of diastolic pressure predominantly 100 or more prior to it being controlled by medication, and there is a need for continuous use of medication to keep the blood pressure under control—10%

You may have noticed that before each blood pressure level, the term predominantly is featured. In this instance, VA defines predominantly as the “most common or prevailing” blood pressure level. This means that the most common blood pressure level (or range) will be used in factoring your disability rating.

If you undergo consecutive sets of blood pressure readings in the same month, VA gives veterans the “benefit of the doubt” and assigns them the highest rating based on the test results. If two sets of readings are taken months apart while a veteran’s claim is being decided, the Veteran is assigned the rating that correlates to the first set of blood pressure levels. If the second set of blood tests yields higher blood pressure levels, a staged rating is assigned effective from the date of the second set of tests.

Exceptions

Those seeking a reevaluation of their service-connected hypertension or isolated systolic hypertension will be required to have their blood pressure read three times on the day of their examination, instead of multiple tests over the course of three days.

Veterans do not need to undergo a new “current” evaluation under the regulatory standards of hypertension if:

  • There has been a previously established diagnosis of hypertension or isolated systolic hypertension that is currently being controlled with medication, resulting in a non-compensable rating; and
  • A previous, competent diagnosis was made; or
  • They are still in service; or
  • The hypertension is considered secondary to a service-connected disability.

Category: Veterans Law

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