What is the VA rating for Hypertension?

VA requires blood pressure readings to be confirmed multiple times across different days to establish the diagnosis.

• Under Note (1) of DC 7101, VA confirms hypertension based on readings taken two or more times on at least three different days.
• This ensures the initial diagnosis captures a predominant baseline rather than a temporary spike.
• This confirmation is for establishing the existence of hypertension or isolated systolic hypertension.
• If a veteran submits readings taken on fewer than three days, the evidence might not satisfy the confirmation rule.

Records to review: Blood pressure log.

A 10% rating is assigned for veterans whose severe hypertension is currently controlled by continuous medication.

• If a veteran's current blood pressure is well-controlled (e.g., 120/80), they would normally receive a 0% rating.
• However, if historical records show the diastolic pressure was predominantly 100 or more before treatment, and continuous medication is required to maintain the current controlled state, a 10% rating is assigned.
• This prevents penalizing veterans for successfully managing a severe chronic condition through ongoing medical compliance.
• The minimum evaluation reflects the ongoing requirement for medical intervention.

Records to review: Historical medical records; Current pharmacy records.

When only the systolic pressure is elevated, the maximum possible rating under DC 7101 is 20%.

• Isolated systolic hypertension means the systolic (top) number is predominantly 160 or more, while the diastolic (bottom) number is less than 90.
• A systolic pressure of 160-199 warrants a 10% evaluation.
• A systolic pressure of 200 or more warrants a 20% evaluation.
• The 40% and 60% evaluations are based exclusively on high diastolic pressure and cannot be reached with isolated systolic readings.

Records to review: Blood pressure log.

Hypertension caused by certain heart or endocrine conditions is not rated separately.

• Note (2) of DC 7101 states that hypertension due to aortic insufficiency or hyperthyroidism is evaluated as part of the condition causing it.
• This typically manifests as isolated systolic hypertension.
• If causation is established for either of these conditions, the veteran will not receive a separate DC 7101 rating to avoid pyramiding (rating the same symptom twice).
• This exception prevents pyramiding when evaluating the overarching condition.

Records to review: Medical nexus letters; Echocardiogram reports.

Key documents to support a hypertension claim.

• Medical and treatment records documenting blood pressure.
• A blood pressure log covering multiple days.
• Medication history showing continuous control.
• These documents help confirm both the predominant readings and the need for medication.

Records to review: Blood pressure log; Medical and treatment records.

The Disability Benefits Questionnaire used by VA examiners.

• The Hypertension Disability Benefits Questionnaire is used during C&P exams.
• It prompts the examiner to record the history of readings.
• It also checks for related conditions like hypertensive heart disease.
• Veterans can review the DBQ form to understand what will be asked.

Records to review: Hypertension Disability Benefits Questionnaire.