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Geo4K

0% On Hypertension Claim

Question

Hi All, I feel that the 0% rating they gave me is low. The following are my thoughts as to why. Did I cover everything?

As always - thank you all for your time and thoughts - George

On my 22 June 2010 claim for Hypertension, I was rated a 0% SC due to the “low” reading of my diastolic pressure. Unfortunately, this decision was not based on all the information that was available. Since I was anticipating a C & P exam, I elected to bring a sheet of several readings with me to the exam. Despite my phone calls to the VA C & P office to ascertain an appointment date and 2 stops to the VA office on Gold St, I was never told that my exam would be passed over for just a records review. I was waiting, in good faith, for an appointment. Here are the additional facts (with supporting documentation) I wish you to consider for a full 10% award.

I was initially made aware of my high blood pressure during my first C & P exam at the VA on January 4, 2010. It was 164/114. I made an appointment immediately with my PCP at Presbyterian Healthcare Rio Rancho, you have these records. On January 5 a reading was taken by the Federal Occupational Health (FOH) RN at my worksite (new evidence/documentation attached), it was 150/110. On January 6 a reading of 160/110 was taken at Presbyterian for my first visit for my BP. On this day my PCP prescribed a daily dose of 25 mg of Hydrochlorothiazide (HCTZ). I started taking this dose the very next day on January 7th. FOH took a reading of 140/104 on January 12. I feel that my body was starting to adjust to the medication at this point. The following readings and dates were recorded by FOH: Jan 19 = 134/92, Jan 21 = 132/90, Feb 11 = 140/100, Feb 16 = 118/80, Feb 23 = 140/100. Any reading of my blood pressure after this date will be influenced by my medications. On February 23, I was prescribed 10 mg of Lisinopril in addition to the 25 mg of HCTZ and on 30 March the dose was increased to 20 mg of Lisinopril and 25 mg HCTZ.

My blood pressure is now well controlled by these medications. I feel that the evidence cited above clearly shows that without them, my diastolic pressure would be predominantly above 100, and my systolic pressure would be in the 160+ to 150 range. In order to offer more proof, I’d have to stop my medications and let my blood pressure rise back to those unhealthy levels – something neither you nor I should ever consider.

Most of the readings you cited show me already under the care of my physician and the medicine prescribed to me, therefore, a poor indicator of my true state of hypertension. Please revisit your decision, consider my first series of readings in early January, prior to the medication and the others as I was adapting and progressing towards a healthy level. I am asking you to award the appropriate rating of 10% for my hypertension claim. Thank you for your attention to this.

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One more question: Which kind of "second-look" or reconsideration from the VA should I ask for?

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Diastolic pressure predominantly 100 or more, or; systolic pressure predominantly 160 or more, or; minimum evaluation for an individual with a history of diastolic pressure predominantly 100 or more who requires continuous medication for control 10

Note (1): Hypertension or isolated systolic hypertension must be confirmed by readings taken two or more times on at least three different days. For purposes of this section, the term hypertension means that the diastolic blood pressure is predominantly 90mm. or greater, and isolated systolic hypertension means that the systolic blood pressure is predominantly 160mm. or greater with a diastolic blood pressure of less than 90mm.

predominantly [prɪˈdɒmɪnəntlɪ]

adv

for the most part; mostly; mainly

You are going to have to show them that the majority of the readings are over 100 Diastolic.

If you have 20 readings and 2 are high than that will not cut the mustard. If you have 20 and 10 or more ore 100 then you can get somewhere.

Also note the medication. It states 100 or more with medication.

You should make a diary of every reading you can get your hands on.

Good Luck

J

Edited by jbasser

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Well, J, looks like you're spot on with your comments. I just got back from the DAV. My rep looked it up in a book, called a friend for more advice and then told me basically the same thing. My diastolic MUST be predominately over 100 WHILE on medication... Basically, the hypertension is not well controlled even under medication, then you'll get a 10% rating. So, I'll leave it as is and not tie up anybodies resources fighting the currrent rating - it would be pointless.

At least I got it SC at 0%. I don't suppose the VA would pay for my meds at that rate, would they?

Anyways, thanks J, for your time on this.

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Well, J, looks like you're spot on with your comments. I just got back from the DAV. My rep looked it up in a book, called a friend for more advice and then told me basically the same thing. My diastolic MUST be predominately over 100 WHILE on medication... Basically, the hypertension is not well controlled even under medication, then you'll get a 10% rating. So, I'll leave it as is and not tie up anybodies resources fighting the currrent rating - it would be pointless.

At least I got it SC at 0%. I don't suppose the VA would pay for my meds at that rate, would they?

Anyways, thanks J, for your time on this.

Even though you have 0%, it's a service-connected condition, which means that they are not supposed to charge you nor your insurance carrier for anything, including meds!!! And if you did pay for meds from the effective date on, they are supposed to pay that money back!!!

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If you have chronic pain you can get compensated for that. Also chronic pain and depression go hand in hand. You can get compensated for that.

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