hypertension Denied, Disappointed, Confused

[Lorraine]

Denial of claim states that "the claim for service connection for hypertension remains denied(had filed a claim back in 1979 that was denied because his bp readings, although elevated, did not meet VA criteria for hypertension)) because the evidence submitted is not new and material" (We sent medical records and they obtained medical records for continuous treatment of hypertension since 1980)."Although you submitted evidence to show that your hypertension manifested to a compensable degree....this did not occur within a year from your discharge from military service.""We determined that the following condition(Hypertension) was not related to your military service, so service connection remains denied."

Of interest to those of you with IHD claims due to herbicide exposure(AO), it goes on to state that "we have deferred a decision on your claim for ischemic heart disease based on heribicide exposure. However, this disease has not yet been added to the Dept of VA regs governing diseases presumptively associated with herbicide exposure. In order to add this disease, we must follow a series of legal requirements, including publishing a notice in the Federal Register. We have begun this process, but are holding your claim until these legal requirments have been met. When the process if complete, we will make a determination on your claim and provide you with a notice of our decision.(dated Oct 4, 2010)

We're in the "dumpers" today and my thought is to wait until we get a ruling on the IHD/AO claim and then go from there - keeping in mind the time restriction for filing a NOD.

Anybody have any thoughts? I'm reading through archives related to hypertension claims, but unable to find if the regs apply to bp readings while under treatment or without. My hubby's on numerous meds to keep his bp lowered, can't imagine what it would be untreated - and, is he to go off meds to get higher readings and risk a stroke?? Not wise.

Lorraine

[Berta]

This is the VA criteria for Hypertension ratiings:

Hypertension is rated under 38 C.F.R. § 4.104, Diagnostic Code

7101. For purposes of rating under 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. A rating of 10 percent requires diastolic blood

pressure predominantly 100 or more, or systolic blood pressure

predominantly 160 or more, or minimum evaluation for an

individual with a history of diastolic blood pressure

predominantly 100 or more who requires continuous medication for

control. A rating of 20 percent requires diastolic blood

pressure predominantly 110 or more, or systolic blood pressure

predominantly 200 or more. A rating of 40 percent requires

diastolic pressure predominantly 120 or more. A rating of 60

percent requires diastolic blood pressure predominantly 130 or

more."

A key word is "predominant" when the entire clinical HBP record is considered.

They do say his HBP readings were compensable.

Was he treated for HTN in service? Do you have his complete SMRs?

Since he has ischemic heart disease and was obviously exposed to AO (because VA put him into the IHD claim snenario) and if he has IHD to a compensable level , they will rate him and compensate him on that.

What I see missing here is there is no nexus to his service for the HTN and ,if a doctor can state that his HTN is due to his IHD, then a successful claim for IHD would also warrant a secondary rating for the HTN if that falls into a compensable rating.

I suggest that you amend the IHD AO claim to request the HTN as a secondary condition to the IHD.To make sure they don't miss it.Does he have private treatment records?

If so, would his private doctor consider preparing an IMO to show it is as likely as not his IHD has caused his HTN?

It seems completely sensible to think VA should SC HTN (HBP) to ischemic heart disease as secondary but they wont do it unless they have a medical statement that states the link and gives a medical rationale.

Maybe the link has already been documented somewhere in his medical records? Does he have copies of all of them?

VA cannot seem to connect the dots on this type of claim-so we have to give them the evidence to do that- and we do not get anything unless we specifically ask for it.

You could use a 21-5138 and refer them to the deferred decision and it's date and put Attention to : and use the initials that appear in the upper right hand corner where the VARO code number is on the letter they sent.And ask them to amend the IHD claim to include HBP as a secondary condition to the IHD.

Most of us here have been denied,disappointed and confused so don't let this get you both down.

With proof of AO exposure and IHD he is sure to get a compensable rating. The IHD regs are in the Agent Orange forum here.

Did they send him a VCAA letter or ask for copies of any recent METS test results or ECHOS he might have had?

[Chuck75]

Assuming evidence of IHD, and related conditions, CAD, etc. It's likely that a doctor will be willing to say that they are related without getting into what is "primary" and secondary".

In actual fact, blood pressure (even below compensatable levels) is usually increased as a result of the conditions that eventually result in IHD.

It's common to see the blood pressure drop closer to normal after successful treatment for such things as CAD, etc.

Successful chemical removal of a blood clot (Emergency treatment for/during a heart attack) using TCB often produces a substantial drop in blood pressure.

The usual initial treatment for heart problems (even before they are fully diagnosed) is to treat higher than normal blood pressure. An adult male with blood pressure above normal,

along with some other "minor" symptoms should consider tests to determine the cause of the high blood pressure, and if there is any heart related disease present.

Denial of claim states that "the claim for service connection for hypertension remains denied(had filed a claim back in 1979 that was denied because his bp readings, although elevated, did not meet VA criteria for hypertension)) because the evidence submitted is not new and material" (We sent medical records and they obtained medical records for continuous treatment of hypertension since 1980)."Although you submitted evidence to show that your hypertension manifested to a compensable degree....this did not occur within a year from your discharge from military service.""We determined that the following condition(Hypertension) was not related to your military service, so service connection remains denied."

Of interest to those of you with IHD claims due to herbicide exposure(AO), it goes on to state that "we have deferred a decision on your claim for ischemic heart disease based on heribicide exposure. However, this disease has not yet been added to the Dept of VA regs governing diseases presumptively associated with herbicide exposure. In order to add this disease, we must follow a series of legal requirements, including publishing a notice in the Federal Register. We have begun this process, but are holding your claim until these legal requirments have been met. When the process if complete, we will make a determination on your claim and provide you with a notice of our decision.(dated Oct 4, 2010)

We're in the "dumpers" today and my thought is to wait until we get a ruling on the IHD/AO claim and then go from there - keeping in mind the time restriction for filing a NOD.

Anybody have any thoughts? I'm reading through archives related to hypertension claims, but unable to find if the regs apply to bp readings while under treatment or without. My hubby's on numerous meds to keep his bp lowered, can't imagine what it would be untreated - and, is he to go off meds to get higher readings and risk a stroke?? Not wise.

Lorraine