hypertension How To Apply Cfr 4.7 Higher Of Two Evaluations. When Rated 0% Versus 10% For High Blood Pressure

[dav_marine72]

Hi All,

I am trying to get an initial 10% rating for my high blood pressure. As part of my reasoning I am trying to apply 4.3 reasonable doubt and possibly 4.7 higher of two evaluations. I have been on hbp meds since 1997 when I was diagnosed. My readings were constantly 150s/90s even on the meds. I have been fighting this for what seems like forever. Service connection was awarded in 2002 secondary to my sc back pain and given a 0% rating because I have only had sporadic readings over 100 for my diastolic pressure.

Here is the 10% rating criteria:

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.

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.

I have had five readings on different days documented over 100 for diastolic pressure. This is while on medication. I was given a blood pressure cuff from the VA and have to come in for readings. Of course to make this harder for me once I get on opiates in 2007 my pressure has been in the 120s / 80s or lower usually. I even had several readings in the 140-150 / 90s in service 91-95 when I was supposedly healthy.

I have looked at many BVA cases with similar stories and they seem to end up given the 10% rating based on CFR 4.3. I haven't made it to the BVA so I probably would get 10% because its a joke and 10% is awarded for a hang nail. In my case 10% means something to me because I have a chance of getting 100% schedular back to 2002. Since I was 70% in 2002, 80% in 2008, and 100% in 2009 there is a chance a big back pay here hence why I am fighting this tooth and nail.

I think alone I would be okay but I wondered if anyone had experience applying CFR 4.7 higher of two evaluations when the rating schedule does not have a 0% rating for an aliment such as high blood pressure. Granted under CFR 4.31 zero percent ratings it says In every instance where the schedule does not provide a zero percent evaluation for a diagnostic code, a zero percent evaluation shall be assigned when the requirements for a compensable evaluation are not met.

So how do I agrue CFR 4.7 when there is no 0% criteria. Certainly I would think in this case based on my readings, need for constant meds since 97, history of medium HBP since in service, VA giving me a blood pressure cuff, and keeping a BP log for the VA, I would meet 10% based on CFR 4.3 and CFR 4.7. Anyone differ with that opinion or have any recommendations for formulating a stronger attack?

Thanks.

[jbasser]

The BVA is flat full of cases like this one and the VA usually wins simply because the regs state the compensable ratings are 160/100 with continuous medication for control.

Be aware if you have any associated CAD or Hypetensive heart disease it is rateable as secondary to the HTN.

It really is the silent Killer.

J

[JamesBreckenridge]

"My readings were constantly 150s/90s even on the meds." "I have only had sporadic readings over 100 for my diastolic pressure."

That's a 0 percent by definition. Also, one thing I do is count blood pressure readings. If half of them meet the 10 percent criteria, I grant at that level. It sounds like you're close, but not quite there. Keep an eye on your BP and if it goes any higher, file for an increase.