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Hypertension Claims And Blood Pressure Readings
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Question
Vync
Hello everyone,
I have an active hypertension claim and have a couple of odd questions regarding BP readings. Hypertension is listed as an active problem in my VAMC medical record and I also take daily medication to help control it. The rating criteria for hypertension is listed further below.
My VAMC takes my blood pressure (BP) only taken at the first clinic I visit each day. If my BP reading is high (usually the case), then the nurse waits a bit, takes another reading, and notes the lower of the two. While reviewing my progress notes, I find that only one BP result is noted. Sometimes the notes indicate it was taken two or three times, but do not include the numbers.
Per the rating criteria below, Note 1 indicates that "hypertension must be confirmed by readings taken two or more times on at least three different days". With the VA noting the results of only one reading this makes it difficult for a veteran to meet the specific requirements of note 1.
Are the nurses supposed to record the values of each BP reading or only the best one?
I usually take my own BP a couple of times a day and log the readings. Would it be helpful to submit a copy of my BP log or would they only consider readings taken at the VAMC or other medical provider?
How does medication used to control high BP factor into a claim?
7101 Hypertensive vascular disease (hypertension and isolated systolic hypertension):
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 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.
Note (2): Evaluate hypertension due to aortic insufficiency or hyperthyroidism, which is usually the isolated systolic type, as part of the condition causing it rather than by a separate evaluation.
Note (3): Evaluate hypertension separately from hypertensive heart disease and other types of heart disease.
For comparison purposes, I included this chart from the Mayo Clinic's web site.
http://www.mayoclinic.com/health/blood-pressure/HI00043
op number (systolic) in mm Hg Bottom number (diastolic) in mm Hg Your category* What to do** Below 120 and Below 80 Normal blood pressure Maintain or adopt a healthy lifestyle. 120-139 or 80-89 Prehypertension Maintain or adopt a healthy lifestyle. 140-159 or 90-99 Stage 1 hypertension Maintain or adopt a healthy lifestyle. If blood pressure goal isn't reached in about six months, talk to your doctor about taking one or more medications. 160 or more or 100 or more Stage 2 hypertension Maintain or adopt a healthy lifestyle. Talk to your doctor about taking more than one medication.
"If it's stupid but works, then it isn't stupid."
- From Murphy's Laws of Combat
Disclaimer: I am not a legal expert, so use at own risk and/or consult a qualified professional representative. Please refer to existing VA laws, regulations, and policies for the most up to date information.
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