hypertension I Had It Need Help

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Filed when discharged in 98 for hypertension, focal segmental glomeruloslerosis (kidney disorder) which was discovered my second year of service. I did the Wilford Hall Medical Center trips back and forth on a Medevac for biopsy tests and care. The case came back service connected but at 0%. I appealed and it still came back 0%. I was on 5mg of BP meds from day one and over the years mgs have increased to now a 10/40 combo. They said I don’t retain water but over the years I been on water pills as well. Now my combo med is for hypertension and water. Over the years I lost testosterone at a young age, ED problems that too at a young age I have tried several diffent testosterone treatment- injections as well as gels, and errection meds Viagra and Cialis, without the now combo of Cialis/Testosterone gel my wife and I cannot have relations. I became diabetic, I have over the years had testicular pains, my reg doctor, urologist and the VA cannot give me any relief. I had it with them, I know it is my fault I took this long but I have been so disgusted with them and burned on the inside knowing I have a kidney disorder which 9 out of 10 will progress in the wrong direction and they just simply give 0%.

With a bag of pills I take everywhere I go (My friends call me Walgreens), the way I have been feeling, the knowledge of my conditions and plus the known side effects of the meds I take (one is known to give headaches as well as capable of giving me prostate cancer) prompt me to look into it AGAIN and stick with it till I get positive results. What extra steps to take and how can get it to stick now? Thank You.

[jbasser]

For HTN here is what you need to get a compensable rating:

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

For the Kidneys, Here is also what you need scroll down to 4.115B Kidney disorders.

[broncovet]

The obvious answer is you need to ask for an increase, if you have not already. You should, if you have not already, file for secondaries related to this, such as ED.

[Berta]

"What extra steps to take and how can get it to stick now?"

You will need New and Material Evidence, in order to re open this claim.

In my opinion that N & M should be an IMO (independent medical opinion) that will show the VA your condition has escalated to a ratable level, to at least 10% as jbasser stated above in the HBP regs.

Also the IMO could help you,if you make sure your claim them as secondarys, as Broncovet said, regarding any other conditions you have now that are due to the HBP condition, such as any possible secondary kidney condition ,and the ED, which might in fact be due to the HBP meds .

An IMO doctor can make a medical rationale for the main condition as well as any potential secondarys...we have IMO info and the IMO criteria here in our IMO forum.

He/she will need copies of all of your private and VA medical records.It would help too to have a copy of your SMRs.

[harleyman]

This post was edited by myself correcting the number of times the BP must be documented in a single day and on two more separate days. Sorry for any confusion this may have caused, the point is, the average doctor is not going to have you come back two more times, to check your blood pressure before he prescribes HBP medication.- IMO

I would like to share a bit of information about High Blood Pressure HBP or Hypertension HTN, considered the same by VA.

In order to get anything more than a “0” percent disabling for this condition, the Veteran must have 2 blood pressure readings in a single day on 3 different days, meeting one of the two criteria either a high diastolic or a high systolic pressure that meets the 38 CFR part 4 criteria as posted above by JBasser.

The problems are as follows:

If the Veterans military records show HBP or HTN while in service and the military doc’s prescribe medication the Veteran will still only get a grant of “0” percent- UNLESS the STRs show two or more (2) blood pressure readings on the same day and check it again on two more different days also showing high readings, in order o meet the scheduler criteria. (I don’t know about you, but I know the doctor never does document all the readingss when they check my blood pressure, let alone write it down for the record. They generally write down the lowest reading even if they take it a couple of thimes. ANd they have never asked me to come back two more times on different days so they can check it again.

When a Veteran goes to his VA appointments after he is service connected, and they check the blood pressure, how many times do they take it? I have gone and they have never checked it more than two times. So ,even if it is a bit high are they going to document those readings and ask me to come back two more times before they prescribe or are they just going to give you HBP medication and tell you to take it.

If the Veteran decides not to take his medications on the day of his appointment, or day of the C&P exam, the Veteran is putting himself at risk of a heart attack or stroke by letting his blood pressure rise, so it is high on the day of the exam to qualify for a percentage rating. And even then there is no guarantee the nurse or examiner will take 2 blood pressure readings, and document the readings and then do it again on two different days. In my opinion, the risk for a 10% or more rating is not worth the risk of injury.

Simply having a diagnosis and taking medication will not get a Veteran a percentage of disability higher than “0” unless it is documented somewhere in the military records or the examination records, there were or are these high readings documented on a single day, and on two more days, thus meeting the 38 CFR schedule of ratings criteria for HBP/HTN. Even private doctors do not document multiple readings very often. And to get a private doctor to agree to such documentation would be difficult as you would have to stop the medication to get the BP to rise. It's just crazy. This is one of those conditions that should be an automatic 10% if medication is required. - IMO

4.104- §4.104—Schedule of ratings–cardiovascular system 4.104-

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.

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Edited September 1, 2013 by harleyman