hypertension CUE for Hypertension

[Steve G.]

Long time reader, looking for advice/help -

I may have screwed up, but last Sept I filed what I was convinced was a slam-dunk CUE. In short, back in 1992 I was rated at 30% for -

"Hypertension was diagnosed from 1983 with persistently high blood pressure reading.... Continuous medication is required for control of blood pressure." ... "[Arthrosclerotic] cardiovascular disease with myocardial infarction, four vessel coronary artery bypass grafting and hypertension."

Later ratings in 2008 and 2012 used the same language "coronary artery bypass grafting and hypertension."

I included copies of my SMR showing several instances (5 shown) where I had multiple readings where I was above the levels authorizing both 10% and 20% ratings and also Note 3 from the VA's rating criteria where it states that "Evaluate hypertension separately from hypertensive heart disease and other types of heart disease."

Looked like a shoo-in.

In Mar of this year I received the following response -

"The Rating Criteria prior to 1998 prohibited granting a separate evaluation for hypertension and heart disease. Hypertension was part of the evaluation criteria for the heart. so it would have been pyramiding to give a separate for the heart and hypertension. While service treatment records show you had a compensable elevated blood pressure readings at the time of the 1992 Rating we were unable to grant a separate compensable evaluation for hypertension and heart disease. The law was changed in 1998 and a separate evaluation for hypertension and heart was allowed. Rating Decision dated January 5. 2012 explained that a separate evaluation for hypertension wasn't warranted unless your symptoms were compensable."

OK, I get it, HPT wasn't rated separately until 1998 so I couldn't receive any additional rating until after 1998. The part I don't get is the last sentence. I have to show current symptoms? I was always under the impression that while a rating could and would change due to on-going symptom changes/deteriorations, but that the intitlement had to originally show in the SMR. I definately had not only sufficient symptoms in my records, but also a diagnosis that "Continuous medication is required for control of blood pressure" (this alone should equal a 10% rating.)

I haven't been able to address this for the last couple of months due to on-going personal/family issues, but I would like to file a NOD as soon as possible if my reasoning is correct.

Am I missing something here? Or are there other factors that I'm missing?

Thanks for any help/advice.

 

 

 

Edited June 28, 2016 by Steve G.

[Chuck75]

3 hours ago, Steve G. said:

Long time reader, looking for advice/help -

I may have screwed up, but last Sept I filed what I was convinced was a slam-dunk CUE. In short, back in 1992 I was rated at 30% for -

"Hypertension was diagnosed from 1983 with persistently high blood pressure reading.... Continuous medication is required for control of blood pressure." ... "[Arthrosclerotic] cardiovascular disease with myocardial infarction, four vessel coronary artery bypass grafting and hypertension."

Later ratings in 2008 and 2012 used the same language "coronary artery bypass grafting and hypertension."

I included copies of my SMR showing several instances (5 shown) where I had multiple readings where I was above the levels authorizing both 10% and 20% ratings and also Note 3 from the VA's rating criteria where it states that "Evaluate hypertension separately from hypertensive heart disease and other types of heart disease."

Looked like a shoo-in.

In Mar of this year I received the following response -

"The Rating Criteria prior to 1998 prohibited granting a separate evaluation for hypertension and heart disease. Hypertension was part of the evaluation criteria for the heart. so it would have been pyramiding to give a separate for the heart and hypertension. While service treatment records show you had a compensable elevated blood pressure readings at the time of the 1992 Rating we were unable to grant a separate compensable evaluation for hypertension and heart disease. The law was changed in 1998 and a separate evaluation for hypertension and heart was allowed. Rating Decision dated January 5. 2012 explained that a separate evaluation for hypertension wasn't warranted unless your symptoms were compensable."

OK, I get it, HPT wasn't rated separately until 1998 so I couldn't receive any additional rating until after 1998. The part I don't get is the last sentence. I have to show current symptoms? I was always under the impression that while a rating could and would change due to on-going symptom changes/deteriorations, but that the intitlement had to originally show in the SMR. I definately had not only sufficient symptoms in my records, but also a diagnosis that "Continuous medication is required for control of blood pressure" (this alone should equal a 10% rating.)

I haven't been able to address this for the last couple of months due to on-going personal/family issues, but I would like to file a NOD as soon as possible if my reasoning is correct.

Am I missing something here? Or are there other factors that I'm missing?

Thanks for any help/advice.

Don't know about help, other than to tell you to get current evidence of the HBP.

What's interesting to me is that for quote some time, the VA often called HBP as "essential", and denied any relationship to other conditions, thus removing the secondary to option.