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Hypertension C&P
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ASU_0331
So had a NOD with DRO review in for hypertension and CAD. CAD was rated at 60%, but it appears that hypertension will be rated at 0% because my diastolic readings at my C&P only averaged out to around 85. However, this was done while medicated on two different blood pressure medications so I do not understand the rationale that VA determines their rating when they use the criteria they have for ratings;
The ratings: If the average diastolic pressure is 130 or more, then it is rated 60%. If the average diastolic pressure is 120 to 129, then it is rated 40%. If the average diastolic pressure is 110 to 119, or the average systolic pressure is 200 or more, then it is rated 20%. If the average diastolic pressure is 100 to 109, or the average systolic pressure is 160 to 199, then it is rated 10%. If the average diastolic pressure was 100 or more before fully controlled by medication and continuous medication is required to keep the blood pressure under control, then the minimum rating is 10%.
I have been on blood pressure medication since my heart attack and hypertension diagnosis in 2005 and all my vitals on record with the VA, with the exception of a few, are also while on blood pressure medication. So there is no way they can determine what my average diastolic pressure was before being fully controlled by medication, except that continuous medication is required to keep my blood pressure under control (currently prescribed Lisinpril & Metoprolol). Below are my BP readings since I first started being cared for by the VA. Note that when I came to the VA, I had already been on blood pressure meds since 2005;
You can see the instances where I was off my blood pressure medications with readings over 100 as well as most of the medicated readings being in the high 80's to mid 90's. I am planning on requesting a reconsideration once I get my BBE for this appeal and making the argument that my diastolic would he averaging over 100, as evidenced by the instances where it has been over 100, and that absent continuous medication my blood pressure would not be fully controlled. Anyone have thoughts on this angle on reconsideration?
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