High blood pressure controlled by medication

[Carl the Engineer]

Ok, I have touched on this in the past, but now I am getting ready for my next round of claims and have been putting information in order, etc.

Background.  Claimed hypertension on my first VA claim in 2008.  Was granted at 0%. From an in-service event in 2004. 

Reason; "A higher evaluation of 10 percent would be assigned for findings of diastolic pressure is predominantly 100 or more; or  systolic pressure i predominantly 160 or more; or as a minimum evaluation for an individual with a history of diastolic pressure predominantly 100 or more requiring continuous medication for control.  The evidence of record does not support a higher evaluation because your pressures are well controlled and you do not have a history of diastolic reading predominantly 100 or more."

Ok, so above ^^^^ is the rule they used and sent me in my big envelope at the time.

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.

Now, from 38 CFR 4.104, we have this above ^^^^.

In my VA record, my C&P in 2008, shows that they took 3 blood pressure checks that day (same day, one after another) with readings of 110/80, 122/88 and 120/80.  Logic check; the VA can use 3 checks from the same day, but you, the Veteran have to use at least two checks, from three separate days, within a month. 

Keep in mind the VA checks were after being on medication for high blood pressure for over 4 years.

Also, in my VA record at that time, was, because of an LOD for high blood pressure on 06/29/04, was a reading during my "age 40" physical, of 156/103 and the civilian doctor on 08/25/04, of 170/106.  Two readings, two months apart, normal real world medical exams and appointments.

My HBP was obviously controlled by medication, but if I had not taken the meds, I could have easily met the requirements for the 10%.  And, also, what doctor takes your blood pressure two or three times, and if they do, they only record the one time.  I've had the nurse have me sit after a high reading and then get a better ready 5 minutes later.  She only records the one reading.  The VA rule stinks in this regard.  Its like they (VA) expects the Soldier or Veteran to know this at the time of the emergency, etc.  And try telling a doctor you need him/her to write in your notes that you took my pressure three times and with readings for each time, and you need to repeat in less than a month on another day and then again on another day.  Not real world.

The extreme option, which is how the VA plays ball would be for me to stop my medication and get the "two or more readings above 100 on three different days" to get the 10 %.  Heck, now that they have upped my meds about 3 times since 2004, I could probably get the next level when off the meds.

I think I will add it to my claim and write it out as best as I can, add evidence and see what happens.

Worst thing is they could deny the request for increase,

Maybe, I'll do a re-open.  Can my new-evidence be reports that were in my VA record at the time, but not mentioned in the findings? LOL.

Hamslice

Rat Bastards...

 

[porgee]

To quit meds for a 10% rating and worst be you could have a stroke or even

loose your life is it worth it???????? .Your call

[vetquest]

Hamslice,

The VA once took me off of a medication without stepping me down.  My blood pressure shot up to levels that were dangerous and I was seriously agitated all of the time for several weeks.  It was the definition of malpractice.  It was also something that I never want to go through again.

Please take off the dunce cap and realize you are worth a lot here and that we do not want to lose you.  It would only gain you two percentage points and that is not worth your life.

[broncovet]

I checked, and CFR 3.104 "did not mention" whether the blood pressure readings were "on medication" or without meds.  At least not that I can find.  

However, with other issues, I noticed:

1.  Hearing loss is rated WITHOUT hearing aids, not with them.  

2.  "Loss of use" of a leg does not "go away", when the vet gets an artificial leg.  

3 .  If you are sc for diabetes, the sc does not go away if you control diabetes with medications.  

4.  If you are on meds for mental health disorders, and these meds work, at least some of the time, the VA wont reduce your rating. They all tell you to tell the C and P examiner what happened on your WORST day, not your best day, when you feel happy.  

     It sounds like its too late to appeal this decision, so you would likely have to CUE it.  Berta could chime in here, BUT, when one takes high blood pressure meds, they have to put up with the side effects of blood pressure meds.  Its my opinion that the VA can not rate this "with meds" unless the regulations specifically so state.  

     For clarification, read the regs on 38 cfr 3.344:    ............

Quote

Ratings on account of diseases subject to temporary or episodic improvement, e.g., manic depressive or other psychotic reaction, epilepsy, psychoneurotic reaction, arteriosclerotic heart disease, bronchial asthma, gastric or duodenal ulcer, many skin diseases, etc., will not be reduced on any one examination, except in those instances where all the evidence of record clearly warrants the conclusion that sustained improvement has been demonstrated. Ratings on account of diseases which become comparatively symptom free (findings absent) after prolonged rest, e.g. residuals of phlebitis, arteriosclerotic heart disease, etc., will not be reduced on examinations reflecting the results of bed rest.

   .......(only relevant portions of regulation posted for brevity).  

Based on 3.344, and the above, I beleive you can make a case that you are to be compensated for high blood pressure WITHOUT meds.  If meds help you, that is not a bases of reduction because that would be tempory and only last until  you stopped the meds.  

 

       My advice is to get your medical records, and see if you "submitted new and material evidence" within one year of your decision.  If you had a medical exam, and they recorded your blood pressure readings, noting whether or not you are on blood pressure meds, this may suffice.  Then ask for a reopening due to N and M evidence 38 cfr 3.156 b (pending claim).  Your claim is pending when you are still in the appeal period.  

      I do not advise sacraficing your health for a disability rating by going off the meds.  I dont even think that will help you.  Beat the VA smart, at their own game, and use their regulations against them.  It may mean you need a lawyer to help, if so, dont cut your face off to save your nose by going cheap and not hiring professional representation.  

      Make no mistake.  The decision to hiring or not hiring an attorney usually boils down to 1 question:

1.  Can hiring the attorney "make me money"?  

         You will have to evaluate your chances of winning this alone, or getting an attorney.  Some Vets advocates can/do "save attorney fees" by doing the claim themselves, but many more miss out on benefits that an attorney could win for them.  

        Alex Graham has considerable legal skills and knowledge.  HE hired an attorney to win his big benefits.  

       I did so likewise .  I have hired an attorney 3 out of my last 3 BVA decisions and have made money doing so on 2, and the third one is pending, and Im expecting my attorney will win additional benefits for me.  

 

   

 

 

[Carl the Engineer]

Porgee, Vetquest and bronco,

I'm not going to stop taking my medications, rest assured, but, it was my way of expressing how asinine the VA rules and regulations can be.

I will submit what I have as an increase to hypertension and see what they say.  I am also claiming irregular heartbeat secondary to hypertension as that is a new phenomenon as of recent and I was put on a Holter monitor for 48 hours, etc.  It showed the extra beats, and I did not have them as of two years ago and believe my medications are causation.  That and my recent win for LVH at 30% with x-ray evidence of enlarged heart.  New medications have been added and my old ones increased, so that my help with the examiner/rater, etc. 

My hope (against all things VA) will be that some rater puts all this together, 2+2=8, and gets me a little more for the whole heart disease question.

Currently 0% for hypertension and 30% for LVH.

Bronco, 

This is my last set of claims submitted by myself.  After this is rated, I may send my complete record to a Dr Bash type person(s) to have a thorough going over to see what I did right and what the hell I did wrong.  LOL..

Me, not taking my medications would be a win for the rat bastards, and not on my watch.

Thanks for the comments,

Hamslice