Hypertension Question

[pyrotaz]

My personal Doctor feels I should file a hypertension claim secondary to my PTSD/MST claim. Looking through my Military medical records it shows that my BP started elevating after the events started both systolic and diastolic numbers. About 3 months after my discharge one of my doctors placed me on bp medications and I have continued taking them. Even while on them my diastolic is always around 82-85. 

My question is that I am aware that the VA wants a 2-5 day consecutive reading to diagnose hypertension. I have been on hypertension medication now for over 25 years. My personal doctor does not feel comfortable taking me off these medications to get these readings. Unless it is in a very controlled environment where I could be monitored. Strokes run in the family and he does not feel safe taking me off these meds. Will a nexus letter from him explaining the visitation be significant to cover this. He feels that without the medication my diastolic BP would be above 130. 

[ShrekTheTank]

You have already been diagnosed with hypertension.  That is what they will be looking for, but I could be wrong here.  For all of mine they just looked for a diagnosis and they didn’t even do a c&p for my ibs. I would say file. 

[Carl the Engineer]

OK, I was service connected for HBP for 10 years at 0%, because it was treatable with medication, etc.

I my last claim for 5 disabilities or increases, I claimed an increase for HBP because my medication had increase, now 2 pills vs 1.  I also included two inservice, one military, one private 90 days apart, reading of over 100 systolic from 5 years before I left service.

While at my C&P, I did explain to the examiner that the VA reg regards 3 tests, same day, 3 separate days, was quite odious and not realistic, and that no physician, military or private would do that.  I also stated that when I was at those appointments, the nurse(s) took my blood pressure, then had me wait 5 minutes and took my blood pressure test again, but only recorded one reading.  Again, I told her that no one does what the VA reg calls for.  She agreed, and said that she would submit the two prior readings and enter an explanation.

I did tell her that one could just not take their meds for a couple months, then get the 3 readings, 3 separate days, etc. like the VA reg calls for and she told me not to do that.  I told I was not, but I made sure she saw  my point of view on the unobtainable VA reg requirements, etc.

That said, my claim for a increase to my service connected HBP was granted for 10% for only  two prior BP readings over 100 systolic taken 90 days apart.

Now, bear in mind, they, the VA had those two readings from the git go, but I am not rocking the boat as far as a claim for retro, etc.  Because, I was awarded, however, it doesn't fit the requirements for awarding.  I am just happy to get the 10% with what I had.

Bottom line for me is have a good history and story with evidence for your C&P examiner.  They do write (opine) your story for the rater, so paint them a good picture even if you don't think you have a shot,

You never know,

Hamslice

 

 

  

[doc25]

5 hours ago, pyrotaz said:

My personal Doctor feels I should file a hypertension claim secondary to my PTSD/MST claim. Looking through my Military medical records it shows that my BP started elevating after the events started both systolic and diastolic numbers. About 3 months after my discharge one of my doctors placed me on bp medications and I have continued taking them. Even while on them my diastolic is always around 82-85. 

My question is that I am aware that the VA wants a 2-5 day consecutive reading to diagnose hypertension. I have been on hypertension medication now for over 25 years. My personal doctor does not feel comfortable taking me off these medications to get these readings. Unless it is in a very controlled environment where I could be monitored. Strokes run in the family and he does not feel safe taking me off these meds. Will a nexus letter from him explaining the visitation be significant to cover this. He feels that without the medication my diastolic BP would be above 130. 

You will need a nexus letter to secondary service connect your hypertension to your PTSD/MST.

Not so much for a visitation. So, correct me if I'm wrong, but the VA is recommending taking you off your meds, just to get some readings? Sounds fishy to me.

Apparently, you've already been diagnosed with hypertension and have been on hypertension medication for over 25 years. You wouldn't need to be on hypertension meds if you were NOT diagnosed with hypertension. The VA doesn't need to do a re-diagnosis; but that's just my version of logical reasoning. I hope that makes some sense. If your doctor doesn't feel comfortable with what the VA is recommending, then there's a very good reason why he wouldn't want you to DIE; if you are taken off your medications. It's a risk even for just a few days. 

To SECONDARY SERVICE CONNECT:

#1. Current service connected disability. (You have that.)

#2. Current diagnosis of condition claimed. (You have that.)

#3. Obtain a nexus of opinion that states the minimum threshold as follows:

The veteran's claimed condition is "at least as likely as not" (equal to or greater than 50% probability) due to or the result of the veteran's service-connected PTSD.

A rationale will be required to be included.

 

[pyrotaz]

Sorry, I've taken so long to respond have a lot going on. Doc25 I was looking at the DBQ form for hypertension and attempting to figure out how they rate it. If my Doctor writes a nexus letter and fills out the DBQ without having me stop my medications to do the 3-5 day multi readings they would like: 

and covers the following

#1. Current service connected disability. (You have that.)

#2. Current diagnosis of condition claimed. (You have that.)

#3. Obtain a nexus of opinion that states the minimum threshold as follows:

The veteran's claimed condition is "at least as likely as not" (equal to or greater than 50% probability) due to or the result of the veteran's service-connected PTSD.

And also states he feels that my diastolic pressure would average above 130 if take off my meds. We have documented proof that on at least  five separate occasions when on a very high dose of hypertension meds my diastolic reading has been 110 which we will put in the Nexus letter. 

What sort of rating could I expect?

Thanks for everyone's help

[treysnonna]

Have they approved hypertension yet as a presumptive caused by AO?

[GBArmy]

No, they have not yet made HTN a presumptive to A.O.

However, an under secretary at the VA was quote that Wilkie will make a decision on 4 presumptives by July 1, 2019, and it is supposed to be one of the 4 to be decided. Keep your fingers crossed.