How to Get a VA Disability Rating for Hypertension

If you’re battling hypertension, also known as high blood pressure, you’re not alone.

Approximately 37% of veterans have high blood pressure, making it the most common chronic condition among veterans.

This high prevalence is often due to the physical and psychological stressors experienced during military service, such as prolonged stress, combat injuries, and exposure to hazardous substances like Agent Orange.

High blood pressure can significantly impact your health and quality of life, and it’s crucial to get the VA rating you deserve.

In this article, we’ll walk you through everything you need to know about securing a VA rating for hypertension—from understanding the condition and its symptoms to proving a service connection, navigating VA rating criteria, and preparing for your C&P exam.

Summary of Key Points

• High Prevalence of Hypertension in Veterans: Approximately 37% of veterans have high blood pressure, making it the most common chronic condition among veterans.

• Causes and Impacts: The high prevalence of hypertension in veterans is often due to physical and psychological stressors experienced during military service, such as prolonged stress, combat injuries, and exposure to hazardous substances like Agent Orange. This condition can significantly impact health and quality of life, leading to serious issues like heart disease, stroke, and kidney failure.

• VA Rating for Hypertension: The VA rates hypertension from 10% to 60% with breaks at 20% and 40% based on blood pressure readings, the need for continuous medication, and your severity of symptoms.

• Presumptive Service Connection for Hypertension: Hypertension is on the VA’s presumptive list. If diagnosed within one year of discharge, it is considered a chronic condition presumed to be related to military service. Veterans exposed to Agent Orange and Gulf War veterans with undiagnosed illnesses or MUCMI are also eligible for presumptive service connection under the PACT Act.

What is Hypertension in Veterans?

Hypertension, or high blood pressure, occurs when the force of blood against the artery walls is consistently too high.

This can lead to serious health issues, such as heart disease, stroke, and kidney failure.

For veterans, the physical and psychological stressors of military service can contribute to the development of hypertension.

Understanding how to get a VA rating for hypertension is vital for accessing proper healthcare and benefits.

Common Signs and Symptoms of Hypertension

Hypertension, often referred to as the silent killer, can sometimes present with noticeable symptoms, particularly when blood pressure levels are very high.

However, some veterans might not have any noticeable symptoms.

Here are the most common symptoms associated with hypertension:

• Headaches: Persistent or severe headaches can be a symptom, especially if blood pressure is very high.

• Dizziness: Feeling lightheaded or dizzy is another common symptom.

• Shortness of Breath: Difficulty breathing can occur, particularly during physical activity.

• Chest Pain: Experiencing chest pain or a feeling of tightness in the chest.

• Blurred Vision: Vision problems, such as blurred or double vision.

• Nausea and Vomiting: These can occur, especially in severe cases of hypertension.

• Fatigue: Feeling unusually tired or fatigued.

• Confusion: Difficulty concentrating or feeling confused.

• Nosebleeds: Frequent or unexplained nosebleeds.

• Irregular Heartbeat: Experiencing palpitations or an irregular heartbeat.

• Buzzing in the Ears: Tinnitus or a ringing/buzzing sound in the ears.

If you experience any of these symptoms, especially in conjunction with high blood pressure readings, it’s crucial to seek medical attention immediately.

How Do I Prove Hypertension is Connected to Military Service?

To establish service connection for hypertension, you need to provide the VA with evidence linking your condition to military service or another service-connected disability.

This process involves proving The Caluza Triangle, which includes:

• Medical Diagnosis: A current medical diagnosis of hypertension must be present in your medical records. Without a medical diagnosis, you cannot establish a service connection.

• In-Service Event, Injury, Disease, Presumption, or Aggravation: You need to provide evidence of an event, injury, disease, presumption, or aggravation that occurred during your military service that could have caused or worsened your hypertension. This could include documented high blood pressure readings, exposure to hazardous substances, or stressful events during active duty.

• Nexus (Link Between Diagnosis and In-Service Event): Competent medical evidence must establish a nexus, or link, between the current diagnosis of hypertension and the in-service event, injury, or disease. This often requires a detailed medical opinion or nexus letter from a healthcare provider that explains how your military service likely caused or aggravated your hypertension. If you have been out of the military for more than a year, it is highly recommended to get a nexus letter from a private healthcare provider and submit it with your claim. This letter should state that it is “at least as likely as not” that your hypertension is related to your service.

VA Disability Rating for Hypertension Explained

Here’s a simple rating chart for VA ratings for hypertension:

The VA rates hypertension (high blood pressure) under 38 CFR § 4.104, Diagnostic Code 7101, based on the severity of your symptoms.

The ratings are determined by your blood pressure readings and the need for continuous medication.

Here is a detailed breakdown of the rating criteria:

10% VA Rating for Hypertension:

• Diastolic Pressure Predominantly 100 or More: Diastolic pressure (the bottom number in a blood pressure reading) measures the pressure in your arteries when your heart rests between beats. A diastolic reading of 100 or more qualifies for a 10% rating.

• Systolic Pressure Predominantly 160 or More: Systolic pressure (the top number) measures the pressure in your arteries when your heart beats. A systolic reading of 160 or more also qualifies for a 10% rating.

• Requiring Continuous Medication: If you have a history of diastolic pressure predominantly 100 or more and require continuous medication to control your blood pressure, you are eligible for a 10% rating.

20% VA Rating for Hypertension:

• Diastolic Pressure Predominantly 110 or More: A diastolic reading of 110 or more increases the severity and thus the rating.

• Systolic Pressure Predominantly 200 or More: A systolic reading of 200 or more also meets the criteria for a 20% rating.

40% VA Rating for Hypertension:

• Diastolic Pressure Predominantly 120 or More: This higher diastolic reading indicates a more severe level of hypertension, qualifying for a 40% rating.

60% VA Rating for Hypertension:

• Diastolic Pressure Predominantly 130 or More: The highest rating for hypertension is given when the diastolic pressure is predominantly 130 or more, reflecting severe hypertension.

Hypertension and Presumptive Service Connection

Yes, hypertension is on the VA’s presumptive list.

If hypertension is diagnosed within one year of discharge, it is considered a chronic condition and is presumed to be related to military service, making it eligible for VA disability benefits.

For veterans exposed to Agent Orange, hypertension is now recognized as a presumptive condition under the PACT Act, meaning they may qualify for benefits without needing to prove a direct connection.

Additionally, for Gulf War veterans, hypertension can be considered part of the broader category of undiagnosed illnesses or medically unexplained chronic multi-symptom illnesses (MUCMI) linked to service in the Gulf War region.

What to Expect During a C&P Exam for Hypertension

Your C&P exam for hypertension is mission critical for securing the VA disability benefits you deserve.

C&P exams can be conducted in-person, via video teleconference, phone call, or through a records-only review (ACE exam).

Here’s what you can expect at your hypertension C&P exam:

• Review of Medical Records: The examiner will review your medical records, including your hypertension diagnosis, treatments, and any related conditions.

• Interview and Questions: You’ll be asked about your medical history, current symptoms (e.g., headaches, dizziness), and various treatments or medications.

• Physical Examination: The examiner will take multiple blood pressure readings and may assess other vital signs. Blood pressure must be measured on at least three different days to confirm hypertension.

• Functional Impairment: The examiner will ask how hypertension affects your daily activities and work.

• Lifestyle Factors: Questions about diet, exercise, smoking, and alcohol use will be discussed as they affect blood pressure.

• Assessment of Complications: If you have related complications like heart or kidney disease, the examiner will evaluate these.

The findings, including blood pressure readings and any functional limitations, will be documented on the Hypertension Disability Benefits Questionnaire (DBQ) and submitted to the VA for processing.

Hypertension and VA Disability: Frequently Asked Questions (FAQs)

What is hypertension and how is it defined for VA disability purposes?

Hypertension, or high blood pressure, occurs when the force of blood against the artery walls is consistently too high. For VA disability purposes, hypertension is defined as a condition where the diastolic blood pressure is predominantly 90mm or higher, or the systolic blood pressure is predominantly 160mm or higher with a diastolic pressure below 90mm.

How common is hypertension among veterans?

Very common. Approximately 37% of veterans have high blood pressure, making it the most common chronic condition among veterans. This high prevalence is often due to the physical and psychological stressors experienced during military service, such as prolonged stress, combat injuries, and exposure to hazardous substances like Agent Orange.

What symptoms should I monitor to detect hypertension early?

Common symptoms of hypertension include persistent headaches, dizziness, shortness of breath, chest pain, blurred vision, nausea and vomiting, fatigue, confusion, nosebleeds, irregular heartbeat, and buzzing in the ears. However, many individuals with hypertension may not experience noticeable symptoms.

How can I prove that my hypertension is related to my military service?

To prove that your hypertension is service-connected, you need to provide evidence of a current diagnosis of hypertension, an in-service event, injury, or disease that could have caused or aggravated the condition, and a medical nexus linking the current diagnosis to the in-service event. This often requires a detailed medical opinion or nexus letter from a healthcare provider.

What are the VA disability ratings for hypertension?

The VA rates hypertension under Diagnostic Code 7101 from 10% to 60% with breaks at 20% and 40%, based on the severity of your symptoms: 10% rating: Diastolic pressure predominantly 100 or more, systolic pressure predominantly 160 or more, or requiring continuous medication. 20% rating: Diastolic pressure predominantly 110 or more, or systolic pressure predominantly 200 or more. 40% rating: Diastolic pressure predominantly 120 or more. 60% rating: Diastolic pressure predominantly 130 or more.

Is hypertension on the VA’s presumptive conditions list?

Yes, hypertension is on the VA’s presumptive conditions list. If diagnosed within one year of discharge, it is considered a chronic condition presumed to be related to military service. Veterans exposed to Agent Orange and Gulf War veterans with undiagnosed illnesses or medically unexplained chronic multisymptom illnesses (MUCMI) are also eligible for presumptive service connection under the PACT Act.

How do I prepare for a C&P exam for hypertension?

To prepare for your C&P exam, bring all relevant medical records, including diagnosis and treatment history. Be ready to discuss your symptoms, medical history, and any treatments or medications you are taking. Understand that the examiner will take multiple blood pressure readings and may assess other vital signs.

What lifestyle factors can influence hypertension?

Several lifestyle factors can influence hypertension, including diet (high salt intake can raise blood pressure), exercise (regular physical activity can help lower blood pressure), smoking (can raise blood pressure), alcohol consumption (excessive intake can increase blood pressure), and stress (chronic stress can contribute to high blood pressure).

What are the common secondary conditions associated with hypertension?

Common secondary conditions associated with hypertension include heart disease, kidney disease, stroke, and vision problems. If your hypertension causes or worsens other conditions, you can apply for secondary service connection.

Can I get a VA rating for secondary conditions related to hypertension?

Yes, if your hypertension causes or worsens other conditions, you can apply for secondary service connection. You need to provide medical evidence linking the secondary condition to your service-connected hypertension.

What should I do if my hypertension claim is denied?

If your hypertension claim is denied, you can request a review or reconsideration of the decision. Submit new and relevant evidence to support your claim, consider getting a nexus letter from a private healthcare provider, and seek assistance from a VA-accredited representative or attorney to help with your appeal.

How does the VA determine the severity of my hypertension?

The VA determines the severity of your hypertension based on your blood pressure readings and the need for continuous medication. Blood pressure must be measured on at least three different days to confirm hypertension for VA rating purposes.

Can lifestyle changes impact my hypertension VA rating?

While lifestyle changes like improving diet, exercising regularly, and reducing stress can help manage hypertension, the VA rating is primarily based on your blood pressure readings and medical evidence. Documenting these lifestyle changes and their impact on your health can support your overall claim.

How does the PACT Act affect hypertension claims for veterans exposed to Agent Orange?

The PACT Act recognizes hypertension as a presumptive condition for veterans exposed to Agent Orange. This means that veterans who develop hypertension after exposure to Agent Orange may qualify for VA disability benefits without needing to prove a direct connection between their hypertension and military service.

How can I monitor my blood pressure to support my VA claim?

Regularly monitoring your blood pressure at home and keeping a log of your readings can support your VA claim. Ensure that readings are taken at consistent times and under similar conditions to provide accurate data. Share this log with your healthcare provider and during your C&P exam to strengthen your case.

What role does a nexus letter play in my hypertension VA claim?

A nexus letter is a detailed medical opinion from a healthcare provider that explains the connection between your hypertension and your military service. It is crucial for establishing the nexus required for service connection, especially if your diagnosis occurred after discharge. The letter should state that it is “at least as likely as not” that your hypertension is related to your service.

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About the Author

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Brian Reese

Brian Reese is a world-renowned VA disability benefits expert and the #1 bestselling author of VA Claim Secrets and You Deserve It. Motivated by his own frustration with the VA claim process, Brian founded VA Claims Insider to help disabled veterans secure their VA disability compensation faster, regardless of their past struggles with the VA. Since 2013, he has positively impacted the lives of over 10 million military, veterans, and their families.

A former active-duty Air Force officer, Brian has extensive experience leading diverse teams in challenging international environments, including a combat tour in Afghanistan in 2011 supporting Operation ENDURING FREEDOM.

Brian is a Distinguished Graduate of Management from the United States Air Force Academy and earned his MBA from Oklahoma State University’s Spears School of Business, where he was a National Honor Scholar, ranking in the top 1% of his class.