Hypertension, commonly known as high blood pressure, is a chronic medical condition defined by the persistent elevation of arterial pressure. A blood pressure reading consists of two numbers: the systolic pressure (the top number) and the diastolic pressure (the bottom number). This condition is formally diagnosed when resting blood pressure consistently meets or exceeds specific thresholds, such as 140/90 or 130/80 millimeters of mercury (mmHg). When high blood pressure becomes a service-connected condition, the Department of Veterans Affairs (VA) determines a disability percentage based on its severity and impact on health.
Understanding the Criteria for Disability Evaluation
Disability evaluation for hypertension requires objective evidence of sustained, predominant high blood pressure over time, not just a single elevated reading. The condition must be confirmed by multiple measurements taken on at least three different days to establish a pattern of persistent elevation. These readings must be documented under appropriate clinical conditions to ensure accuracy and rule out temporary spikes caused by stress or other transient factors.
The evaluation process primarily considers the static blood pressure readings and the symptomatic severity, including the level of treatment required. A compensable disability rating is warranted when the condition meets the minimum threshold of severity and is linked to service. The evaluation determines if the hypertension is controlled, partially controlled, or resistant to treatment, which directly influences the final rating percentage assigned.
The VA Rating Schedule for Hypertension
The Department of Veterans Affairs rates hypertensive vascular disease under Diagnostic Code 7101, basing the evaluation on specific, sustained blood pressure measurements. A rating of 60 percent, the highest available based on blood pressure numbers alone, is assigned when the diastolic pressure is predominantly 130 mmHg or more. This level indicates severe, sustained hypertension that is highly resistant to medical intervention.
A rating of 40 percent is warranted if the diastolic pressure remains predominantly at 120 mmHg or more. A 20 percent rating is assigned when the diastolic pressure is predominantly 110 mmHg or greater, or when the systolic pressure is predominantly 200 mmHg or greater. These ratings reflect a moderate to severe level of hypertension requiring continuous medical management.
The minimum compensable rating of 10 percent is given when the diastolic pressure is predominantly 100 mmHg or more, or the systolic pressure is predominantly 160 mmHg or more. A 10 percent evaluation is also assigned as a minimum for any individual who requires continuous medication for control and has a history of diastolic pressure predominantly 100 mmHg or more. If the hypertension is fully controlled by medication with readings below the 10 percent threshold, a non-compensable 0 percent rating is assigned.
How Secondary Conditions Impact the Final Rating
While hypertension is rated based on blood pressure measurements, the most significant disability ratings often arise from secondary conditions caused by its long-term effects. Uncontrolled high blood pressure damages blood vessels throughout the body, leading to systemic complications that are rated separately and often at much higher percentages. These conditions are considered secondary to the service-connected hypertension.
Common secondary conditions include hypertensive heart disease, which can manifest as left ventricular hypertrophy or heart failure. Chronic kidney disease (nephropathy) is another frequent complication, as high pressure damages the filtering units of the kidneys, potentially leading to renal failure. Cerebrovascular accidents (strokes) are also directly linked to hypertension and are rated based on the resulting neurological and physical deficits.
Each secondary condition is evaluated independently under its respective diagnostic code. The final combined disability rating is calculated using the VA’s specific rounding rules, which prevents “pyramiding”—rating the same impairment under multiple conditions. Ultimately, a veteran’s highest combined rating reflects the organ damage and functional impairment caused by the condition, rather than the blood pressure numbers alone.
Necessary Medical Evidence and Documentation
Successfully claiming a disability rating for hypertension requires submitting comprehensive and continuous objective medical evidence. This documentation must include a formal diagnosis from a qualified healthcare provider and a history of repeated blood pressure measurements demonstrating sustained severity. Records of ongoing treatment, including medication names, dosages, and physician’s notes on treatment efficacy, are also necessary.
A Compensation and Pension (C\&P) examination, conducted by a VA-assigned clinician, is a standard requirement to confirm the diagnosis and assess the current functional impact. For service connection, the applicant must provide a medical opinion, often called a nexus letter, that explicitly links the onset or aggravation of hypertension to military service. The strength of the claim depends on this objective proof showing the severity of the condition and its connection to service.