Hypertension, or high blood pressure, is a common health concern among veterans that can qualify for disability compensation through the U.S. Department of Veterans Affairs (VA). The VA assigns a disability rating based on the condition’s severity, primarily evaluated through specific blood pressure measurements, to determine the level of monthly benefits a veteran receives. Understanding the criteria involves knowing the administrative steps and the medical thresholds the VA uses to assess the condition’s impact.
Requirement for Service Connection
Before the VA assigns a disability percentage for hypertension, the condition must be formally connected to the veteran’s military service. Establishing a service connection requires three elements: a current diagnosis of hypertension, evidence of an event or injury during service, and a medical link between the two. The diagnosis must be supported by medical records showing multiple elevated blood pressure readings over time, often requiring at least two readings on three different days to confirm the condition’s chronic nature.
Service connection can be established in several ways. A direct service connection applies if hypertension was diagnosed during active duty or shortly after separation. If the condition developed years later, a medical opinion, often called a nexus letter, is necessary to link the current diagnosis to the veteran’s time in service. This letter must state that it is “at least as likely as not” that the hypertension is related to military service.
Connection can also be established through aggravation, where a pre-existing condition worsened beyond its natural progression due to military service. Furthermore, hypertension is sometimes considered presumptively service-connected, particularly for veterans exposed to certain environmental hazards like Agent Orange or those diagnosed within a year of discharge. Presumptive status removes the requirement for the veteran to provide a nexus letter, simplifying the initial claims process.
Rating Schedule Based on Blood Pressure Measurement
The VA evaluates hypertension under Diagnostic Code 7101 within the Schedule for Rating Disabilities, which sets specific criteria for assigning disability percentages. Ratings are determined by sustained blood pressure readings, focusing on the diastolic (bottom) and systolic (top) numbers. These readings are typically taken during a Compensation and Pension (C&P) examination or drawn from the veteran’s comprehensive medical records.
The highest direct rating for hypertension is 60%, assigned when the veteran’s diastolic pressure is predominantly 130 mmHg or higher. A 40% rating is given for a diastolic pressure that is predominantly 120 mmHg or more. These percentages reflect the increased strain on the cardiovascular system and the elevated risk of organ damage associated with sustained high pressures.
Lower severity levels correspond to the 20% and 10% ratings. The 10% rating is also the minimum evaluation for any veteran whose hypertension requires continuous medication for control, provided the readings meet the 10% threshold.
Rating Criteria
- 20% rating: Diastolic pressure is 110 mmHg or more, or systolic pressure is 200 mmHg or more.
- 10% rating: Diastolic pressure is 100 mmHg or more, or systolic pressure is 160 mmHg or more.
Secondary Conditions Caused by Hypertension
While the direct rating for hypertension is capped at 60%, the condition often leads to other health issues that can result in a much higher overall disability rating. These are known as secondary conditions, which occur when a service-connected disability causes or aggravates a separate, non-service-connected condition. The damage caused by long-term, uncontrolled high blood pressure can affect various organ systems, which are then rated separately under their own diagnostic codes.
Common secondary conditions include various forms of cardiovascular disease, such as hypertensive heart disease or left ventricular hypertrophy, which is the thickening of the heart muscle. Hypertension is also a significant contributor to chronic kidney disease, where the high pressure damages the small blood vessels in the kidneys, impairing their ability to filter waste. These kidney complications can be rated as high as 100% depending on the level of functional impairment or the need for dialysis.
Neurological conditions like stroke and certain eye disorders, such as retinopathy, can also develop as a consequence of sustained high blood pressure. The rating for the secondary condition often supersedes the rating for hypertension itself, as the VA avoids “pyramiding,” or assigning multiple ratings for the same manifestation. Instead, the VA grants the rating for the secondary condition that captures the most significant functional impairment.