{"page":"https://casescribe.ai/explorer/secondary/hypertension-secondary-to-psychiatric-disorder","generated_at":"2026-10-03T18:34:30.515Z","data_as_of":{"decisions":944125,"first_year":2017,"last_year":2026,"latest_decision":"2026-04-30","cfr":"2026-10-01","m21":"2026-09-29"},"about":{"publisher":"CaseScribe AI (VA Law Explorer)","source":"Public Board of Veterans' Appeals decisions (appeals of VA decisions, not VA's first decisions), M21-1 Adjudication Procedures Manual, 38 CFR Parts 3 and 4.","method":"Outcomes are issue-level: each condition the Board decided in a decision counts once. Decision data is extracted by AI and can contain errors. Rates describe past appeals and do not predict any claim.","disclaimer":"For research only. CaseScribe AI is not a law firm and this is not legal advice. Verify figures against the source decisions and regulations.","attribution":"Cite as: VA Law Explorer, CaseScribe AI, with the page URL."},"data":{"claim":"Hypertension secondary to a psychiatric disorder","secondary_condition":"Hypertension","service_connected_disability":"a psychiatric disorder","decisions":1789,"years":"2017-2026","granted_pct":18.9,"denied_pct":17.8,"remanded_pct":62,"granted_on_merits_pct":51.4,"by_year":[{"year":2017,"issues":94,"granted_pct":10.6,"denied_pct":26.6,"remanded_pct":57.4},{"year":2018,"issues":182,"granted_pct":10.4,"denied_pct":20.9,"remanded_pct":65.4},{"year":2019,"issues":187,"granted_pct":16,"denied_pct":19.8,"remanded_pct":63.6},{"year":2020,"issues":234,"granted_pct":15.8,"denied_pct":21.4,"remanded_pct":61.1},{"year":2021,"issues":224,"granted_pct":17.9,"denied_pct":23.7,"remanded_pct":56.7},{"year":2022,"issues":195,"granted_pct":18.5,"denied_pct":12.3,"remanded_pct":68.7},{"year":2023,"issues":216,"granted_pct":16.7,"denied_pct":14.4,"remanded_pct":68.1},{"year":2024,"issues":189,"granted_pct":22.2,"denied_pct":11.1,"remanded_pct":66.7},{"year":2025,"issues":188,"granted_pct":29.3,"denied_pct":12.2,"remanded_pct":58},{"year":2026,"issues":88,"granted_pct":37.5,"denied_pct":19.3,"remanded_pct":43.2}],"benefit_of_doubt_in_grants_pct":76,"evidence_on_merits":[{"evidence":"va_exam_favorable","decisions_with":211,"granted_pct_with":74,"granted_pct_without":46},{"evidence":"va_exam_unfavorable","decisions_with":1363,"granted_pct_with":48,"granted_pct_without":70.7},{"evidence":"nexus_positive","decisions_with":430,"granted_pct_with":84.8,"granted_pct_without":23.9},{"evidence":"nexus_negative","decisions_with":1136,"granted_pct_with":46,"granted_pct_without":65.2},{"evidence":"private_opinion","decisions_with":618,"granted_pct_with":68.4,"granted_pct_without":33.3},{"evidence":"treating_physician","decisions_with":105,"granted_pct_with":71.2,"granted_pct_without":49.8},{"evidence":"lay_statement","decisions_with":1360,"granted_pct_with":43.8,"granted_pct_without":85.8},{"evidence":"buddy_statement","decisions_with":49,"granted_pct_with":50,"granted_pct_without":51.5},{"evidence":"combat_service","decisions_with":87,"granted_pct_with":48.3,"granted_pct_without":51.6}],"top_reasons":{"granted":[{"reason":"caused by the service-connected disability","decisions":61},{"reason":"current diagnosis established","decisions":44},{"reason":"service connection established","decisions":36},{"reason":"aggravated by the service-connected disability","decisions":20},{"reason":"hypertension diagnosed","decisions":5},{"reason":"service records negative or silent","decisions":4}],"denied":[{"reason":"va examiner: less likely than not related to service","decisions":67},{"reason":"no in-service complaints, treatment or diagnosis","decisions":47},{"reason":"service records negative or silent","decisions":35},{"reason":"preponderance of the evidence against the claim","decisions":29},{"reason":"aggravated by the service-connected disability","decisions":13},{"reason":"no current diagnosis","decisions":13}]},"recent_examples":{"granted":[{"case_id":"A26038343","year":2026,"judge":"YVETTE R. WHITE","rationale":"New and relevant evidence submitted in December 2024 warranted readjudication.; In-service elevated blood pressure readings noted.; Veteran provided competent and credible lay statements of continuity of symptomatology.; Evidence found to be in equipoise, resolving doubt in Veteran's favor."},{"case_id":"A26037676","year":2026,"judge":"R. FEINBERG","rationale":"Competent diagnosis of hypertension since October 1999.; Presumed herbicide exposure due to Vietnam service.; Probiric February 2020 VA examiner opinions linking anxiety/PTSD to hypertension.; Resolving all doubt in Veteran's favor."},{"case_id":"A26035885","year":2026,"judge":"G. A. WASIK","rationale":"Hypertension diagnosed.; Evidence divided on secondary link to depression.; VA opinion found unlikely due to pre-existing depression; Board found opinion limited.; Private opinion supported link.; Approximate balance of evidence invoked benefit of doubt."}],"denied":[{"case_id":"A26039336","year":2026,"judge":"RAY BARTO SLABBEKORN, JR.","rationale":"No evidence of in-service chronicity, manifestation within presumptive period, or continuity of symptomatology.; Service treatment records silent regarding hypertension; post-service diagnosis years later.; No evidence of herbicide exposure to support presumptive claim."},{"case_id":"A26039704","year":2026,"judge":"J.P. NORMAN","rationale":"No competent positive nexus opinion; VA examiner opined less likely than not caused by toxic exposure; Hypertension attributed to lifestyle factors"},{"case_id":"A26034578","year":2026,"judge":"J. KIRBY","rationale":"No in-service hypertension diagnosis; Negative VA nexus opinion; Psychiatric condition not service-connected"}]},"how_argued":{"note":"From keyword matches in each issue's AI summary and rationale, not the full decision. Only issues whose text names a medical link are counted under pathways; one issue can name several. A link named in a denial was often the argument the Board rejected.","issues":1797,"aggravation_discussed":{"issues":743,"granted_pct":16.7},"causation_only":{"issues":1054,"granted_pct":20.3},"issues_naming_a_pathway_pct":18,"pathways":[{"pathway":"Weight gain or obesity","issues":159,"granted_pct":25.8,"examples":[{"case_id":"26004219","year":2026,"outcome":"GRANTED","quote":"Obesity as intermediate step"},{"case_id":"26000629","year":2026,"outcome":"DENIED","quote":"Hypertension attributed to genetics, obesity, and lifestyle.."}]},{"pathway":"Stress","issues":109,"granted_pct":23.9,"examples":[{"case_id":"A26028875","year":2026,"outcome":"GRANTED","quote":"Private medical opinion linked hypertension to service-connected PTSD and in-service stressors"},{"case_id":"26000629","year":2026,"outcome":"DENIED","quote":"The Veteran sought service connection for hypertension, claiming it was secondary to his service-connected bowel issues and stress."}]},{"pathway":"Chronic pain","issues":24,"granted_pct":50,"examples":[{"case_id":"26002222","year":2026,"outcome":"GRANTED","quote":"December 2025 VA examiner found chronic pain can worsen hypertension via sympathetic nervous system activation and sleep issues.."},{"case_id":"23003290","year":2023,"outcome":"DENIED","quote":"Private opinion lacked rationale for nexus to chronic pain."}]},{"pathway":"Sleep disruption","issues":24,"granted_pct":20.8,"examples":[{"case_id":"A25037550","year":2025,"outcome":"GRANTED","quote":"Service-connected for persistent depressive disorder with alcohol use disorder and insomnia."},{"case_id":"A25021919","year":2025,"outcome":"DENIED","quote":"Veteran has current hypertension and service-connected insomnia/anxiety/alcohol use disorder."}]},{"pathway":"Medication side effects","issues":16,"granted_pct":25,"examples":[{"case_id":"25011081","year":2025,"outcome":"GRANTED","quote":"The Board found that while VA examinations were inadequate or did not fully address the veteran's risk factors, the May 2020 opinion noting a nexus to NSAID and alcohol use related to service-connected conditions raised reasonable..."},{"case_id":"20043214","year":2020,"outcome":"DENIED","quote":"The veteran claimed entitlement to service connection for hypertension, alleging it was secondary to his service-connected depression and joint disabilities, potentially due to medication side effects."}]},{"pathway":"Reduced activity or mobility","issues":12,"granted_pct":0,"examples":[{"case_id":"23013980","year":2023,"outcome":"DENIED","quote":"Service connection for hypertension was denied, claimed as secondary to obesity caused by inactivity due to the service-connected back condition and/or acquired psychiatric disorder."}]}]},"how_va_rates":{"citation":"38 CFR 4.104","diagnostic_code":"7101","name":"Hypertensive vascular disease (hypertension and isolated systolic hypertension)","url":"https://www.ecfr.gov/current/title-38/section-4.104","levels":[{"criteria":"Diastolic pressure predominantly 130 or more","rating":60},{"criteria":"Diastolic pressure predominantly 120 or more","rating":40},{"criteria":"Diastolic pressure predominantly 110 or more, or; systolic pressure predominantly 200 or more","rating":20},{"criteria":"Diastolic pressure predominantly 100 or more, or; systolic pressure predominantly 160 or more, or; minimum evaluation for an individual with a history of diastolic pressure predominantly 100 or more who requires continuous medication for control","rating":10}],"notes":["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.","Note (2): Evaluate hypertension due to aortic insufficiency or hyperthyroidism, which is usually the isolated systolic type, as part of the condition causing it rather than by a separate evaluation.","Note (3): Evaluate hypertension separately from hypertensive heart disease and other types of heart disease."]},"requirements":"38 CFR 3.310: a current diagnosis, a service-connected disability, and medical evidence that it caused (3.310(a)) or aggravated (3.310(b)) the condition."}}