HYPERTENSION

H. SEESEL · 2026 · Case ID: A26040699

MIXED

Summary

The veteran, who served from November 2013 to March 2014 and April 2014 to September 2014, appeals the reduction of her 10 percent rating for hypertension. The Board reviewed the case under the Appeals Modernization Act, noting the claim was initially a Higher-Level Review but was transferred to a Supplemental Claim due to a duty to assist error. The veteran elected a Board hearing, which was held in January 2026. The Board's decision is based on evidence of record up to the September 2025 AOJ decision and evidence submitted at the hearing or within 90 days thereafter. The veteran contended that her hypertension rating should not have been reduced. The Board found that the reduction was improper because the AOJ based it solely on blood pressure readings from a single day, failing to demonstrate actual improvement in the veteran's ability to function under ordinary conditions. Therefore, the Board ordered the restoration of the 10 percent rating for hypertension effective December 1, 2025. The veteran also sought an increased rating for hypertension. The Board reviewed the criteria for higher ratings, noting the term "predominant" is not defined. Based on the evidence, including blood pressure readings from VA examinations and a self-recorded log, the Board found that the criteria for a 20 percent rating (diastolic 110+ or systolic 200+) were not met. The Board concluded that at most, the criteria for a 10 percent rating were approximated, and thus denied the increased rating.

Rationale

Reduction improper as based on single day's readings; Did not demonstrate actual improvement in functioning; Restoration of 10 percent rating warranted

Special Benefit

NO SPECIAL BENEFIT

Docket No.

250916-585223

Full Decision Text

Citation Nr: A26040699
Decision Date: 04/30/26 Archive Date: 04/30/26

DOCKET NO. 250916-585223
DATE: April 30, 2026

ORDER

Entitlement to a restoration of the 10 percent rating for the Veteran's service-connected hypertension effective December 1, 2025, is granted.

Entitlement to a rating in excess of 10 percent for hypertension is denied.

FINDINGS OF FACT

1. The evidence does not show actual improvement in the Veteran's service-connected hypertension such that there is improvement in the Veteran's ability to function under the ordinary conditions of life and work as of December 1, 2025.

2. The Veteran's hypertension has not manifest with diastolic pressure predominantly 110 or more, or; systolic pressure predominantly 200 or more.

CONCLUSIONS OF LAW

1. The reduction of the disability evaluation for the Veteran's hypertension from 10 percent to noncompensable effective December 1, 2025, was not proper, and restoration of the 10 percent rating is warranted. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.105, 3.344, 4.1, 4.2, 4.10.

2. The criteria for a rating in excess of 10 percent for hypertension have not been met. 38 U.S.C. § 1155; 38 C.F.R. §§ 3.102, 4.1-4.14, 4.104, Diagnostic Code 7101.

REASONS AND BASES FOR FINDINGS AND CONCLUSIONS

The Veteran served on active duty from November 2013 to March 2014 and April 2014 to September 2014.

The rating decision on appeal was issued in September 2025 and constitutes an initial decision; therefore, the modernized review system, also known as the Appeals Modernization Act (AMA), applies.

Although the Veteran initially requested Higher-Level Review when submitting the April 2025 VA Form 20-0996, Decision Review Request: Higher-Level Review, in July 2025, the Higher-Level Reviewer determined that there had been a duty to assist error and transferred the claim to the Supplemental Claim decision review option for additional development. A Supplemental Claim decision was issued in September 2025.

In the September 2025 VA Form 10182, Decision Review Request: Board Appeal (Notice of Disagreement), the Veteran elected the Hearing docket. A Board hearing was held in January 2026.

Therefore, the Board may only consider the evidence of record at the time of the September 2025 Agency of Original Jurisdiction (AOJ) decision, as well as any evidence submitted by the Veteran [or representative] at the hearing or within 90 days following the hearing. 38 C.F.R. §?20.302(a). If evidence was submitted either (1) during the period after the AOJ issued the September 2025 decision and prior to the Board hearing, or (2) more than 90 days following the hearing, the Board did not consider it in its decision. 38 C.F.R. §§ 20.300, 20.302(a), 20.801.

If the Veteran would like VA to consider any evidence that was submitted and the Board could not consider, the Veteran may file a Supplemental Claim (VA Form 20-0995) and submit or identify this evidence. 38 C.F.R. § 3.2501. If the evidence is new and relevant, VA will issue another decision on the claim[s], considering the new evidence in addition to the evidence previously considered. Id. Specific instructions for filing a Supplemental Claim are included with this decision.

1. Propriety of the reduction in the rating for hypertension from 10 percent to noncompensable effective December 1, 2025

The Veteran contends her rating for hypertension should not have been reduced.

Where a reduction in an evaluation of a service-connected disability is considered warranted and the lower evaluation would result in a reduction or discontinuance of compensation payments currently being made, a rating proposing the reduction or discontinuance must be prepared setting forth all material facts and reasons. VA must also notify the veteran that he has 60 days to present additional evidence showing that compensation should be continued at the present level. 38 C.F.R. § 3.105(e).

Here, the Veteran had a 10 percent rating for hypertension effective January 9, 2023. In a September 2025 rating decision, the AOJ reduced the Veteran's hypertension rating from 10 percent to noncompensable effective December 1, 2025. The Veteran's combined rating both prior to
-connected disability is considered warranted and the lower evaluation would result in a reduction or discontinuance of compensation payments currently being made, a rating proposing the reduction or discontinuance must be prepared setting forth all material facts and reasons. VA must also notify the veteran that he has 60 days to present additional evidence showing that compensation should be continued at the present level. 38 C.F.R. § 3.105(e).

As the September 2025 rating decision did not result in a reduction or discontinuance of compensation payments, the RO was not required to provide the Veteran with a rating decision proposing the reduction or discontinuance setting forth all material facts and reasons and provide her 60 days to present additional evidence showing that compensation should be continued at the present level. See e.g., Reizenstein v. Peake, 22 Vet. App. 202, 207-08 (2008) (explaining the purpose was to protect veterans who had come to rely on disability ratings and the compensation attached thereto, already in effect from arbitrary reductions); O'Connell v. Nicholson, 21 Vet. App. 89, 93 (2007) (holding that 38 U.S.C. § 5112(b)(6) and 38 C.F.R. § 3.105(e) do not apply in the context of the assignment of a staged rating where the Veteran's total disability rating is not reduced, for any period of time, to a level below that which was in effect); VAOPGCPREC 71-1991 (noting the pre-reduction procedures required by 38 C.F.R. § 3.105(e) do not apply to all rating reductions, but only to those rating reductions, which result in a reduction or discontinuance of compensation payments currently being made.)

Therefore, there was compliance with all requisite procedural matters, and the Board will proceed to determine whether the reduced rating was supported by the evidence at the time of the rating decision.

In a rating reduction, not only must it be determined that an improvement in a disability has actually occurred, but also that the improvement actually reflects an improvement in a veteran's ability to function under the ordinary conditions of life and work. Brown v. Brown, 5 Vet. App. 413, 420-21 (1994); Schafrath v. Derwinski, 1 Vet. App. 589, 594 (1991).

The provisions of 38 C.F.R. §§ 4.1, 4.2, and 4.10 require that a reduction in rating be based upon review of the entire history of a veteran's disability. VA must then ascertain whether the evidence reflects an actual change in the disability and whether the examination reports reflecting such change are based on thorough examinations. Faust v. West, 13 Vet. App. 342 (2000). The examination reports on which the reduction is based must be adequate. See Tucker v. Derwinski, 2 Vet. App. 201 (1992).

In addressing whether improvement is shown, the comparison point generally is the last examination on which the rating at issue was assigned or continued. See Hohol v. Derwinski, 2 Vet. App. 169 (1992). Where, however, the rating was continued in order to see if improvement was in fact shown, the comparison point could include prior examinations as well. Collier v. Derwinski, 2 Vet. App. 247 (1992).

Specific requirements must be met in order for VA to reduce certain ratings assigned for service-connected disabilities. See 38 C.F.R. § 3.344; see also Dofflemyer v. Derwinski, 2 Vet. App. 277 (1992).

The Veteran's 10 percent rating had been in effect for less than five years, therefore the provisions of 38 C.F.R. § 3.344(a) do not apply.

Under the provisions of 38 C.F.R. § 3.344(c), when a disability rating has been in effect for less than five years, a reexamination that shows improvement in a disability warrants a reduction in disability benefits. Specifically, it is necessary to ascertain, based upon a review of the entire recorded history of the condition, whether the evidence reflects an actual change in disability and whether examination reports reflecting change are based upon thorough examinations. In addition, it must be determined that an improvement in a disability has actually occurred and that such improvement actually reflects an improvement in the Veteran's ability to function under the ordinary conditions of life and work. See Brown at 420-421 (citing 38 C.F.R. §§ 4.1, 4.2, 4.10, and 4.13); 38 C.F.R. § 3.344(c).

A veteran's disability evaluation will not be reduced unless an improvement in the disability is shown to have occurred. 38 U.S.C. § 1155.

Under Diagnostic Code 7101, a 10 percent rating is warranted for 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. 38 C.F.R. § 4.104.

The Veteran's 10 percent rating was originally granted after a February 2023 VA examination. At that examination, the Veteran reported taking three different medications for her blood pressure and the Veteran had blood pressure readings of 161/96, 159/94, and 162/89. The AOJ stated that the basis of the grant of a 10 percent rating was that the Veteran's systolic pressure was predominantly 160 or more.

In February 2025, the Veteran underwent another VA examination. At that examination the Veteran reported taking three different medications for her blood pressure and the Veteran had blood pressure readings of 167/100, 146/99, and 142/92.

Finally, in August 2025, the Veteran underwent another VA examination after which the AOJ reduced her rating from 10 percent to noncompensable. At that examination, the Veteran had blood pressure readings of 137/88, 128/86, and 132/90. This examination reported the Veteran continued to take medication for her hypertension.

VA treatment records reflect some changes in the Veteran's medication dosages for blood pressure over the years. Records reflect that she had a reading of 180/90 at a June 2024 VA appointment and reported that her blood pressure at home had been in the 180's over 100s recently. A smattering of other readings include blood pressure readings below 160 systolic.

In the September 2025 rating decision reducing the Veteran's rating, the AOJ stated that the August 2025 examination showed an improvement in the Veteran's condition over the February 2023 and February 2025 VA examinations. The AOJ did not discuss any other blood pressure readings or evidence other than the blood pressure readings from the VA examinations.

The burden is on VA to justify a reduction in a rating. See Brown v. Brown, 5 Vet. App. 413 (1993).

The Board finds that actual improvement in the Veteran's service-connected hypertension such that there is improvement in the Veteran's ability to function under the ordinary conditions of life and work has not been shown. Instead, the AOJ based the reduction on blood pressure readings taken on a single day.

Based on the foregoing, the Board finds that the reduction was not proper and reinstatement of the 10 percent rating is warranted.

2. Entitlement to a rating in excess of 10 percent for hypertension

The Veteran has claimed an increased rating for her service-connected hypertension.

As the Board has found above that a reinstatement of the 10 percent rating effective December 1, 2025 is warranted, the Board will now consider whether a rating in excess of 10 percent is warranted.

Hypertension is rated pursuant to 38?C.F.R. §?4.104, Diagnostic Code (DC) 7101, for hypertensive vascular disease (hypertension and isolated systolic hypertension). Under DC 7101, a 10 percent rating is warranted for diastolic pressure predominantly 100 or more, or; systolic pressure predominantly 160 or more, or; it is the minimum evaluation for an individual with a history of diastolic pressure predominantly 100 or more who requires continuous medication for
Board has found above that a reinstatement of the 10 percent rating effective December 1, 2025 is warranted, the Board will now consider whether a rating in excess of 10 percent is warranted.

Hypertension is rated pursuant to 38?C.F.R. §?4.104, Diagnostic Code (DC) 7101, for hypertensive vascular disease (hypertension and isolated systolic hypertension). Under DC 7101, a 10 percent rating is warranted for diastolic pressure predominantly 100 or more, or; systolic pressure predominantly 160 or more, or; it is the minimum evaluation for an individual with a history of diastolic pressure predominantly 100 or more who requires continuous medication for control. A 20 percent rating is warranted for diastolic pressure predominantly 110 or more, or systolic pressure predominantly 200 or more. A 40 percent rating is warranted for diastolic pressure predominantly 120 or more and a 60 percent rating is warranted for diastolic pressure predominantly 130 or more.

The term "predominant" is not defined in the rating criteria. Merriam-Webster defines predominant to mean "being most frequent or common." See, e.g., "predominant," Merriam-Webster.com Online Dictionary, https://www.merriam-webster.com/dictionary/predominant.

The Board finds that the evidence is persuasive that a rating in excess of 10 percent is not warranted.

At her January 2026 Board hearing, the Veteran testified that in 2025 her blood pressure was more elevated than usual and her medical treatment providers were making changes to her medication to help.

Records reflect that she had a reading of 180/90 at a June 2024 VA appointment and reported that her blood pressure at home had been in the 180's over 100s recently. VA treatment records from February 2025 include readings of 118/85 and 137/92. A May 2025 treatment records notes a reading of 149/100. In June 2025, she had readings of 125/85, 134/93, and 134/91 on one day and 126/90 on another.

On VA examination in February 2025, the Veteran had blood pressure readings of 167/100, 146/99, and 142/92. She was noted to be taking medication and not to have a history of a diastolic BP elevation to predominantly 100 or more.

On VA examination in August 2025, the Veteran had blood pressure readings of 137/88, 128/86, and 132/90.

The Veteran submitted a blood pressure log where she reported she recorded a reading she took herself every day during September 2025. The log reflects systolic readings between 160 and 190 and diastolic readings between 78 and 90.

As no records reflect that the Veteran's hypertension manifested in diastolic pressure predominantly 110 or more, or systolic pressure predominantly 200 or more, during the period on appeal, the Board finds that a 20 percent rating is not warranted.

The Board finds that at most the criteria for a 10 percent rating are most closely approximated. Therefore, the Board finds that an increased rating is not warranted.

H. SEESEL

Veterans Law Judge

Board of Veterans' Appeals

Attorney for the Board A. Christensen

The Board's decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.

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