Hypertension grants at the Board more than doubled between 2018 and 2025

The Board of Veterans' Appeals granted hypertension claims in 24.3% of its decisions in 2024 and 2025, up from 10.7% in 2018 and 2019. The grant share rose 13.6 percentage points over that span, while the share of remands fell.

The figures come from 49,650 Board decisions on hypertension from 2018 to 2026. Across all years, the Board granted 18.3% of these claims, denied 31.5% and remanded 49.6%.

Share of decisions each year. 2026 is a partial year.

A jump after 2021

The rise was not steady. Grants stayed in a narrow band for four years: 10.2% in 2018, 11.2% in 2019, 11.6% in 2020 and 13.8% in 2021. They then climbed to 21.7% in 2022 and 28.6% in 2023, the high point. Since then the share has stayed below that peak: 25.6% in 2024, 23.0% in 2025 and 25.7% in 2026 so far.

Remands moved the other way. They peaked at 55.4% in 2019 and fell to 40.6% in 2025.

Fewer remands do not explain the whole change. Setting remands aside, the Board granted 23.1% of the claims it decided on the merits in 2018 and 2019, and 42.2% in 2024 and 2025. When the Board reached the merits, it said yes more often. The data does not show why.

What the records held

Some evidence appears alongside much higher grant rates. With a positive nexus opinion in the record, the Board granted on the merits in 65.6% of decisions; without one, in 29.6%. With a favorable VA exam, the rate was 59.6%, against 32.6% without one.

Opinions from outside VA also track with higher rates. A treating physician opinion came with a merits grant rate of 51.8%, compared with 35.8% without. For a private medical opinion, the figures were 44.3% and 32.8%.

Claims framed as secondary service connection under 38 CFR 3.310 were granted on the merits in 48.4% of decisions, compared with 33.8% for other claims.

Not every kind of evidence points up. Records with an unfavorable VA exam were granted in 33.4%, against 48.9% without one. Records with a lay statement were granted in 32.4%, lower than the 50.5% for records without one, while buddy statements came with a higher rate, 50.9% against 36.4%. The data does not explain that split.

In the recordNot in the record

Positive nexus opinion

65.6%

29.6%

Favorable VA exam

59.6%

32.6%

Treating physician opinion

51.8%

35.8%

Combat service

50.6%

35.8%

Merits decisions only (granted or denied). Associations, not causes.

These are associations, not causes. A record that includes a positive nexus opinion may be stronger in other ways too.

Why the Board said no, and yes

The most common reason in denials was "no in-service complaints, treatment or diagnosis," cited in 1,827 denials. Next came "preponderance of the evidence against the claim," in 1,734, and a VA examiner's finding that the condition was "less likely than not related to service," in 1,467.

On the grant side, "current diagnosis established" led with 1,275 grants. "Requires continuous medication for control" appeared in 312, and "caused by the service-connected disability" in 298.

The Board applied the benefit of the doubt under 38 CFR 3.102 in 67.9% of hypertension grants. Many of these decisions turned on evidence the Board found roughly balanced, not one-sided.

Read the decisions

Recent examples, with the Board's reasons as summarized by AI:

• A26040461, granted in 2026: veteran presumed exposed to herbicide agents in Vietnam.
• A26040478, granted in 2026: favorable finding of current heart condition.
• A26040644, granted in 2026.
• 26005096, denied in 2026: no evidence of in-service incurrence or aggravation.
• 26005112, denied in 2026: hypertension claimed secondary to diabetes mellitus, which was not service-connected.
• A26040451, denied in 2026: blood pressure readings do not meet criteria for higher ratings.

For representatives

• The leading denial reason is the absence of in-service complaints or treatment. Where service records are silent, a secondary theory under 38 CFR 3.310 is one route the Board has granted, and those claims were granted on the merits in 48.4% of decisions.
• A positive nexus opinion came with a merits grant rate of 65.6%, compared with 29.6% without one. A VA examiner's negative opinion is the third most common denial reason, so check whether it addresses the veteran's actual history.
• With the benefit of the doubt applied in 67.9% of grants, building a record that is at least in balance can matter.