VA Disability for Hypertension (High Blood Pressure): Ratings, Evidence & Secondary Conditions

How the VA rates Hypertension (High Blood Pressure)

Hypertension (High Blood Pressure) is rated under 38 CFR 4.104, Diagnostic Code 7101 (ratings of 10%–60%). Each criterion below is transcribed verbatim from the VA rating schedule and verified against the regulation (eCFR / Cornell LII) — never paraphrased.

• 10%

  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.

• 20%

  Diastolic pressure predominantly 110 or more; or systolic pressure predominantly 200 or more.

• 40%

  Diastolic pressure predominantly 120 or more.

• 60%

  Diastolic pressure predominantly 130 or more.

Common conditions secondary to Hypertension (High Blood Pressure)

Veterans routinely under-claim because they don't know a secondary condition exists. These are commonly claimed as secondary to service-connected Hypertension (High Blood Pressure) — each is a candidate to raise with your provider, not an automatic grant, and each needs a medical nexus opinion.

• Chronic kidney disease (hypertensive nephropathy)

  Long-standing hypertension is a leading cause of chronic kidney disease (hypertensive nephropathy); commonly claimed as secondary to service-connected hypertension with a nexus opinion.

Evidence the VA looks for

A strong Hypertension (High Blood Pressure) claim ties a current diagnosis to your service with a medical nexus. The records that move a Hypertension (High Blood Pressure) claim, in priority order:

• Blood-pressure readings taken two or more times on at least three different days (38 CFR 4.104 requires this to confirm the diagnosis)
• A record showing you require continuous medication to control your blood pressure
• Treatment records establishing the diagnosis and how long you've had it
• A nexus opinion tying the hypertension to service — or, for a secondary claim, to a service-connected condition such as PTSD, sleep apnea, or diabetes

The C&P exam & the nexus

For most Hypertension (High Blood Pressure) claims the VA schedules a Compensation & Pension (C&P) exam. The examiner measures the things the rating schedule turns on and gives a medical opinion on whether your Hypertension (High Blood Pressure) is at least as likely as not connected to your service (the “nexus”). Knowing what the examiner will assess — and bringing the evidence above — is the single biggest thing you control. Prepare for the exam and check that your records support a nexus before you file.

Hypertension (High Blood Pressure) VA disability: frequently asked questions

How does the VA rate hypertension?

Hypertension is rated under 38 CFR 4.104 (Diagnostic Code 7101) at 10, 20, 40, or 60 percent, based primarily on your diastolic and systolic readings — and a minimum 10% if you have a history of diastolic pressure predominantly 100 or more and require continuous medication. See the ladder on this page for each level.

Why do I need multiple blood-pressure readings?

The rating schedule (38 CFR 4.104, Note 1) requires hypertension to be confirmed by readings taken two or more times on at least three different days. A single high reading isn't enough, so consistent documentation of your readings is important evidence.

Can hypertension be claimed as a secondary condition?

Yes. Hypertension is commonly claimed as secondary to a service-connected mental-health condition, obstructive sleep apnea, or diabetes. Each secondary claim needs a medical nexus opinion linking the hypertension to that primary condition.

What conditions are secondary to hypertension?

Long-standing hypertension is a recognized contributor to chronic kidney disease (hypertensive nephropathy) and other vascular conditions, which can be separately ratable with a nexus opinion.