10-13 832, 10-13 832

Background

Veteran served active duty 1969–1972 and 1982–1983; claim for service-connected hypertension granted but appeal concerns initial compensable rating.
RO decision from June 2008; Board denied compensable rating in May 2016; CAVC partially vacated and remanded in Feb 2017 limited to hypertension rating issues.
Medical record shows elevated BP readings in Feb 2006 (multiple diastolic readings ≥100 and systolics >160), variable readings thereafter, and continuous antihypertensive medication (Benicar) beginning Jan 2009.
Post-2009 readings are predominantly below Diagnostic Code thresholds (diastolic <100, systolic <160), with one diastolic 101 in March 2012 while on medication.
Board found the preponderance of evidence that, throughout the rating period, diastolic pressure was predominantly below 100 and systolic predominantly below 160, and that VA satisfied its notice and assistance duties.
Board concluded schedular criteria adequately describe the disability; denied an initial compensable (10% or higher) rating and denied extraschedular referral.

Issues

Issue	Plaintiff's Argument	Defendant's Argument	Held
Entitlement to an initial compensable rating for hypertension (≥10%)	Veteran argued BP readings and treatment show compensable hypertension; pointed to multiple high readings in 2006 and history of treatment starting Feb 2006.	VA/Board argued readings across the rating period are predominately below DC 7101 thresholds; medication began in 2009 and post-medication readings do not meet higher criteria.	Denied: preponderance of evidence shows diastolic predominantly <100 and systolic predominantly <160; no compensable rating warranted.
Whether Feb 2006 and other records create predominance of BP ≥criteria	Veteran relied on several Feb 2006 readings ≥100 diastolic and some systolics >160.	Board noted many readings before and after Feb 2006 were below thresholds; predominance standard not met.	Board found Feb 2006 readings isolated; overall predominance not established.
Effect of continuous medication (post‑2009) on rating	Veteran noted continuous medication for control since 2009, which can support a 10% minimum in some cases.	Board acknowledged medication but found post‑2009 BP readings still below systolic/diastolic thresholds required for a compensable rating.	Medication does not, by itself here, trigger a compensable rating because the ‘‘predominantly’’ threshold was not met.
Extraschedular evaluation/referral under 38 C.F.R. §3.321	Veteran implicitly argued current schedular rating inadequate given symptoms (e.g., headaches).	Board argued symptoms fit within schedular criteria (DC 7101 evaluates by BP readings); no exceptional/unusual picture or related-factor showing inadequacy.	Denied: no exceptional disability picture; schedular criteria adequately describe the Veteran’s hypertension.

Key Cases Cited

Thun v. Peake, 572 F.3d 1366 (Fed. Cir. 2009) (affirming that extraschedular referral requires comparison showing schedular criteria inadequate)
Johnson v. McDonald, 762 F.3d 1362 (Fed. Cir. 2014) (extraschedular relief may be required when combined effects of multiple conditions create exceptional disability not captured by individual ratings)