The U.S. Department of Veterans Affairs revealed that hypertension impacts more than 37% of veterans, ranking it among the most widespread chronic health issues within the veteran population. Whether your high blood pressure or hypertension developed during service or appeared years later, it’s a condition that deserves attention and possibly compensation.
In this guide, we will walk you through everything you need to know about VA disability for hypertension, from eligibility and rating criteria to establishing a service connection and securing deserved benefits.
What Is Hypertension and Its Causes for Veterans?
Hypertension, or high blood pressure, occurs when the pressure of blood against artery walls remains too high over time. Left unmanaged, it’s a silent threat that can lead to heart attacks, strokes, kidney disease, and more. According to a comprehensive study of over 4.8 million veterans, using the updated Veterans Health Administration (VHA) and Department of Defense (DoD) guideline of ≥130/90 mmHg, the prevalence of hypertension was found to be 81%.
Symptoms of Hypertension
While hypertension is often asymptomatic, especially early on, here are signs to watch for:
- Headaches
- Dizziness or lightheadedness
- Blurred vision
- Chest pain or tightness
- Shortness of breath
- Irregular heartbeat
- Blood in urine
- Fatigue
- Confusion
- Ringing in the ears (tinnitus)
Any of these, especially combined with high blood pressure, should be documented and discussed with your doctor and during your Compensation and Pension (C&P) exam.
Veterans are especially vulnerable to hypertension due to the physical, mental, and emotional demands of military service. Stress from combat, disrupted sleep schedules, exposure to toxic substances like Agent Orange, or secondary conditions like PTSD and diabetes often contribute to the development or worsening of hypertension.
VA Rating for Hypertension
The VA rates hypertension under Diagnostic Code 7101 (38 CFR § 4.104 – cardiovascular system) in the Schedule for Rating Disabilities. Ratings are based on diastolic and systolic blood pressure readings, the bottom and top numbers in a BP measurement. These VA disability ratings determine how much compensation you receive each month.
Here’s a full explanation of the VA’s hypertension rating criteria:
- 0% Rating: Presence of a service-connected diagnosis, but the blood pressure is controlled and does not meet the compensable threshold.
- 10% Rating: Diastolic pressure is predominantly 100 or more, or systolic pressure is predominantly 160 or more, or continuous medication is necessary with a documented history of diastolic pressure at or above 100.
- 20% Rating: Given when the diastolic pressure is predominantly 110 or more, or the systolic pressure is predominantly 200 or more.
- 40% Rating: Awarded when the diastolic pressure is predominantly 120 or higher.
- 60% Rating: Awarded when the diastolic pressure is predominantly 130 or above. This is the highest VA disability rating for hypertension.
For example, suppose your blood pressure reads 165/108 consistently and you are taking medication daily. In that case, you may be eligible for a 10% rating or more, depending on your medical history and additional factors.
I’m on Hypertension Medication, Can I Get a VA Rating?
Yes, but there’s a catch.
Veterans often find themselves receiving a frustrating 0% VA rating because their hypertension appears “controlled” by medication. The VA bases its rating on your current blood pressure readings while under treatment, unless you provide documentation showing your pre-treatment blood pressure levels. If your diastolic pressure was consistently over 100 before starting medication, you may qualify for a 10% or higher rating, especially with solid medical records documenting this history.
The VA’s evaluation of post-medication use can be misleading, as treatment often masks the severity of your hypertension. If your pre-treatment readings were 160/100 or higher and you are on continuous medication, you likely deserve a minimum 10% rating.
Always submit your original diagnosis, treatment history, a record of ongoing blood pressure readings, and a nexus letter from your doctor explaining that medication is critical to manage otherwise disabling hypertension.
Establishing a Direct Service Connection for Hypertension
If you are seeking VA compensation for hypertension, you will need to demonstrate that the condition is directly linked to your active duty events. Here’s the type of evidence you will need to support your claim:
- Current Diagnosis – The VA requires at least two elevated blood pressure readings (systolic 160+ or diastolic 100+) taken on three separate days.
- In-Service Event – Documentation of high BP readings or stressful events during active duty that may have triggered the condition. For example, in-service events like combat stress, toxic exposure, or other physically demanding situations.
- Medical Nexus – A nexus letter from a qualified healthcare provider helps to effectively link your current condition to your military service. This opinion must state it is “at least as likely as not” (50% or greater probability) that the hypertension began during or was caused/aggravated by military service. While formal letters may be helpful, a nexus can be established by simply attending the VA’s compensation examination. If the evidence aligns to support a positive nexus, the VA examiner will note this.
As an independent provider, Prestige Veteran specializes in writing detailed, evidence-backed nexus letters that link your condition to your service, especially when it’s been years since discharge.
Agent Orange Presumption and the PACT Act
The VA presumes certain conditions are service-connected for veterans who served in specific regions or timeframes. Under the Honoring Our PACT Act of 2022, hypertension is now recognized as a presumptive condition for those exposed to Agent Orange.
Veterans may qualify for a presumptive service connection if they served in the following locations within specific timelines:
- In Vietnam (including Blue Water Navy) between January 9, 1962 and May 7, 1975
- In Thailand on or near Royal Thai Air Force bases between January 9, 1962 and June 30, 1976
- In Laos, Cambodia, Johnston Atoll, Guam, or American Samoa during specific dates
If you were diagnosed with hypertension and served in any of these locations, the VA automatically presumes the condition is connected to your military service. Having a presumptive condition means veterans don’t have to always prove a nexus. Only providing your medical diagnosis and proof of service in the qualifying area may be sufficient.
Secondary Service Connection for Hypertension
Hypertension can oftentimes develop or aggravate due to other service-connected health issues. Veterans should know that the VA recognizes secondary service connections, which can not only support your claim for compensation but also boost your total VA disability rating.
Below are some of the conditions tied to hypertension:
- Heart Disease: Chronic high blood pressure puts strain on the heart and arteries, potentially leading to congestive heart failure, coronary artery disease, or ischemic heart disease. These debilitating service-related conditions may warrant the veteran higher VA ratings.
- Kidney Disease: Your kidneys filter waste from the bloodstream. High blood pressure damages kidney vessels, reducing their ability to filter waste effectively, leading to chronic kidney disease, renal failure, or other serious kidney conditions.
- Stroke: Elevated blood pressure can block or rupture brain vessels, triggering ischemic or hemorrhagic strokes and causing long-term cognitive, speech, or physical disabilities, which may qualify for a high disability rating.
- Vision Problems: Known as hypertensive retinopathy, high blood pressure can damage the tiny blood vessels in the eyes, leading to blurred vision or even permanent blindness.
- Cognitive Issues: In severe cases, prolonged hypertension can contribute to vascular dementia or other forms of cognitive decline.
- PTSD: Post-traumatic stress disorder raises baseline stress levels, increasing blood pressure and risk for cardiovascular disease, while hypertension can worsen anxiety and emotional regulation.
- Sleep Apnea: Sleep apnea and hypertension often co-occur; breathing disruptions during sleep increase stress hormones, raising blood pressure and worsening cardiovascular health over time.
- Diabetes: Hypertension and diabetes together multiply the risks for kidney damage, heart disease, stroke, and vision problems by stressing the blood vessels.
If you have been diagnosed with any of these conditions, it’s essential to gather medical evidence that links them to your service-connected hypertension. An independent nexus letter for a secondary service connection should state that the condition is “at least as likely as not” caused or worsened by your high blood pressure.
Filing secondary claims can increase your monthly VA compensation by raising your combined disability rating or helping you meet the eligibility criteria for TDIU, which pays at the 100% rate.
Considerations for Filing a VA Disability Claim for Hypertension
- Get Diagnosed: A formal medical diagnosis with consistent blood pressure readings is required. The VA wants BP readings from at least three separate days.
- Gather Evidence:
- Medical records showing diagnosis and treatment
- Nexus letter from a qualified provider (if applicable)
- Military treatment records, deployment records
- Complete VA Form 21-526EZ
- Submit Your Claim via VA.gov, mail, or at a VA regional office in accordance with VA guidelines.
- Attend a C&P Exam: The VA may schedule a Compensation & Pension exam to evaluate the severity of your condition and eventually determine your final VA rating.
- Track Your VA Claim: Check updates on VA.gov and be prepared to submit any additional documentation.
Mistakes to Avoid When Filing for a Hypertension VA Claim
When applying for VA disability compensation for hypertension, many veterans unintentionally make mistakes that can delay their claims, lead to low disability ratings, or even result in denial. Understanding and avoiding these common pitfalls is essential to building a strong, successful claim.
1. Inadequate Blood Pressure Readings
One of the most crucial pieces of evidence the VA looks for is consistent blood pressure readings. The VA requires at least two elevated readings showing elevated diastolic (110+) or systolic (200+) pressures on three different days to confirm a hypertension diagnosis. Make sure your records show an ongoing pattern of high blood pressure to meet the VA’s diagnostic criteria.
2. Missing or Weak Nexus
The nexus is influential evidence for many VA claims. Without a detailed medical opinion linking your hypertension to your military service or another service-connected condition, your claim may fall short. Many veterans either don’t submit one or submit vague, ineffective letters that lack medical reasoning. While never required, a supportive nexus letter from your treating doctor may be helpful. As previously stated, the VA will also provide a medical opinion at the C&P examination regarding the relationship between your diagnosed medical condition and your service.
A well-crafted nexus letter should be written by a qualified doctor, in this case, your primary care doctor or a specialist like a cardiologist or an independent medical examiner (IME).
3. Minimizing Symptoms During the C&P Exam
Unfortunately, many veterans downplay their symptoms during a C&P exam out of habit or humility. Telling the examiner that you are “doing okay” or “not too bad” can result in a lower rating. Be honest and specific about how hypertension affects your daily life, whether it’s fatigue, headaches, anxiety, or physical limitations.
4. Overlooking Secondary Service Connection
Veterans often don’t realize that hypertension may be secondary to other service-connected conditions like PTSD, diabetes, chronic kidney disease, or sleep apnea. Failing to explore these connections can significantly limit your compensation. If hypertension developed as a result of another rated condition, you are entitled to file a secondary claim that could increase your total VA disability rating.
5. Submitting Incomplete Medical Documentation
A common misstep is not submitting comprehensive medical evidence. Missing treatment records, medication history, or documentation of secondary complications like heart or kidney issues can lower your VA rating or even lead to a denial. These documents help VA understand the severity of your condition and justify a higher VA rating for hypertension.
Moreover, many veterans consider submitting VA Form 21-526EZ to request an increased disability rating. Working with a VA-accredited representative or attorney can improve your chances of receiving the VA benefits for hypertension you deserve.
Hypertension C&P Exam Process for VA Disability
The Compensation and Pension (C&P) examination for hypertension is scheduled by the VA to evaluate whether a veteran’s high blood pressure is linked to their military service and how it affects their life and employment capabilities. Once a claim is filed, the VA may schedule an in-person exam, often requiring multiple blood pressure readings over at least three different days to confirm a diagnosis. Veterans will receive a notification packet detailing the exam location, examiner credentials, and appointment time.
What to Expect During the Exam
During the exam, the clinician uses a Hypertension Disability Benefits Questionnaire (DBQ) to evaluate medical history, current medications, complications, and how the condition affects daily function. Benchmarks for blood pressure include diastolic readings of 90mm or higher and/or systolic readings of 160mm or more. The examiner reviews VA, private, and military service treatment records and may explore secondary conditions such as kidney disease or heart complications.
Supporting Documentation and Evidence
Veterans should bring medical records, maintain a blood pressure log, and prepare a diary of symptoms. They should honestly explain how hypertension affects their daily tasks and performance, as the outcome of this exam heavily influences the VA’s decision on service connection and compensation. If denied, veterans can request another C&P examination.
TDIU Benefits for Hypertensive Veterans
If your service-connected hypertension or a combination of conditions prevents you from maintaining gainful employment, TDIU (Total Disability Individual Unemployability) may be the right path. Even if your combined rating is less than 100%, TDIU allows you to receive a 100% rating compensation even if standard VA criteria are not met.
To qualify for TDIU, you must meet one of the following:
- Have at least a single service-connected disability rated at 60% or above, or
- Have two or more service-connected disabilities with a combined rating of at least 70%, including at least one disability rated at 40% or higher.
Your medical condition(s) must also prevent you from holding substantially gainful employment.
VA.gov Notes Instructions on How to apply for TDIU:
- Complete and submit VA Form 21-8940, the Application for Increased Compensation Based on Unemployability.
- Request your most recent employer to fill out VA Form 21-4192.
- You can provide medical evidence, including a professional nexus letter, to show how hypertension or related conditions limit your ability to work.
TDIU provides critical financial support to veterans who can no longer work due to service-related conditions, even if they don’t meet the 100% schedular rating.
Appealing a Denied VA Claim for Hypertension
A denied VA claim for hypertension isn’t the end; it is the next chance to strengthen your case. First, review your VA decision letter to understand the reason behind the claim denial. Previously Veterans would submit or file a Notice of Disagreement (NOD), that is, VA Form 10182. With the advent of the appeals modernization act there is now a much more streamlined process and details can be found on VA.gov.
Choose your appeal option:
- Higher-Level Review (no new evidence allowed).
- Supplemental Claim (submit new and relevant evidence, for instance, updated blood pressure readings, treatment or diagnostic records, or additional nexus letters).
- Board Appeal (reviewed by a Veterans Law Judge).
Consider adding buddy statements that describe how your high BP has affected your daily life.
Veterans often successfully win their appeals when they provide new, compelling medical documentation and get support from veterans’ organizations.
Case Study of a Vietnam Veteran
A U.S. Army veteran who served in Vietnam began suffering from hypertension decades after returning home. When he first filed a claim, the VA denied it, stating there was no presumption linking high blood pressure to Agent Orange at the time.
Frustrated but determined, the veteran gathered the right medical evidence. With the help of an experienced physician, he secured a detailed medical nexus letter that directly connected his hypertension to his herbicide exposure.
The VA granted service connection, and later recognized his secondary ischemic heart disease, awarding him a combined 40% disability rating. Thanks to his perseverance and the strong medical documentation, the veteran now receives over $1,000 each month in tax-free VA compensation.
Conclusion
Getting VA disability benefits for hypertension doesn’t have to be complicated. With solid medical evidence, proven service connection, and the right guidance, you can receive the compensation you deserve. Whether caused by direct service or linked to secondary conditions like PTSD or Agent Orange exposure, taking action now is key. Stay informed, be prepared, and take professional guidance from accredited legal professionals. Your health and benefits are worth fighting for.
FAQs
Is it possible to get VA disability for hypertension?
It can be challenging without strong evidence, but with a diagnosis, service connection, and medical support, many veterans successfully get approved for VA disability benefits.
What VA ratings are assigned for high blood pressure?
VA disability ratings for hypertension can range between 0%, 10%, 20%, 40% and 60%, depending on blood pressure readings and how much the condition impacts daily life.
What is the C&P exam for hypertension?
The C&P exam evaluates your blood pressure, symptoms, and medical history to help the VA decide if your hypertension is service-connected and how severe it is.
What VA claims are secondary to hypertension?
Common secondary claims linked to hypertension include heart disease, kidney disease, strokes, vision problems, cognitive decline, PTSD, and sleep apnea.
How does being on medication affect my VA rating for hypertension?
If your blood pressure was high before starting medication and you require continuous treatment, you may still qualify for a 10% or higher VA rating.
What is a 10 percent VA disability for hypertension?
A 10% rating for hypertension is awarded if you need continuous medication and had a diastolic pressure that measures over 100 or a systolic pressure of 160 or higher.
Is hypertension a VA presumptive condition for veterans exposed to Agent Orange?
Hypertension is now a presumptive condition for veterans exposed to Agent Orange under the PACT Act, making it easier to get approved without a medical nexus.
Also read: Hypertension and PTSD in Veterans Disability
At Prestige Veteran Medical Consulting, a veteran-owned company, we specialize in Independent Medical Opinions (IMOs) known as Nexus letters.
Our purpose is to empower YOU, the veteran, to take charge of your medical evidence and provide you with valuable educational tools and research to guide you on your journey.
Understanding the unique challenges veterans face, our commitment lies in delivering exceptional service and support.
Leveraging an extensive network of licensed independent medical professionals, all well-versed in the medical professional aspects of the VA claims process, we review the necessary medical evidence to incorporate in our reports related to your VA Disability Claim.
Prestige Veteran Medical Consulting is not a law firm, accredited claims agent, or affiliated with the Veterans Administration or Veterans Services Organizations. However, we are happy to discuss your case with your accredited VA legal professional.
