Hypertension VA rating
The VA rates hypertension under DC 7101, and most ratings land in the 10–60% range. What decides yours is the criteria below and what your record actually documents.
What the criteria ask for at each level
DC 7101 — 38 CFR §4.104
| Rating | What the record has to show |
|---|---|
| 10% | Diastolic predominantly 100–109, or systolic predominantly 160–199. |
| 20% | Diastolic predominantly 110–119, or systolic predominantly 200+. |
| 40% | Diastolic predominantly 120–129. |
| 60% | Diastolic predominantly 130+. |
The schedule's own words
Ratings turn on specific terms, and a record that describes the same reality in different language often reads as a lower rating. These are the words this code measures:
- diastolic pressure predominantly
- requires continuous medication for control
Evidence that moves this rating
- A blood-pressure log: multiple readings across different days (home cuff readings count as supporting evidence)
- Pharmacy records showing continuous medication
What your statement has to cover
Doctors chart symptoms; they rarely chart consequences. That part is yours, and it is usually what separates a documented rating from a reported one.
- The rating is pure numbers — your statement should establish history and medication requirement.
- If you take diuretics, mention urinary frequency (a separate secondary claim).
Our Statement Builderwalks through the questions that produce that kind of statement, in the schedule's own terms.
What hypertension can lead to5 documented pathways
A secondary claim runs through a condition the VA already accepts, so the argument about your service is already won. What is left is the medical link — and a nexus opinion has to name the mechanism, not just the pair.
| Can lead to | The mechanism a nexus has to state |
|---|---|
| Diabetic retinopathy / eye conditions | Chronic high blood pressure damages the blood vessels of the retina. |
| Urinary frequency / voiding dysfunction | Diuretics ("water pills") force fluid excretion, directly causing urinary frequency day and night — frequently rated 20%. |
| Erectile dysfunction / FSAD | Beta-blockers and diuretics restrict vascular flow. Qualifies for SMC-K even at 0%. |
| Chronic kidney disease | Uncontrolled pressure damages the kidneys over time. |
| Heart disease (ischemic / CAD) | Sustained pressure hardens arteries and strains the heart. |
A pathway existing in the literature is not the same as your claim being granted — your records and the VA decide that. How secondary claims work covers the argument.
Before you spend money on this claim
VA ratings do not add. Each new rating applies only to the part of you the VA still counts as unimpaired, then rounds to the nearest ten — so from 70%, a new 10% condition leaves you at exactly 70% and changes your payment by nothing.
That does not make the claim worthless; it can still matter for TDIU, for SMC, or later when something else is added. But it is worth knowing before you pay for a nexus letter rather than after. Check what one more condition does at your rating — it takes a minute.