BVA9505758 DOCKET NO. 92-22 020 ) DATE ) ) On appeal from the decision of the Department of Veterans Affairs Regional Office in No. Little Rock, Arkansas THE ISSUE Entitlement to an increased rating for the veteran's service- connected hypertension, currently rated 10 percent disabling. REPRESENTATION Appellant represented by: Disabled American Veterans WITNESSES AT HEARING ON APPEAL Appellant and spouse ATTORNEY FOR THE BOARD L. J. Vecchiollo, Associate Counsel INTRODUCTION The veteran served on active duty in the Armed Forces from September 1965 to October 1970. This matter came before the Board of Veterans' Appeals (Board) on appeal from a February 1992, rating decision from the No. Little Rock, Arkansas, Department of Veterans Affairs (VA) Regional Office (RO). A notice of disagreement was received in March 1992. A statement of the case was issued in April 1992. A substantive appeal was received in May 1992. The veteran, in his substantive appeal received in May 1992, requested a 100 percent rating due to his service-connected post- traumatic stress disorder (PTSD). The veteran was granted an increased rating of 50 percent for his PTSD in a July 1992 rating decision. A supplemental statement of the case issued that same month noted this grant of an increase and it stated that this issue was no longer in appellate status. The Board notes that the veteran did not receive the total grant of benefits sought. Therefore, the Board finds that this matter has not been resolved and it is referred to the RO to provide the veteran with a supplemental statement of the case regarding this issue. CONTENTIONS The veteran contends that his service-connected hypertension should be rated more than 10 percent disabling, as the symptoms and manifestations of the disability from which he suffers have increased in severity and have limited his employment opportunities. The veteran maintains that he takes medication for his hypertension and monitors his blood pressure. He contends that his diastolic blood pressure averages 98 to 100, but occasionally rises to 110. He claims that his blood pressure readings from his last VA examination do not represent the severity of his condition as he remained sedentary in the waiting room prior to these measurements. He further claims that, had his blood pressure been measured while traveling to the examination or immediately thereafter, it would have been much higher. DECISION OF THE BOARD The Board, in accordance with the provisions of 38 U.S.C.A. § 7104 (West 1991), has reviewed and considered all of the evidence and material of record in the veteran's claims file. Based on its review of the relevant evidence in this matter, and for the following reasons and bases, it is the decision of the Board that a disability rating of more than 10 percent for the veteran's service-connected hypertension is not warranted. FINDING OF FACT The veteran's service-connected hypertension is manifested by diastolic blood pressure readings ranging from a low of 84 to a high of 106 with no other clinical manifestations. CONCLUSION OF LAW A disability rating higher than 10 percent for the veteran's service-connected hypertension is not warranted. 38 U.S.C.A. §§ 1155, 5107 (West 1991); 38 C.F.R. §§ 4.3, 4.104, Diagnostic Code 7101 (1994). REASONS AND BASES FOR FINDINGS AND CONCLUSION The evaluation assigned for the veteran's service-connected hypertension is established by comparing the manifestations indicated in his medical records with those manifestations described in the prior medical findings, and with the criteria in the VA's Schedule for Rating Disabilities, 38 C.F.R. Part 4 (1994). 38 U.S.C.A. § 1155 (West 1991). In this case, the RO rated the veteran's hypertension using Diagnostic Code 7101, which bases the evaluation on the measurement of the veteran's diastolic blood pressure. Diagnostic Code 7101 provides that a 10 percent evaluation is warranted for hypertensive vascular disease (essential arterial hypertension) where the diastolic pressure is predominantly 100 or more; a 20 percent evaluation requires diastolic pressure of predominantly 110 or more with definite symptoms; a 40 percent evaluation requires diastolic pressure of predominantly 120 or more and moderately severe symptoms. Service medical records reveal that the veteran's blood pressure readings were 154/100 on April 21, 1970, 146/92 on April 23 1970, and 130/90 and 138/90 on June 22, 1970. In a letter dated in February 1979, the veteran's private physician, George E. Malone, M.D., states that the veteran's systolic blood pressure reading ranges from 140 to 160 and his diastolic blood pressure reading is 100. He also states that the veteran's blood pressure reading was 180/110 in July 1974. A VA examination was performed in March 1979. Examination revealed blood pressure readings of 120/80, 120/80, 118/84, 118/80 and 119/80. His heart rhythm and first heart sound were normal and his second heart sound was normal to split. An x-ray evaluation of the heart and an electrocardiogram (EKG) were normal. The RO in an April 1979 rating decision granted service connection for hypertension and assigned a 10 percent disability rating. An August 1979 VA EKG was normal. A VA examination conducted in February 1981 revealed a blood pressure reading of 116/84. A VA examination conducted in September 1981 revealed five diastolic blood pressure readings ranging from a low 80 to a high of 90. An EKG was normal. A diagnosis of well-controlled essential hypertension was given. A VA examination conducted in September 1985 revealed blood pressure readings of 140/102, 148/100, and 140/100. A VA progress note, in September 1991 noted that his chest was "clear." The veteran was hospitalized at a VA facility for an unrelated disorder in January 1990 and a blood pressure reading of 150/105 was noted. VA outpatient treatment records from July 1990 to January 1992 show diastolic blood pressure readings ranging from a low of 84 to a high of 106. A VA examination was conducted June 1992. Blood pressure readings of 161/105, 150/90, and 133/89 were recorded. This examination report noted that the veteran's diastolic blood pressure readings are usually between 80 and 90. It also noted that the veteran has no previous history of myocardial infarction, cerebrovascular accidents or angina. A diagnosis of essential hypertension, treated, was given. The veteran contends that his service-connected hypertension should be rated more than 10 percent disabling, as the symptoms and manifestations of the disability from which he suffers have increased in severity and have limited his employment opportunities. The veteran, at his personal hearing at the RO in May 1992, maintains that he takes medication for his hypertension and monitors his blood pressure. He contends that his diastolic blood pressure averages 98 to 100, but occasionally rises to 110. He claims that his blood pressure readings from his last VA examination do not represent the severity of his condition as he remained sedentary in the waiting room prior to these measurements. He further claims that, had his blood pressure been measured while traveling to the examination or immediately thereafter, it would have been much higher. Although a lay witness can testify to the symptomatology he experiences, a lay witness cannot give an opinion regarding the severity of his disability. Espiritu v. Derwinski, 2 Vet.App. 492 (1992). The Board, therefore, accords little probative weight to these statements. As set forth above, the veteran's diastolic blood pressure in recent years has not been measured at 110 or more, nor have definite symptoms of hypertension been noted by treating or examining physicians. Accordingly, a higher evaluation for hypertension is not in order. 38 U.S.C.A. § 1155; 38 C.F.R. Part 4, Diagnostic Code 7101. The Board has also considered whether the veteran is entitled to an extraschedular rating under 38 C.F.R. § 3.321(b)(1) (1994). That regulation permits the application of an extraschedular rating in exceptional cases where the schedular ratings do not adequately represent the disability picture. However, the schedular ratings in this case do adequately represent the disability picture. That is, his service-connected disability does not require frequent periods of hospitalization nor has marked interference with employment been shown. 38 C.F.R. § 3.321(b)(1) (1994). The disability picture, in this case, does not require application of this regulation, as the veteran's disability is adequately addressed by the schedular evaluation discussed above. ORDER The appeal is denied. EUGENE A O'NEILL Member, Board of Veterans' Appeals The Board of Veterans' Appeals Administrative Procedures Improvement Act, Pub. L. No. 103-271, § 6, 108 Stat. 740, ___ (1994), permits a proceeding instituted before the Board to be assigned to an individual member of the Board for a determination. This proceeding has been assigned to an individual member of the Board. NOTICE OF APPELLATE RIGHTS: Under 38 U.S.C.A. § 7266 (West 1991), a decision of the Board of Veterans' Appeals granting less than the complete benefit, or benefits, sought on appeal is appealable to the United States Court of Veterans Appeals within 120 days from the date of mailing of notice of the decision, provided that a Notice of Disagreement concerning an issue which was before the Board was filed with the agency of original jurisdiction on or after November 18, 1988. Veterans' Judicial Review Act, Pub. L. No. 100-687, § 402 (1988). The date which appears on the face of this decision constitutes the date of mailing and the copy of this decision which you have received is your notice of the action taken on your appeal by the Board of Veterans' Appeals.