Hypertension C&P Exam

Inside the exam room

1. The examiner will review blood-pressure readings, your diagnosis, and medicine. Bring dated readings and your medicine list.

2. Your blood pressure will be taken while seated with your back and feet supported. Confirming a new diagnosis requires readings on multiple days. Follow the instructions and identify earlier readings in your records.

3. You will be asked about complications and effects on work. Explain limits and identify separately diagnosed problems.

How VA rates hypertension

Use several blood-pressure readings and your treatment history. The top number is systolic pressure; the bottom number is diastolic pressure. The table uses the readings that occur most often. DC 7101 uses blood-pressure readings that occur most often and a specified history-plus-medication criterion. A single high reading, medication use alone, PTSD, or a stroke does not automatically establish a percentage under this code. Hypertensive heart disease and other complications require their own applicable evaluation.

What each rating percentage means

Match the whole description with your exam and records. A single symptom or illustration does not decide your rating.

Rating	What the rule requires
10%	Bottom-number blood pressure (diastolic pressure) mostly 100 or more, top-number blood pressure (systolic pressure) mostly 160 or more, OR a history of bottom-number blood pressure (diastolic pressure) mostly 100 or more requiring continuous medication for control.
20%	Bottom-number blood pressure (diastolic pressure) mostly 110 or more OR top-number blood pressure (systolic pressure) mostly 200 or more.
40%	Bottom-number blood pressure (diastolic pressure) mostly 120 or more.
60%	Bottom-number blood pressure (diastolic pressure) mostly 130 or more.

Check these details in your records

The examiner uses a condition form called a Disability Benefits Questionnaire (DBQ). Compare these items with your own records and explain what actually happens in daily life.

Bottom-number blood pressure (diastolic pressure) mostly 100 or more, top-number blood pressure (systolic pressure) mostly 160 or more, OR a history of bottom-number blood pressure (diastolic pressure) mostly 100 or more requiring continuous medication for control.10%Compare the whole description with your medical records. Choosing it here does not decide your VA rating.
Bottom-number blood pressure (diastolic pressure) mostly 110 or more OR top-number blood pressure (systolic pressure) mostly 200 or more.20%Compare the whole description with your medical records. Choosing it here does not decide your VA rating.
Bottom-number blood pressure (diastolic pressure) mostly 120 or more.40%Compare the whole description with your medical records. Choosing it here does not decide your VA rating.
Bottom-number blood pressure (diastolic pressure) mostly 130 or more.60%Compare the whole description with your medical records. Choosing it here does not decide your VA rating.

What may happen in the exam room

Blood-pressure measurement and review of readings over time.
Review of diagnosis, treatment, and relevant medical history.

What the measurements tell you

The top and bottom blood-pressure numbers that occur most often.
History of bottom-number blood pressure (diastolic pressure) mostly 100 or more and required continuous medication.
To confirm high blood pressure, the rule calls for two or more readings on at least three different days under DC 7101 Note 1.

Questions the examiner may cover

What readings and treatment are recorded over time?
What medication is required for control?
Are heart or other complications separately diagnosed?

Questions to expect

What are your readings over time and medication history?

Explain: Bring dated readings and treatment records, including before medication if available. Identify usual patterns rather than only the single highest reading.

Rating connection: DC 7101 uses predominantly elevated systolic or diastolic readings. Its minimum-rating medication pathway also requires the specified diastolic history.

Are complications separately diagnosed?

Explain: Identify clinician-recorded heart, kidney or other conditions and their treatment.

Rating connection: Symptoms or medication alone do not establish a blood-pressure percentage; distinct diagnosed complications require their own evaluation.

Your answer outline

My readings are recorded in [log or medical record] for [period]. My prescribed medication is [name, or refer to the medication list]. [When treatment changed, if applicable]. I have noticed [actual effects or no noticeable symptoms], and [questions or uncertainty].

Mark approximate dates and counts as estimates.

My notes: ________________________

Service connection records

1. How is this connected to your service?

For a direct claim, identify your current disability, what happened in service, and evidence linking them. Being on active duty or orders alone does not prove that link.

Write the 5 Ws and how: who was there; what happened; when; where; why you were there; how the problem began. Add duty status, treatment, witnesses, and records. Mark uncertain dates as estimates.
Guard or Reserve: find your orders, dates, duty type, and any line-of-duty records. Active duty, training, and drills have different rules.
Secondary condition: it may start after service. Identify the service-connected condition and evidence that it caused or worsened this problem. A medical opinion may help explain the link.
Started before service? Record what changed during service. Presumptive condition? Check the required diagnosis and service history; qualifying claims do not require separate proof of a link.
Already service connected and seeking an increase? Focus on what has worsened and the records showing it.

If you do not know the cause, say so. Do not guess a medical connection.

Explain what changes in daily life

Describe both what you can do and what becomes difficult. Include how often it happens and how long it lasts.

Bring dated readings rather than only the highest result.
Describe actual symptoms and treatment without assigning a medical cause.

Common mistakes to avoid

Stopping medication to obtain a higher reading.
Treating any medication use as an automatic 10%.
Assigning a blood-pressure percentage because another condition is present.

Records to get ready before the exam

Blood-pressure readings with dates and a note of where and how they were taken.
Medication history.
Relevant diagnosis and complication records.

Preparation notes

Continue medication as directed by your clinician.
The rating schedule is not advice about when to seek treatment; discuss concerning readings with a healthcare professional.

Official rating rule and code numbers

Use this source to check the full rule and its medical terms: 38 CFR 4.104, DC 7101. Source review recorded 2026-09-04.

Could one health problem have caused another?

A condition VA has already linked to your service may cause another health problem or make it worse. VA calls this secondary service connection. Having both conditions does not prove the link. Your records need to show a current diagnosis and explain how the first condition or its treatment affected the second.

Start with your records. Find the current diagnosis, the condition VA already linked to service, and evidence from someone qualified to explain the connection.
Ask about cause and worsening. Did the first condition or its treatment cause the new disability, or make an existing disability worse? These are different questions. The rules call them causation under 38 CFR § 3.310(a) and aggravation under § 3.310(b). If both are raised by your records, the medical opinion should address both; answering only the cause question may not be enough (El-Amin).
If treatment may be involved, collect the dates. List the medicine or surgery prescribed for the condition VA linked to service, the side effect, and the new diagnosis. Bring pharmacy records and dates when treatment started or stopped. A provider must explain the connection in your case; taking a medicine alone does not prove it.
If weight gain may be involved, ask how it fits. Weight gain or obesity can be a step between the first condition and another diagnosed disability under VAOPGCPREC 1-2017. Obesity itself does not receive a VA disability rating.
You do not need absolute certainty. VA uses the “at least as likely as not” standard and the reasonable-doubt rule under 38 CFR § 3.102. Ask a VA-accredited representative how the evidence applies to your claim.
The same symptom cannot be counted twice. This is the rule against pyramiding in 38 CFR § 4.14. Mental-health diagnoses generally share one § 4.130 rating when they affect the same work and social abilities. Trouble sleeping may be a symptom rather than a separate disability.
Check whether VA already assumes a link to service. Some conditions qualify based on where or when you served. These are called presumptive conditions. Examples can include chronic rhinitis, chronic sinusitis, hypertension after qualifying herbicide exposure, and type 2 diabetes. Sleep apnea (OSA) is not a PACT Act presumptive. Check eligibility before seeking a medical opinion about the link.
An exam form and a medical opinion do different jobs. A Disability Benefits Questionnaire (DBQ) records the diagnosis and how severe it is. It may not explain why it is linked to service, often called a nexus. A VA-accredited veterans service organization (VSO) can help you file at no charge.

If another prescribed treatment may have caused a problem, ask your health care provider to record what happened and explain the connection in your case.

Sources: 38 CFR § 3.310 · 38 CFR § 4.14 · VA-accredited representatives

C&P exam for hypertension: what to expect and how VA rates it.