Once hypertension is service connected, the next question is the percentage. The VA rates high blood pressure under 38 CFR 4.104, Diagnostic Code 7101, using specific diastolic and systolic thresholds rather than symptoms or how the condition feels day to day.
This guide explains each rating level and the rules that surround it. For how a claim gets connected in the first place, start with how hypertension service connection works.
The rating levels under Diagnostic Code 7101
The schedule assigns four levels based on documented readings:
- 10 percent - diastolic pressure predominantly 100 or more, or systolic pressure predominantly 160 or more, or a minimum rating for an individual with a history of diastolic pressure predominantly 100 or more who requires continuous medication for control
- 20 percent - diastolic pressure predominantly 110 or more, or systolic pressure predominantly 200 or more
- 40 percent - diastolic pressure predominantly 120 or more
- 60 percent - diastolic pressure predominantly 130 or more
Why “predominantly” matters
The criteria use the word predominantly, which means the rating turns on the pattern across recorded readings rather than a single high number. A veteran with one reading of 112 diastolic and many readings in the 90s will generally not meet the 20 percent criteria.
This is why the completeness of the treatment record matters so much. Readings recorded across multiple visits - including those taken by non-VA providers - give the rater the pattern the criteria call for.
The minimum 10 percent rating
Many veterans take medication that keeps their blood pressure in a normal range, which can make current readings look unremarkable. The minimum-rating provision addresses that: where there is a history of diastolic pressure predominantly 100 or more and continuous medication is required for control, a 10 percent rating applies.
Establishing that history usually depends on older records - readings from before the medication was started, or from a period when it was not effective. Retrieving those earlier records is often the practical difference between a 0 and a 10 percent outcome.
Where veterans start
Every case is different, and there is no obligation at any step. When veterans want to understand what their records actually support, these are the two most common starting points:
- Medical records review
A licensed physician reviews your records for a $250 flat fee and identifies which conditions the available evidence may support. The fee is refunded in full if nothing supportable is identified.
- Nexus letter
When the records support one, a licensed provider writes the medical opinion that addresses the link between your blood pressure condition and your service or an already service-connected disability.
The confirmation requirement
38 CFR 4.104 requires that hypertension be confirmed by readings taken two or more times on at least three different days. This is a documentation rule, not a medical one, and it applies regardless of how obvious the condition is clinically. Veterans who monitor at home can ask their treating provider to record readings in the chart so the requirement is satisfied by the medical record.
Separate evaluation from heart conditions
The notes to Diagnostic Code 7101 direct that hypertension be evaluated separately from hypertensive heart disease and other heart disease. That matters when multiple cardiovascular conditions are service connected, because separate evaluations are combined under 38 CFR 4.25 rather than merged into one.
Combined ratings do not add. Our VA disability calculator applies the same combination math the VA uses so you can see how an additional evaluation would change a combined rating.
Where ratings and evidence meet
A rating decision can only reflect what is in the record. Where readings are scattered across providers, or where an earlier period of uncontrolled pressure is documented only in old records, assembling that history is part of the work. Our guide to medical evidence for a hypertension claim covers what to gather, and the hypertension DBQ guide explains the form the VA uses to capture it.
Frequently asked questions
What is the VA rating for hypertension on medication?
Diagnostic Code 7101 provides a minimum 10 percent rating for an individual with a history of diastolic pressure predominantly 100 or more who requires continuous medication for control. Medication use alone, without that documented history, does not automatically establish the rating.
What is the highest VA rating for hypertension?
The maximum schedular rating under Diagnostic Code 7101 is 60 percent, which requires diastolic pressure predominantly 130 or more.
Does the VA rate hypertension separately from heart disease?
Yes. Under the notes to Diagnostic Code 7101, hypertension is evaluated separately from hypertensive heart disease and other types of heart disease rather than combined into a single evaluation.