Hypertension sometimes damages the blood vessels in the kidneys, reducing their ability to function properly. Over time, this can cause chronic kidney disease: a long-term condition leading to the build-up of waste products in the body. Chronic kidney disease is rated as a secondary condition to hypertension if it is found to be caused or aggravated by service-connected high blood pressure.
What Is the VA Rating for Chronic Kidney Disease Secondary to Hypertension?
According to VA regulations, chronic kidney disease is rated based on the level of kidney function, the need for dialysis, and other symptoms such as edema or complications in other organs. VA ratings for chronic kidney disease typically range from 0% to 100%, with higher percentages reflecting more severe disability.
| VA Criteria | Rating |
|---|---|
| Chronic kidney disease with glomerular filtration rate (GFR) less than 15 mL/min/1.73 m2 for at least 3 consecutive months during the past 12 months; or requiring regular routine dialysis; or eligible kidney transplant recipient | 100% |
| Chronic kidney disease with GFR from 15 to 29 mL/min/1.73 m2 for at least 3 consecutive months during the past 12 months | 80% |
| Chronic kidney disease with GFR from 30 to 44 mL/min/1.73 m2 for at least 3 consecutive months during the past 12 months | 60% |
| GFR from 60 to 89 mL/min/1.73 m2 and albumin/creatinine ratio (ACR) ≥30 mg/g for at least 3 consecutive months during the past 12 months | 30% |
| Minimal symptoms that do not interfere with daily life | 0% |
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How a Veteran Secured a Higher Rating for Hypertension with Chronic Renal Disease and Hypertensive Heart Disease
Initial Appeal and Medical Evidence: The veteran’s appeal (Board of Veterans Appeal Citation Nr: 1543467) emphasized that his hypertension was severe and hard to control, even with multiple medications. He provided evidence of consistently high diastolic pressures, including a VA exam showing diastolic pressures above 130 in two out of three readings. A letter from the chief of the renal department confirmed the severity, noting blood pressures frequently over 200/130.
Increased Rating Granted: The Board awarded a 60% rating for hypertension with hypertensive heart disease and chronic renal disease from February 16, 2010, to June 12, 2013. This decision was based on the veteran’s diastolic pressures predominantly being 130 or more during this period.
Further Appeal for Higher Rating: The veteran sought a higher rating, and in September 2014, the VA increased it to 80% effective June 13, 2013, due to worsening conditions, including generalized poor health, lethargy, weakness, and limited exertion caused by renal dysfunction.
Denial of Ratings Above 60% and 80%: The Board denied ratings higher than 60% before June 13, 2013, and above 80% afterward. The evidence did not show the need for regular dialysis, significantly decreased kidney function, or left ventricular dysfunction with an ejection fraction below 30%, which are required for higher ratings.
Award of Total Disability Based on Individual Unemployability (TDIU): The veteran was granted TDIU effective February 16, 2010, due to his service-connected hypertension, hypertensive heart disease, and chronic renal disease, which made him unable to maintain substantially gainful employment.
Key Factors for Success
- Consistent Medical Documentation: Severe hypertension with diastolic pressures predominantly over 130, along with additional complications like chronic renal disease and hypertensive heart disease.
- Expert Medical Opinion: A letter from the veteran’s treating physician describing the severity of the hypertension and providing a detailed assessment in support of the veteran’s claim.
- Detailed VA Examinations: Documentation of the progression of the condition, including the impact on overall health and ability to work, which are crucial in securing both an increased rating and TDIU.
Gather Comprehensive Medical Evidence
Medical evidence is the cornerstone of a successful VA disability claim for chronic kidney disease secondary to hypertension. Veterans should collect:
- Detailed medical records from both VA and private doctors.
- Test results showing kidney function over time.
- Statements from medical professionals linking kidney disease to hypertension.
Utilize Expert Opinions
Expert opinions, especially from nephrologists, can significantly bolster a claim. Veterans should seek detailed reports from specialists who can explain how hypertension has impacted their kidney function.
Document Symptom Progression
Keeping a thorough record of symptoms and their progression can provide compelling evidence. Veterans should document:
- Frequency and severity of symptoms.
- Impact on daily activities.
- Any changes in treatment or medication.
Securing VA disability for a disease secondary to hypertension involves a thorough understanding of the condition, diligent documentation, and robust medical evidence. Veterans and their families should seek comprehensive medical evaluations and legal assistance to navigate the complexities of the VA claims process.
Content Reviewed by
Attorney Matthew Hill
Attorney Matthew Hill, licensed in Florida and Washington D.C., a dedicated advocate for disabled veterans with over two decades of experience, reviewed the information in this post.
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