Hypertension

Your doctor will complete VA Form 21-0960A-3 (Hypertension DBQ) after examining you. This walkthrough helps you prepare them. The DBQ is a standardized questionnaire; your doctor's answers directly determine your VA rating. Brief them on these specific points before the exam so nothing important is missed or underdocumented.

Common mistakes

• ×Asking your doctor to just "fill out the VA form" without briefing them - an uninformed completion is often generic and leads to lower ratings.
• ×Bringing the DBQ to a provider who has never seen you before - your treating physician who knows your history will write the most credible documentation.
• ×Going to the exam and waiting for the doctor to ask questions - come prepared with specific examples of your worst days and functional limitations.

These are the key clinical questions from the Hypertension DBQ. Help your doctor understand what each question is asking and give them concrete examples for your situation. Print this section and bring it to the appointment. 1. What are the current systolic and diastolic blood pressure readings? WHY IT MATTERS: Specific BP thresholds determine rating percentages TIPS: Multiple readings are taken; the VA uses the average; Diastolic 100+ or systolic 160+ supports a 10% rating; Diastolic 110+ or systolic 200+ supports a 20% rating 2. Is continuous medication required for control? WHY IT MATTERS: History of diastolic 100+ requiring continuous medication supports a 10% rating TIPS: Bring your complete medication history; Note if medications have been added or increased over time 3. What are the blood pressure readings over time (history)? WHY IT MATTERS: Pattern of elevated readings is more persuasive than a single measurement TIPS: Keep a BP log for several weeks before the exam; Include readings at different times of day 4. Are there any complications from hypertension? WHY IT MATTERS: Complications like heart disease or renal involvement may be rated separately TIPS: Report any history of hypertensive crisis; Mention any organ damage attributed to high blood pressure

Common mistakes

• ×Taking blood pressure medication right before the exam, masking true severity
• ×Not keeping a blood pressure log to show patterns
• ×Failing to mention complications like kidney or heart issues

VA raters use the Hypertension DBQ to determine your disability rating. The most important rating factors for this condition are: 1. Diastolic pressure predominantly 100 or more = 10% 2. Diastolic pressure predominantly 110 or more = 20% 3. Diastolic pressure predominantly 120 or more = 40% 4. Systolic pressure predominantly 200 or more = 40% 5. History of diastolic 100+ requiring continuous medication = minimum 10% 6. Complications (renal, cardiac) may be rated separately For each factor, give your doctor specific examples from your daily life so they can document accurately (not generically).

Common mistakes

• ×Not documenting medication history showing escalating treatment

Authority

• 38 CFR 4.1 - Functional impairment as the basis for rating.

Preparation checklist for the Hypertension DBQ exam: 1. Keep a detailed BP log for at least 2-4 weeks before the exam 2. Ask your doctor about medication timing relative to the exam 3. Bring your complete medication history showing changes over time 4. Document any hypertension-related complications or ER visits 5. Note any secondary conditions caused by hypertension Remember: Describe your WORST days, not your average days. VA raters evaluate the full range of your disability including its worst manifestations.

Common mistakes

• ×Describing your best days or average functioning instead of your worst - VA rates the full range of disability.
• ×Minimizing symptoms out of stoicism or pride - accurate documentation is not exaggeration; it is honesty.
• ×Not mentioning secondary symptoms, side effects, or additional conditions the doctor may not ask about.