Hypertension
High blood pressure. PACT Act added for Vietnam veterans. Common as secondary to PTSD, sleep apnea, diabetes.
VA rating criteria
| Rating | Criteria |
|---|---|
| 60% | Diastolic pressure predominantly 130 or more |
| 40% | Diastolic pressure predominantly 120 or more |
| 20% | Diastolic pressure predominantly 110 or more, or; systolic pressure predominantly 200 or more |
| 10% | Diastolic pressure predominantly 100 or more, or; systolic pressure predominantly 160 or more, or; minimum rating for individual with a history of diastolic pressure predominantly 100 or more who requires continuous medication for control |
Pro tips
Often claimed secondary to
If you're already service-connected for any of these, Hypertension is often a viable secondary claim.
Post-Traumatic Stress Disorder (PTSD)
Mental health condition from experiencing or witnessing a traumatic event. Stressor verification required (except combat-related, which is presumed if consistent with circumstances of service).
Sleep Apnea (Obstructive/Central/Mixed)
Apneic episodes during sleep. CPAP-required = 50% rating (current rule; proposed changes have not been finalized). Hard to win directly post-service — much easier as secondary.
Diabetes Mellitus, Type II
Agent Orange presumptive. Triggers cascade of secondaries: neuropathy, ED, retinopathy, kidney disease.
Filing this claim
If you have qualifying service for the Agent Orange (PACT Act) / Chronic disease 1-year presumption, you don't need a nexus letter — file as a primary claim with proof of qualifying service and your current diagnosis. Use the letter generators to draft your nexus letter and Statement in Support of Claim.
Step by step
- File an Intent to File (Form 21-0966) to lock your effective date.
- Confirm you have a current medical diagnosis in a medical record.
- Gather proof of qualifying service (DD-214, deployment records, etc.) — no nexus letter needed.
- Write a Statement in Support of Claim (21-4138).
- If applicable, gather buddy statements (21-10210).
- File the formal 21-526EZ.
Source: 38 CFR §4.104. For exact regulatory language, consult eCFR Title 38. This is general education — for your specific case, consult a VA-accredited representative.