High blood pressure (hypertension): what the Board looked for
Real appeals where a private medical opinion tied high blood pressure to PTSD, to Agent Orange, or to Camp Lejeune water.
A nexus letter is a signed medical opinion that links a current condition to your service.
If the VA just denied your high blood pressure claim: your decision letter lists the reasons. We read those reasons next to your records, page by page.
If you haven’t filed yet: the points below are what the Board weighed in these appeals. A letter can cover them from the start.
Why high blood pressure claims get denied
- The VA exam points to normal readings in service, or calls one high reading a one-off. The Board also checks if it showed up within one year of discharge.
- The VA exam says your blood pressure was high before PTSD was diagnosed, so PTSD can’t be the cause. The Board has rejected that reasoning.
- The VA exam blames weight, kidney disease, or stress, says no studies support the link, or answers only one of your claims.
- Private letters fall short when they give a bare conclusion, skip a normal separation exam, or leave out exposures at jobs after service.
What the Board looked for
“Probative” is the Board’s word for convincing.
The VA exam said PTSD came too late.Granted · 2026
“The examiner’s opinion was based on a review of the claims file and the examiner offered a reasonable medical basis for their conclusion.”
The VA examiner said no because high blood pressure came before the PTSD diagnosis. The Board said the first condition doesn’t have to be diagnosed first. The private examiner reviewed the file and explained the path from PTSD to high blood pressure: stress, smoking or drinking, less activity, poor diet.
Read decision A26068157 on VA.gov (opens in a new tab)Studies answered the VA exam on Camp Lejeune water.Granted · 2024
“The private examiner cited multiple studies that show a connection between the exposure of contaminants present at Camp LeJeune and the development of hypertension.”
The VA examiner said no studies linked the water to high blood pressure, and pointed to kidney disease, weight, and stress. The private examiner reviewed the file, met with the veteran remotely, and cited studies. The Board resolved the doubt in the veteran’s favor.
Read decision A24041596 on VA.gov (opens in a new tab)The VA exam only asked about diabetes.Granted · 2022
“After a robust discussion of the Veteran’s medical history and relevant discussion of pertinent medical research on the impact of Agent Orange exposure”
Agent Orange exposure was already conceded. The old VA exam only asked whether diabetes caused the high blood pressure. A private registered nurse reviewed the service records, treatment records, and VA exams, and cited research on Agent Orange. The Board found the evidence favored the veteran.
Read decision A22020927 on VA.gov (opens in a new tab)A private letter the Board turned down.Denied · 2025
“However, such opinion is conclusory in nature and does not include a rationale, to include citation to supporting evidence or medical principles other than a notation that he reviewed the STRs and post-service treatment records.”
Service records showed one high reading, then a normal recheck. The letter said high blood pressure went undiagnosed in service but gave no reasons. A VA examiner walked through the readings and cited studies. The Board gave the letter no weight.
Read decision A25051167 on VA.gov (opens in a new tab)
What a strong nexus letter for high blood pressure does
From the opinions the Board found convincing:
- Reviews your service records, your VA file, and your treatment since, and says so.
- Walks through your blood pressure readings in service and after, including any high ones.
- If PTSD is the cause, explains how: stress, smoking or drinking, less activity, poor diet.
- If an exposure is the cause, like Agent Orange or Camp Lejeune water, cites studies and ties them to you.
- Deals with the evidence against you: a normal separation exam, other risk factors, or exposures at later jobs.
- Covers each way you say it happened, not just one.
- Uses the VA’s standard, “at least as likely as not.”
- Gives real reasons. The Board called one letter “conclusory” and gave it no weight.
See what your records support
Our Nexus Check reads every page you send and cites the page for each finding, including pages that work against the claim. It’s free. If you request a letter, we draft it, and a licensed clinician reviews it, edits it and signs only what they support.
(360) 347-2563 · Mon–Fri 8am–5pm, Sat–Sun 8am–2pm Pacific. Outside those hours, request a call and we respond the next day we’re open.
If we don’t respond the same day during business hours, you get 15% off your nexus letter.
A call, voicemail or text from us counts as our reply. Business hours: Mon to Fri 8 to 5, Sat and Sun 8 to 2 Pacific. Terms
We don’t file claims or contact the VA for you. You or your accredited representative decide how to submit your evidence.
Public Board of Veterans’ Appeals decisions. These veterans weren’t Anchorpoint clients. Every claim is decided on its own evidence.