The PACT Act disability rating for hypertension runs from 0% to 60%, but the number that matters most is this: roughly 82% of veterans who win service connection for hypertension under the PACT Act receive a 0% rating, which means no monthly check.1Military.com. VA Reviews Ratings Schedule After High Number of 0% Disability Awards Under PACT Act Hypertension is presumptive for veterans with qualifying herbicide-era service, so proving cause is not the hurdle. The rating itself is, because the VA measures the condition by blood pressure readings, and medication brings most veterans’ readings below the compensable threshold.
The Rating Tiers
The VA rates hypertension under Diagnostic Code 7101 in 38 CFR § 4.104. Ratings are based on blood pressure measured predominantly over time, confirmed by readings taken at least two times on at least three different days.2Cornell Law Institute. 38 CFR § 4.104 Schedule of Ratings, Cardiovascular System
- 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 a history of diastolic pressure predominantly 100 or more with a continuous need for medication to control it.
- 0%: Diagnosed hypertension that does not meet the criteria for any higher rating.
Why Most Approved Claims Land at 0%
A veteran whose medication keeps diastolic pressure well under 100 and systolic under 160 does not meet the criteria for 10%, regardless of how severe the underlying condition would be without treatment.3DAV. How a 0% Disability Rating Unlocks Additional VA Benefits The 10% tier does have a second path for medicated veterans: a documented history of diastolic pressure predominantly at 100 or more, combined with continuous medication use. But that path only works if the record shows readings at that level before medication brought them under control. Many veterans do not have that documentation, especially those diagnosed and treated in civilian practice years after service.
In February 2026, the VA published an interim final rule amending 38 CFR § 4.10 that reinforced this reality across all conditions. Examiners are told to evaluate the veteran’s actual level of functional impairment under ordinary conditions of daily life. If medication lowers the level of disability, the rating is based on that lowered level. Examiners are explicitly instructed not to estimate what the disability would look like without treatment.4Federal Register. Evaluative Rating Impact of Medication The VA said the rule was needed to counteract a 2025 Court of Appeals for Veterans Claims decision, Ingram v. Collins, which the VA argued would have forced examiners to speculate about unmedicated disability levels across more than 500 diagnostic codes.
Never stop taking prescribed blood pressure medication before a C&P exam to try to produce higher readings. Uncontrolled hypertension can be life-threatening, and the DAV and other veteran service organizations specifically warn against it.3DAV. How a 0% Disability Rating Unlocks Additional VA Benefits
Monthly Compensation at Each Rating
As of December 1, 2025, basic monthly VA disability compensation for a veteran with no dependents at each rating level:
- 0%: No monthly payment.
- 10%: $180.42
- 20%: $356.66
- 40%: $795.84
- 60%: $1,435.02
Veterans rated at 30% or higher receive additional compensation for dependents.5VA.gov. VA Disability Compensation Rates
What a 0% Rating Still Gets You
A 0% rating pays nothing, but service connection at that level opens the door to real benefits. The VA lists VA healthcare (checkups, specialist appointments, prescriptions), travel pay reimbursement for medical appointments, dental and vision care if otherwise eligible, and low-cost VALife insurance as available to veterans with a non-compensable service-connected disability.6VA.gov. Non-Compensable Disability The DAV notes that 0%-rated veterans may also qualify for copayment waivers and federal hiring preferences.3DAV. How a 0% Disability Rating Unlocks Additional VA Benefits
Priority group placement depends on income, enrollment date, and other factors. A 0%-rated veteran may land in Priority Group 5, 6, or one of the Priority Group 8 subgroups. In the least favorable placement, Priority Group 8 subgroup e, the veteran is eligible only for care related to the service-connected condition, not general VA healthcare.7VA.gov. Priority Groups for VA Health Care
The bigger reason a 0% rating matters is what it makes possible later. Service connection for hypertension, even at 0%, is the foundation for claiming secondary conditions caused or aggravated by it. Those secondary conditions often rate much higher than the hypertension itself.
Secondary Conditions Are Where the Rating Actually Grows
Under 38 CFR § 3.310(a), a veteran can claim service connection for a condition caused or aggravated by an already service-connected disability. This requires a current diagnosis of the secondary condition and a medical opinion stating the condition is at least as likely as not caused or aggravated by the service-connected hypertension.
- Heart disease: Ischemic heart disease is rated up to 100% under Diagnostic Code 7005. Hypertensive heart disease and heart failure also fall in this category.
- Kidney disease: Chronic kidney disease and end-stage renal failure rate up to 100% under 38 CFR § 4.115a. Hypertension is the second leading cause of chronic kidney disease.
- Stroke: A temporary total rating applies for six months post-treatment, with ongoing compensation for residual effects.
- Other: Peripheral artery disease, retinopathy and other vision problems, erectile dysfunction, chronic headaches, cognitive impairment, sleep apnea, and mental health conditions such as depression and anxiety.
A veteran with 0% for hypertension who later establishes ischemic heart disease at 60% sees both the combined rating and monthly compensation jump substantially.8VA.gov. About VA Disability Ratings Veterans whose combined rating reaches 70% (with at least one condition at 40%), or who have a single condition rated at 60%, may qualify for Total Disability based on Individual Unemployability, which pays at the 100% rate if the veteran cannot maintain substantially gainful employment. In one Board of Veterans’ Appeals decision, a veteran with hypertension (10–20%), PTSD (70%), and knee disabilities received TDIU after the Board found the combined effect prevented him from working, given a work history limited to physical labor.9VA.gov. BVA Decision A22001680
Who Qualifies for the Presumption
The PACT Act (Public Law 117-168), signed August 10, 2022, added hypertension to the conditions presumed to be caused by exposure to Agent Orange or other tactical herbicides used during the Vietnam era. Veterans who served in a qualifying location during a qualifying period do not need to prove herbicide exposure caused their high blood pressure; they need only show a current diagnosis and qualifying service.
- Republic of Vietnam: January 9, 1962, through May 7, 1975, including territorial waters within 12 nautical miles of shore.
- Korean DMZ: September 1, 1967, through August 31, 1971.
- Thailand: Any U.S. or Royal Thai military base, January 9, 1962, through June 30, 1976.
- Laos: December 1, 1965, through September 30, 1969.
- Cambodia: Mimot or Krek, Kampong Cham Province, April 16, 1969, through April 30, 1969.
- Guam or American Samoa: Including territorial waters, January 9, 1962, through July 31, 1980.
- Johnston Atoll: Including ships that called at the atoll, January 1, 1972, through September 30, 1977.
- C-123 aircraft: Air Force or Air Force Reserve veterans who regularly operated, maintained, or served aboard C-123 aircraft known to have been used for spraying herbicides during the Vietnam era.
Two boundaries are worth knowing. Hypertension is not currently a presumptive condition for burn pit or other post-9/11 toxic exposures. The PACT Act burn pit presumptive list covers cancers and respiratory illnesses, not hypertension.11VA.gov. Specific Environmental Hazards and Exposures And hypertension does not qualify for retroactive benefits under the Nehmer consent decree, which covers “heart disease” but treats hypertension as a separate condition. Veterans previously denied a hypertension claim must file a Supplemental Claim to have the case reconsidered under the new presumptive rules.12VA.gov. The PACT Act and Your VA Benefits
Filing the Claim and the C&P Exam
File online at VA.gov, by mail, or at a VA regional office. The core documents are a medical record showing a current diagnosis of hypertension and service records (such as a DD214) confirming service in a qualifying location during the relevant timeframe.12VA.gov. The PACT Act and Your VA Benefits Veterans previously denied should file a Supplemental Claim rather than wait for VA outreach.
The VA typically orders a Compensation and Pension exam to assess severity. During the exam, the veteran is seated with back and feet supported, and the examiner records three blood pressure readings. There is no required interval between them; they may be taken sequentially. Lying and standing measurements are not required by VA examination guidelines.13VA.gov. Hypertension Disability Benefits Questionnaire The examiner reviews military records, treatment history, and current medications, and may check for heart or kidney complications. Bringing home blood pressure logs and documentation of past readings, especially any showing diastolic pressure at 100 or higher before medication, is the practical way to support a case for a compensable rating.
The Claims Data
Hypertensive vascular disease is the single most frequently claimed condition under the PACT Act. Through December 31, 2025, veterans filed 696,580 hypertension claims, with a 60% grant rate.14Department of Veterans Affairs. VA PACT Act Performance Dashboard, Issue 54 That grant rate runs below the 73% overall PACT Act approval rate, and the 82.1% share of granted hypertension claims that carry a 0% rating remains the reason many veterans come away disappointed even after winning service connection.1Military.com. VA Reviews Ratings Schedule After High Number of 0% Disability Awards Under PACT Act The path to compensation for most of those veterans runs through documenting pre-medication readings if the record allows it, and through secondary conditions if the hypertension has produced them.