Filing a Hypertension Claim

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This is general education, not legal or claims advice, and not guidance for your specific claim. It cannot promise you a rating or an outcome, and no one can. For help with your own claim, see a free accredited representative (see Get free, accredited help below). Nothing here creates a representative relationship.

Current as of October 2026. Rules, forms, and figures change. Check current details at va.gov.

The best way to use this guide

The strongest position is to be your own informed advocate and to work with a free accredited representative. An accredited Veterans Service Organization, such as the DAV, VFW, American Legion, or a county or state veterans office, helps at no charge. Accredited claims agents and attorneys can help too. They can't charge for work done before VA issues its initial decision on your claim, and after that they may charge a fee within the limits of 38 CFR 14.636. This guide is here so you understand your own situation and can work with them as a full partner instead of handing it over blind. If you'd rather handle this yourself, and you're comfortable doing that, the guide walks you through every step. Either way, you stay in control.

What you'll get done

The outcome: By the end of this guide you'll have filed a complete hypertension claim on VA Form 21-526EZ on the path that fits your history (direct, secondary, or presumptive), with your blood-pressure evidence attached.

This guide prepares you for the task. It doesn't and can't promise a rating, a percentage, or an outcome. The evidence in your file decides the result.

What you need before you start

• A way to get on VA.gov, or VA's main number, 1-800-827-1000.
• Your service dates and branch, and where you served (especially any service in Vietnam, its waters, Thailand, Laos, Cambodia, Guam, American Samoa, Johnston Atoll, or in or near the Korean DMZ during the Agent Orange dates VA lists, which run from 1962 to as late as 1980).
• Medical records with your blood-pressure readings across several days.
• A current hypertension diagnosis and your medication list.
• The names of any service-connected conditions that may have caused or worsened your blood pressure.
• Your VA file number, if you have one.

When to start: Today. An Intent to File holds your potential start date for one year while you gather the rest.

Start here: the basics

Hypertension is high blood pressure. VA rates it under Diagnostic Code 7101, and it has to be confirmed by readings taken two or more times on at least three different days. There are four ways it can be connected to service. Direct: it started in service, and a medical link ties today's condition to it. The one-year rule: it showed up to a compensable degree within one year after you left active duty. Secondary: a service-connected condition caused it or made it worse. Agent Orange: the PACT Act added hypertension to the Agent Orange list for veterans with qualifying herbicide-exposure service. That presumption is tied to Agent Orange service, not to burn pits or a post-9/11 deployment. This guide prints no rating percentages. See how hypertension is rated at va.gov.

Where this is written down: 38 CFR § 4.104, DC 7101, Note (1); 38 CFR §§ 3.303, 3.307(a)(3), 3.309(a), 3.310; 38 U.S.C. § 1116(a)(2)(M) and (d).

The steps

Step 1. File an Intent to File today.

How. Go to va.gov/resources/your-intent-to-file-a-va-claim, call 1-800-827-1000, or mail VA Form 21-0966. If you start the online 21-526EZ while signed in, VA records it for you. Save the confirmation.

If VA already denied a hypertension claim, then talk with a representative about a Supplemental Claim on VA Form 20-0995. VA's website says an Intent to File can hold your date for a Supplemental Claim, but the regulation says its Intent to File rule doesn't apply to Supplemental Claims. Don't count on it. Send VA Form 20-0995 itself as soon as you can.

Do not wait until your evidence is perfect. The Intent to File costs nothing, and it holds your date only if the complete claim follows within one year.

Where this is written down: 38 CFR § 3.155(b).

Done when you have a confirmation saved.

Step 2. Gather your blood-pressure evidence.

How. Collect the records that show your readings and your diagnosis. VA needs the hypertension confirmed by readings taken two or more times on at least three different days. List your blood-pressure medicines and when you started each one. Readings from before you started medicine matter, so look for old ones in service records and early doctor visits.

Do not count on a single high reading. Hypertension is shown by a pattern over several days.

Where this is written down: 38 CFR § 4.104, DC 7101, Note (1).

Done when you have readings from at least three different days and your medication history.

Step 3. Choose your service-connection path.

How. Match your history to one or more paths. A representative can help you see which fit.

If you served in Vietnam, its offshore waters, or another listed Agent Orange place and time, then claim it as an Agent Orange presumptive. If a service-connected condition (for example, diabetes or kidney disease) caused it, then claim it as secondary. If a service-connected condition made existing high blood pressure worse, then claim aggravation, and VA will need medical evidence of how bad it was before it got worse, or the earliest medical evidence from after it started getting worse. If it reached a ratable level within a year of leaving active duty, then look at the one-year rule. If it started in service, then claim it directly.

Where this is written down: 38 U.S.C. § 1116; 38 CFR §§ 3.303, 3.307(a)(3), 3.309(a), 3.310(a) and (b).

Done when you've written down which path or paths fit your history.

Step 4. Line up the medical link your path needs.

How. For a direct or secondary claim, the file needs a medical opinion on whether your hypertension is "at least as likely as not" related to service, or caused or made worse by the service-connected condition you named. VA usually asks its examiner for that opinion. You can also send one from your own provider. For an Agent Orange claim, you don't need a link opinion. You need proof of the qualifying service and the diagnosis.

If you get a private opinion for a secondary claim, then make sure it names the service-connected condition and explains how it caused or worsened your blood pressure. If you're filing as Agent Orange, then put your effort into proving where and when you served.

Where this is written down: 38 CFR § 3.159(c)(4); 38 CFR § 3.102.

Done when you have the opinion your path needs, or you know VA will get one, or your path needs none.

Step 5. Fill out VA Form 21-526EZ and name the condition clearly.

How. List "hypertension." If you're filing secondary, name the condition that caused it (for example, "hypertension, secondary to type 2 diabetes"). If Agent Orange, say where and when you served.

Do not assume hypertension controlled by medicine can't be rated. The rating schedule counts a history of high readings that now needs continuous medication. Check how at va.gov.

Where this is written down: 38 CFR § 4.104, DC 7101.

Done when hypertension is on the form with your path stated and every service field filled in.

Step 6. Get ready for the C&P exam.

How. Expect the examiner to take several readings and go over your history. Bring a home blood-pressure log if you keep one, and know your medicines and doses.

Do not skip the exam. If you can't make it, call before the appointment to reschedule. Without good cause, VA decides a first claim on what's already in the file.

Where this is written down: 38 CFR § 3.655(b).

Done when your readings and medication list are ready to take to the exam.

Step 7. Send one organized package and keep proof.

How. Put the 21-526EZ, your blood-pressure records, medication history, and any opinion or service evidence together with a short cover page listing what's inside. File online at va.gov/disability/file-disability-claim-form-21-526ez and save the confirmation. Or mail it to: Department of Veterans Affairs, Claims Intake Center, PO Box 4444, Janesville, WI 53547-4444, with tracking.

Done when your package is sent and you have a dated confirmation or tracking receipt.

Step 8. Confirm VA got everything.

How. About 10 days after you file, check va.gov/claim-or-appeal-status or call 1-800-827-1000. Make sure the claim shows as received and each document is in the file.

If VA later decides the claim without getting records you told it about, then write that down and take it to a free accredited representative. A Higher-Level Review can send a claim back to fix a duty-to-assist error.

Where this is written down: 38 CFR § 3.2601(g); 38 CFR § 3.159.

Done when you've confirmed each document you sent is in your claims file.

Recap checklist

• Filed an Intent to File and saved the confirmation.
• Gathered readings from at least three different days and my medication history.
• Chose my path: direct, one-year rule, secondary or aggravation, or Agent Orange.
• Lined up the medical link my path needs, or confirmed it needs none.
• Filled out the 21-526EZ naming hypertension and my path.
• Got my readings and medication list ready for the C&P exam.
• Sent one organized package and kept proof.
• Confirmed every document is in my file.

Reminder: rules and rates change. Check any current figure at va.gov. Help from an accredited Veterans Service Organization is free. Accredited claims agents and attorneys can't charge for work done before VA issues its initial decision on your claim. After that, they may charge a fee within the limits of 38 CFR 14.636. This guide prepared you for the task. The evidence in your file decides the result.

Go further

• The book: VA Secondary Claims Manual, the full guide this one comes from. Coming soon as a PDF on this site and in Kindle and paperback on Amazon.
• The workbook: The Master VA Claim Workbook, a fillable PDF. Coming soon.
• Free toolkit: the worksheets that go with VA Secondary Claims Manual. No signup.

Get free, accredited help

For anything about your own claim, talk to an accredited representative. Help from an accredited Veterans Service Organization is free. Accredited claims agents and attorneys can't charge for work done before VA issues its initial decision on your claim. After that, they may charge a fee within the limits of 38 CFR 14.636. Free help is available through Veterans Service Organizations such as the DAV, VFW, and American Legion, and through county and state veterans offices.

To find one near you, visit va.gov/get-help-from-accredited-representative. Representation begins only when you sign VA Form 21-22 (for a Veterans Service Organization) or 21-22a (for an individual agent or attorney). With one rare exception for a single unpaid case, only accredited people can represent you before the VA, and only an accredited agent or attorney can charge you a fee. Nothing in this guide creates that relationship.

A warning about claim sharks. Anyone who offers to file your initial claim for a fee, or who guarantees you a rating or a percentage, is selling something you shouldn't buy. Accredited Veterans Service Organizations help at no charge, and accredited claims agents and attorneys may charge only after VA issues its initial decision, within the limits of 38 CFR 14.636. Report predatory companies to the VA Office of Inspector General at 1-800-488-8244.

About this guide

This guide is education, not representation. It explains how part of the VA system works so you can handle your own business with confidence. It is not legal or claims advice, and reading it does not create any representative relationship between you and the author. The author is not affiliated with the Department of Veterans Affairs, and nothing here is endorsed by the VA.

This guide prints no live VA dollar figures and no rating percentages on purpose, because they change. Before you make a decision based on any number, check the current figure at va.gov. No book can promise you a rating; the evidence in your file decides the result. Help from an accredited Veterans Service Officer is always free.

Details

• PDF, US Letter, 9 pages including the cover
• 14 fillable checkboxes
• Current as of October 2026

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Never a cut of your claim.

About the author: J. Erickson is a service-disabled Air Force veteran. He served as a military firefighter and as a veteran service officer, where he spent years walking veterans through the same claims process he writes about now. He holds an MBA and writes plain-language guides for veterans who want to understand the system without a translator.