VET|100

What Changed for Hypertension

Under the 2026 PACT Act expansion (Section 902), hypertension is now a presumptive condition for toxic exposure-eligible veterans. This is one of the most significant additions because hypertension is among the most common diagnoses in the veteran population.

Previously, veterans had to prove a direct nexus — a medical opinion linking their hypertension to their military service. That often required an independent medical opinion (IMO), extensive research into medical literature, and navigating a claims process stacked against them.

Now, if you are a toxic exposure-eligible veteran with a hypertension diagnosis, the VA presumes it is connected to your service. The burden of proof shifts from you to the VA.

Who Qualifies

To qualify for presumptive hypertension under the PACT Act, you must be a toxic exposure-eligible veteran. This includes veterans who served in:

• Burn pit exposure zones — Iraq, Afghanistan, Southwest Asia, and other post-9/11 deployment areas
• Agent Orange exposure areas — Vietnam, Thailand (select bases), C-123 aircraft crews, test/storage locations
• Radiation risk activities — nuclear weapons testing, Hiroshima/Nagasaki occupation, specific operations
• Camp Lejeune — 30+ days of service between 1953 and 1987
• Gulf War service — Southwest Asia theater of operations
• Other qualifying exposures — identified contamination sites, specific military occupational specialties with documented toxic exposure

What "Presumptive" Means

A presumptive condition means the VA accepts that your military service caused the condition without requiring you to prove a direct connection. You do not need:

• A nexus letter from a doctor for the service connection itself
• Medical literature linking hypertension to your specific exposure
• An independent medical opinion (IMO)

You do still need:

• A current diagnosis of hypertension from a medical provider
• Blood pressure readings documenting your condition
• Evidence of your qualifying service (deployment records, DD-214, service records)

How to File a New Hypertension Claim

1. Get a current diagnosis — if you do not already have a formal hypertension diagnosis, see your doctor. Blood pressure readings of 140/90 or higher on multiple occasions typically qualify.
2. Gather service records — DD-214, deployment orders, personnel records showing service in qualifying locations.
3. File on VA.gov or through a VSO — submit a claim for hypertension citing PACT Act presumptive status.
4. Prepare for the C&P exam — the VA will likely schedule a Compensation and Pension exam. Use Vet100's C&P Exam Prep tool to know what to expect.

Previously Denied? How to Reopen

If you were previously denied for hypertension, you have options:

Secondary Conditions from Hypertension

Once hypertension is service-connected, you can also claim secondary conditions caused or aggravated by your hypertension. Common secondary conditions include:

• Chronic kidney disease — hypertension is a leading cause of kidney damage
• Heart disease — including coronary artery disease, left ventricular hypertrophy, and congestive heart failure
• Stroke / TIA — hypertension is the primary risk factor for cerebrovascular events
• Peripheral artery disease — narrowing of blood vessels caused by chronic high blood pressure
• Retinopathy — damage to the blood vessels of the retina from hypertension
• Erectile dysfunction — vascular damage from hypertension is a common cause

Use Vet100's Secondary Conditions tool to map all potential secondary claims from your hypertension rating.

Timeline Expectations

Here is what to expect after filing:

• Claim submission to C&P exam: typically 30-60 days
• C&P exam to decision: typically 30-90 days
• Total process: 2-6 months on average, though complex claims or supplemental claims may take longer
• Backpay processing: if approved with a retroactive effective date, backpay is typically deposited within 2-4 weeks of the decision

Frequently Asked Questions

Do I need a nexus letter for hypertension now?

No — not for the primary service connection. As a presumptive condition, the VA accepts the connection to service. However, if you are claiming secondary conditions caused by hypertension, you may need a nexus letter for those secondary claims.

What if my hypertension is controlled with medication?

You can still file. The VA rates hypertension based on your blood pressure readings and medication requirements. Being on medication is actually evidence of a current diagnosis and ongoing treatment.

I served in Iraq but was never exposed to burn pits directly. Do I qualify?

The PACT Act defines toxic exposure eligibility broadly. Service in Iraq, Afghanistan, and other Southwest Asia locations during qualifying periods generally makes you eligible, regardless of whether you were directly next to a burn pit.

Can I file before August 2026?

Yes. You can file now. If the presumptive status is not yet active when your claim is processed, the VA will hold it until the effective date. Filing early preserves your effective date for backpay purposes.

What rating will I get for hypertension?

Hypertension is rated under Diagnostic Code 7101. Common ratings are 10% (diastolic predominantly 100 or more, or systolic predominantly 160 or more, or minimum evaluation for an individual with a history of diastolic 100+ requiring continuous medication), 20% (diastolic predominantly 110+), 40% (diastolic predominantly 120+), and 60% (diastolic predominantly 130+).

Ready to File Your Hypertension Claim?

Use Vet100's free tools to prepare your claim and C&P exam.

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