Can You Claim Hypertension Secondary to PTSD With DVA?

Hypertension secondary to PTSD is one of the most widely applicable secondary DVA claims in the system and one of the least known. The Hypertension SoP contains a direct mental health factor that connects accepted PTSD, depression, or anxiety to hypertension through a single step.

Most veterans with accepted PTSD who also have hypertension have never been told this claim exists. Many are managing blood pressure medication for a condition that is directly claimable under DVA.

The SoP factor

The Hypertension SoP No. 21 of 2022 (Reasonable Hypothesis version) contains factor 9(12):

“Having a clinically significant disorder of mental health as specified at the time of the clinical onset of hypertension.”

The SoP dictionary lists agoraphobia, anxiety disorder, depressive disorder, obsessive-compulsive disorder, panic disorder, posttraumatic stress disorder, social anxiety disorder and specific phobia, where the condition is severe enough to warrant ongoing management. The Balance of Probabilities version is SoP No. 22 of 2022. It has the same factor 9(12), but its list leaves out depressive disorder.

Why PTSD causes hypertension

PTSD produces chronic activation of the hypothalamic-pituitary-adrenal (HPA) axis and the sympathetic nervous system. This sustained stress response elevates baseline cortisol and catecholamine levels, increases heart rate and cardiac output, causes vascular inflammation, and impairs baroreflex sensitivity. Over time, these physiological changes drive structural changes in the vasculature that produce sustained hypertension.

Under the reasonable hypothesis standard, the treating physician’s report needs to establish that the connection is a reasonable scientific hypothesis — not prove it beyond doubt. The clinical mechanism is well-documented in the medical literature, making this a straightforward factor for a reporting psychiatrist or GP to address.

What counts as hypertension

The SoP defines hypertension as persistently elevated blood pressure diagnosed by a medical practitioner, shown by a usual clinic reading of 140 mmHg systolic or more or 90 mmHg diastolic or more (or equivalent ambulatory readings), a usual home reading of 135/85 or more, or the regular use of antihypertensive therapy to reduce blood pressure. If you are on antihypertensive medication, you meet the definition by virtue of being on treatment, regardless of your current controlled readings.

Additional SoP factors

Factor 9(12) is the mental health pathway, but the hypertension SoP contains other factors that may apply alongside it or independently:

Multiple factors can be cited in a single claim. DVA only needs to find one factor satisfied. Veterans with both PTSD and sleep apnoea accepted — two increasingly common combinations — have two independent pathways to hypertension through factors 9(12) and 9(9).

GARP M assessment for hypertension

Hypertension is assessed under GARP M’s cardiovascular tables. The assessment considers blood pressure readings, medication requirements, and evidence of end-organ damage. Hypertension well-controlled on medication typically produces a 5 to 10 point impairment rating. Hypertension with end-organ effects (left ventricular hypertrophy, renal impairment, or retinal changes) can attract a higher rating.

While the impairment points from hypertension alone may be modest, they add to your combined impairment score. Veterans who already have PTSD, lumbar spondylosis, and hearing loss accepted may find that adding hypertension and one or two other secondary conditions pushes their combined score across the 60-point Gold Card threshold or the 50-point SRDP threshold.

Why almost no veteran knows this claim exists

Hypertension is widely viewed as a lifestyle condition linked to diet, weight, and age. DVA's mental health factor is not prominently discussed in any publicly available DVA guidance, and the condition is not flagged by most GPs or treating psychiatrists as a potential DVA claim.

Veterans with accepted PTSD are typically told to claim conditions that are clearly psychiatric in nature. The cardiovascular secondary pathway sits outside that framing, which is why it falls through the cracks in nearly every veteran’s claim history.

Frequently asked questions

My blood pressure is well controlled with medication. Can I still claim?

Yes. Being on treatment for hypertension satisfies the SoP definition regardless of your current controlled readings. Effective medication management does not extinguish the underlying condition or the claim.

I have both PTSD and sleep apnoea accepted. Which factor should I use?

Both may apply. Cite multiple factors in a single claim. DVA only needs to find one satisfied. Having two independent pathways strengthens the claim.

Does claiming hypertension affect my PTSD impairment rating?

No. Each condition is assessed independently under GARP M. Claiming hypertension does not reduce or modify the existing PTSD impairment rating.

My PTSD developed years after my hypertension was diagnosed. Does that rule out the claim?

It depends on the clinical onset dates. Factor 9(12) requires the mental health condition to be present at the time of clinical onset of the hypertension. If the hypertension predates the PTSD, the direct pathway through factor 9(12) may not be available. However, other factors — such as 9(9) for sleep apnoea or 9(1) for overweight — may independently be satisfied. A careful review of the onset timeline is needed.

I have depression, not PTSD. Does the same factor apply?

Under the RH SoP (warlike and non-warlike service), yes. Its list for factor 9(12) includes depressive disorder, not only PTSD. Under the BoP SoP (peacetime service), depressive disorder is not on the list, so accepted depression alone does not satisfy factor 9(12). Other factors, such as being overweight for five years, may still apply.