Heart Disease: Does it Qualify?

Both congenital heart disease and ischemic heart disease are recognized by the VA as potential service-connected impairments. In particular, ischemic heart disease, which is better known as coronary artery disease, has been linked to Agent Orange exposure. For this reason, veterans who have been exposed to Agent Orange are not required to prove a connection between their ischemic heart disease and their service in the military in order to qualify for VA disability benefits. There are a number of other cardiovascular conditions that also fall under the umbrella term of “heart disease” which also qualify for VA disability compensation, but this article will mainly focus on those conditions which are most commonly claimed by veterans:

Congenital heart disease is another condition that can be subject to service connection, although the rating schedule used to rate it depends on the type of congenital abnormality causing the disease. For example, if the abnormality causing the disease is a heart valve defect, it would be rated under the valvular heart disease rating schedule. Since congenital heart disease is a genetic disease, individuals that have it are predisposed genetically to cardiac arrest and/or coronary blockages. However, this condition can still be service connected if it became symptomatic during your time in the military.

Getting Service Connected for Heart Disease: What Evidence is Needed

As with other service-connected conditions, the most important pieces of evidence needed to prove service connection are your medical records. Ideally, these records will include documents (1) diagnosing you with heart disease that began in service or that was made worse during your military service and (2) specifying the severity of the condition and its effects on your daily functioning. In addition to providing both in-service and post-service medical records to the VA, you should also submit any military service records showing an in-service diagnosis of heart disease, onset of symptoms, or change of duty due to your heart condition. Other helpful evidence could include signed statements from family members, friends, and others familiar with your condition. Overall, you want to provide as much information to the VA as possible showing that your heart disease (ischemic or congenital) was caused or exacerbated by your military service.  

The VA uses METs, also known as Metabolic Equivalents (or more colloquially, exercise tests), when considering what rating to grant someone with heart disease. A MET can be measured as the ratio of your working metabolic rate compared to your resting metabolic rate. This ratio is important for determining heart health because the level of energy you exert when engaged in physical activities is directly tied to your heart’s functioning. The more METs you are able to produce during a single test session, the healthier your heart is. During a VA exam to determine your METs level, the examiner will attach electrodes to your chest, arms, and legs. He or she will then ask you to walk on a treadmill or bike and gradually increase the level of difficulty of the exercise until you are unable to continue due to your heart rate reaching a certain level or you exhibiting symptoms of significant fatigue, such as dizziness, abnormal heart rhythm, or significant shortness of breath.

How the VA Rates Cardiovascular System Impairments

Under 38 CFR § 4.104, the VA provides a schedular rating system for heart disease and a number of other cardiovascular-related conditions. In this section, I will include the rating schedules for several of the most common cardiovascular conditions claimed by veterans:

  • Diagnostic code 7005: Arteriosclerotic heart disease (Coronary artery disease)
  • With documented coronary artery disease resulting in: Chronic congestive heart failure, or; workload of 3 METs or less results in dyspnea, fatigue, angina, dizziness, or syncope, or; left ventricular dysfunction with an ejection fraction of less than 30 percent: 100%
  • More than one episode of acute congestive heart failure in the past year, or; workload of greater than 3 METs but not greater than 5 METs results in dyspnea, fatigue, angina, dizziness, or syncope, or; left ventricular dysfunction with an ejection fraction of 30 to 50 percent: 60%
  • Workload of greater than 5 METs but not greater than 7 METs results in dyspnea, fatigue, angina, dizziness, or syncope, or; evidence of cardiac hypertrophy or dilatation on electrocardiogram, echocardiogram, or X-ray: 30%
  • Workload of greater than 7 METs but not greater than 10 METs results in dyspnea, fatigue, angina, dizziness, or syncope, or; continuous medication required: 10%
  • Diagnostic code 7007: Hypertensive heart disease
  • Chronic congestive heart failure, or; workload of 3 METs or less results in dyspnea, fatigue, angina, dizziness, or syncope, or; left ventricular dysfunction with an ejection fraction of less than 30 percent: 100%
  • More than one episode of acute congestive heart failure in the past year, or; workload of greater than 3 METs but not greater than 5 METs results in dyspnea, fatigue, angina, dizziness, or syncope, or; left ventricular dysfunction with an ejection fraction of 30 to 50 percent: 60%
  • Workload of greater than 5 METs but not greater than 7 METs results in dyspnea, fatigue, angina, dizziness, or syncope, or; evidence of cardiac hypertrophy or dilatation on electrocardiogram, echocardiogram, or X-ray: 30%
  • Workload of greater than 7 METs but not greater than 10 METs results in dyspnea, fatigue, angina, dizziness, or syncope, or; continuous medication required: 10%
  • Diagnostic code 7000: Valvular heart disease (including rheumatic heart disease)
  • During active infection with valvular heart damage and for three months following cessation of therapy for the active infection: 100%

Thereafter, with valvular heart disease (documented by findings on physical examination and either echocardiogram, Doppler echocardiogram, or cardiac catheterization) resulting in:

  • Chronic congestive heart failure, or; workload of 3 METs or less results in dyspnea, fatigue, angina, dizziness, or syncope, or; left ventricular dysfunction with an ejection fraction of less than 30 percent: 100%
  • More than one episode of acute congestive heart failure in the past year, or; workload of greater than 3 METs but not greater than 5 METs results in dyspnea, fatigue, angina, dizziness, or syncope, or; left ventricular dysfunction with an ejection fraction of 30 to 50 percent: 60%
  • Workload of greater than 5 METs but not greater than 7 METs results in dyspnea, fatigue, angina, dizziness, or syncope, or; evidence of cardiac hypertrophy or dilatation on electro-cardiogram, echocardiogram, or X-ray: 30%
  • Workload of greater than 7 METs but not greater than 10 METs results in dyspnea, fatigue, angina, dizziness, or syncope, or; continuous medication required: 10%
  • Diagnostic code 7006: Myocardial infarction
  • During and for three months following myocardial infarction, documented by laboratory tests: 100%

Thereafter:

  • With history of documented myocardial infarction, resulting in: Chronic congestive heart failure, or; workload of 3 METs or less results in dyspnea, fatigue, angina, dizziness, or syncope, or; left ventricular dysfunction with an ejection fraction of less than 30 percent: 100%
  • More than one episode of acute congestive heart failure in the past year, or; workload of greater than 3 METs but not greater than 5 METs results in dyspnea, fatigue, angina, dizziness, or syncope, or; left ventricular dysfunction with an ejection fraction of 30 to 50 percent: 60%
  • Workload of greater than 5 METs but not greater than 7 METs results in dyspnea, fatigue, angina, dizziness, or syncope, or; evidence of cardiac hypertrophy or dilatation on electrocardiogram, echocardiogram, or X-ray: 30%
  • Workload of greater than 7 METs but not greater than 10 METs results in dyspnea, fatigue, angina, dizziness, or syncope, or; continuous medication required: 10%

Contact Our Law Firm About Your Heart Condition Claim

If you have completed a VA test for heart disease or another cardiovascular condition and believe you received an unfair assessment or inaccurate disability rating, or are otherwise interested in obtaining service connection for your heart condition, please contact our office today. Our experienced veterans law attorneys are ready to help you get the compensation you deserve.