/ Conditions · Cardiovascular

Heart disease VA Claim Guide

Heart disease is rated by the VA under the cardiovascular portion of the rating schedule. Cardiovascular ratings are driven by current METs / ejection fraction and (for hypertension) by a sustained pattern of elevated readings.

38 CFR §4.104

Common symptoms

  • Chest pain, palpitations, or shortness of breath
  • Fatigue with exertion
  • Swelling in the legs
  • Often asymptomatic (e.g., hypertension)

Common evidence

  • Cardiology evaluation with echocardiogram
  • Stress test or METs measurement
  • Blood pressure readings over time
  • Medication records

Primary service connection examples

  • Agent Orange exposure (ischemic heart disease, hypertension — presumptive)
  • In-service cardiac event or diagnosis

Secondary service connection examples

  • Hypertension secondary to PTSD, sleep apnea, or diabetes
  • Heart condition secondary to hypertension

Rating basics

Most cardiac conditions are rated by workload in METs that triggers symptoms, plus ejection fraction for heart disease. Hypertension rated under DC 7101 by diastolic / systolic readings. Atrial fibrillation rated by frequency of episodes.

Common denial reasons

  • Single elevated BP reading rather than a pattern
  • No current cardiac workup
  • Diagnosis outside presumptive window