How to Prove 60% and 100% Heart VA Disability Ratings
Types of Heart Conditions
Veterans who develop heart conditions as a result of service may be eligible to receive VA disability benefits. Some of the most common heart conditions that veterans experience include the following:
Coronary Artery Disease
Coronary artery disease (CAD) represents the most common type of heart disease. It happens when the arteries that supply blood to the heart muscle become hardened and narrow. CAD is typically due to the buildup of cholesterol and other material, called plaque, on the arteries’ inner walls. Symptoms of coronary artery disease include pain or discomfort in other areas of the upper body (e.g. arms, back, and neck), difficulty breathing, sweating, indigestion, etc.
Myocardial Infarction
Myocardial infarction, commonly known as a heart attack, occurs when a portion of the heart is deprived of oxygen due to blockage of a coronary artery. Symptoms include pressure or tightness in the chest, sweating, shortness of breath, dizziness, increased heart rate. Importantly, the severity of the symptoms can vary for each individual.
Coronary Bypass Surgery
Coronary bypass surgery is a procedure that restores blood flow to the heart muscle by diverting the flow of blood around a section of a blocked artery in the heart. It does not cure the heart disease that caused the blockages (e.g. CAD), but it can ease the symptoms. For some people, this procedure can improve heart function and reduce the risk of dying of heart disease.
Veterans can receive VA disability compensation for any of the above-mentioned conditions if they are able to establish service connection.
Establishing Service Connection
Service connection for heart conditions can be established in several ways, including the following: direct service connection, secondary service connection, and presumptive service connection. Direct service connection is arguably the most common way for veterans to pursue VA disability benefits and requires the following:
- a current diagnosis of a heart condition;
- an in-service event, injury, or illness; and
- a medical nexus linking the current, diagnosed heart condition to the in-service event.
However, veterans may also be able to establish service connection for their heart conditions on a secondary basis. Specifically, if veterans have an already service-connected condition that causes or aggravates their heart condition, secondary service connection may be warranted.
Finally, veterans may be able to receive service-connected compensation for their heart conditions on a presumptive basis. If you served in Vietnam between 1962 and 1975, or in the Korean DMZ between September 1, 1967 and August 31, 1971, VA should grant service connection for your heart condition.
Importantly, presumptive service connection removes the second element of service connection that requires an in-service event. Here, a veteran’s presumed herbicide exposure serves as the in-service event. Furthermore, a medical nexus is not required because VA has already established that herbicide exposure is associated with heart conditions.
How VA Rates Heart Conditions
The majority of heart conditions are rated based on a set rating system under 38 CFR § 4.104, Schedule of Ratings – Cardiovascular System. The ratings below are assigned if veterans meet one or more of the criteria listed for each percentage:
- 100% – continuous congestive heart failure; the condition scores 3 METs or less on an MET test and causes shortness of breath, fatigue, chest pain, dizziness, or fainting; or left ventricular dysfunction with an ejection fraction of less than 30 percent
- 60% – two or more episodes of congestive heart failure in the past year; the condition scores 4 or 5 METs and causes shortness of breath, fatigue, chest pain, dizziness, or fainting; left ventricular dysfunction with an ejection fraction between 30 and 50 percent
- 30% – the condition scores 6 or 7 METs on an MET test and causes shortness of breath, fatigue, chest pain, dizziness, or fainting; or evidence (X-ray, electrocardiogram, or echocardiogram) of hypertrophy or dilation
- 10% – the condition scores 8, 9, or 10 METs and causes shortness of breath, fatigue, chest pain, dizziness, or fainting; or continuous medication is required
Veterans can submit medical records, lay statements, and doctor’s opinions in order to demonstrate that their heart conditions meet a certain level of disability. Importantly, if veterans do not agree with the disability rating that VA assigns, they have the right to appeal for an increased rating.
60% Versus 100% for Heart Conditions
As outlined above, VA assigns a 60 percent rating when a veteran experiences debilitating symptoms during low levels of exercise, including walking or light yard work (e.g. weeding, mowing with a power mower). This rating would also be appropriate if veterans have experienced several episodes of congestive heart failures (i.e. occasional not constant congestive heart failure).
To obtain the highest disability rating for heart conditions, veterans must prove that there has been an escalation in symptomology. Namely, veterans should show that they experience the symptoms of heart conditions at extremely minimal levels of exercise, including walking slowly for one or two blocks, showering, dressing, or eating. Furthermore, if veterans have chronic or continuous congestive heart failure rather than just occasional episodes of congestive heart failure, they may be eligible for a 100 percent rating.
It is important to note that a 100 percent rating is also awarded for certain heart conditions that require hospitalization. Veterans will receive a 100 percent, temporary total rating for the duration of the hospitalization and the first three months following the end of treatment or hospitalization for the condition.
