Getting Veterans (VA) Disability for Heart Conditions
Veterans who develop heart conditions as a result of military service may be eligible to receive VA disability compensation.
Most Common VA Heart Conditions
Coronary Artery Disease (CAD)
Coronary artery disease represents the most common type of heart disease. It occurs when the arteries that supply blood to the heart muscle become hardened and narrow. Coronary artery disease is usually 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.
Hypertension is another name for high blood pressure. Blood pressure is determined both by the amount of blood your heart pumps and the amount of resistance to blood flow in your arteries. The more blood your heart pumps and the narrower your arteries, the higher your blood pressure. Hypertension can lead to severe health complications and increase the risk of heart disease, stroke, and sometimes death.
If you develop an additional heart condition, such as CAD, as the result of your hypertension, you can receive a secondary disability rating for Coronary Artery Disease.
Establishing Service Connection for Heart Conditions
In order to receive VA disability benefits, veterans must establish service connection. This can be done in a number of ways, including the following:
Direct Service Connection
Establishing direct service connection for heart conditions involves three elements:
- A current, diagnosed heart condition
- An in-service event or illness (e.g. onset of symptoms of a heart condition in service)
- A medical nexus linking the current, diagnosed heart condition and the in-service event
Veterans can submit evidence in support of their claims for direct service connection for heart conditions, including medical records, service personnel records, and lay statements.
Presumptive Service Connection—Agent Orange
A presumption of exposure means that if a veteran has qualifying service, (i.e. they served in a specific area during a defined timeframe) VA will presume that they were exposed to certain harmful chemicals or environmental hazards. If VA concedes exposure and you later develop certain health conditions, you may be eligible for service connection on a presumptive basis.
Coronary artery disease is an example of a condition that may warrant presumptive service connection. Specifically, veterans with coronary artery disease who served in Vietnam between January 9, 1962 and May 7, 1975 should receive VA disability benefits under this presumption.
However, the presumption of service connection only applies to coronary artery disease. Hypertension is not currently a presumptive condition associated with herbicide exposure. In 2018, the National Academy of Sciences (NAS), which conducts biannual reviews of the evidence linking certain conditions to herbicide exposure, finally indicated that there was sufficient evidence linking the development of hypertension with Agent Orange exposure.
There has since been communication from VA that hypertension would be added as a presumptive condition; however, no action has been taken. Nonetheless, even though hypertension is not a presumptive condition, veterans can still receive service-connected compensation. The NAS report is very persuasive, so submitting that along with additional evidence can be another path to getting service connection for hypertension.
Secondary Service Connection
A secondary service-connected condition is one that results from or is aggravated by an already service-connected condition. There is current medical literature that shows certain conditions can cause or aggravate heart conditions. For example, diabetes has been associated with the subsequent development of a heart condition.
Furthermore, recent research also shows an association between a diagnosis of post-traumatic stress disorder (PTSD) and heart conditions. Secondary service connection may also be warranted in cases where medications used to treat service-connected conditions cause or aggravate a heart condition.
Overall, there are many ways to demonstrate that your heart condition is due to your time in service. While your heart condition may not be directly related to service, it may be related to a condition that you have as a result of your time in service. Veterans should consider all avenues to getting service connection when pursuing VA disability compensation.
How VA Rates Heart Conditions
VA rates heart conditions under 38 CFR § 4.104, Schedule of Ratings – Cardiovascular System, primarily based on a series of tests. Specifically, VA examiners will perform metabolic equivalent tests (METs), also known as exercise testing.
METs measure the energy cost on your heart during various physical activities. It also measures when an individual starts to experience symptoms during a physical activity and how strenuous the activity was during that onset. If you start walking and are already feeling out of breath or dyspnea (i.e. shortness of breath), then you are going to receive a low METs rating.
The higher the METs rating, the more efficient and functioning your heart is, and the lower your disability rating is going to be. For most heart conditions, VA will assign a 0, 10, 30, 60, or 100 percent rating.
Other symptoms VA looks at when rating heart conditions include shortness of breath, fatigue, angina (i.e. heart pain), dizziness, fainting, and loss of consciousness. The rating criteria is objective and requires an examiner to either interview you or perform an exercise-based test as discussed above. It is important to talk with your doctor and your veterans advocate about providing evidence regarding daily activities that you struggle with as a result of your heart condition.
Totally Disabling Symptoms – 100% Ratings for Heart Conditions
In some cases, a veteran’s heart condition is so disabling that it warrants a 100 percent, total disability rating from VA. For example, if you are doing physical activity that is as minimal as showering, walking one block, or getting dressed, and you start to experience symptoms, VA will likely say your heart condition is totally disabling. VA will also look for the presence of chronic congestive heart failure as that would also warrant a 100 percent rating.
Temporary Total Ratings for Heart Conditions
There are several heart complications for which VA provides temporary total ratings, which is a limited-time 100 percent disability rating.
If a veteran experiences a heart attack, they will be rated at the 100 percent level for three months following that incident. After that, they will be re-evaluated based on their METs testing and given a rating depending on how severe the resulting conditions is.
A pacemaker is a small device that is placed under the skin in a person’s chest to help control their heartbeat. If a veteran has a pacemaker installed, they will receive a 100 percent rating for two months following the surgery. That 100 percent rating is then re-evaluated based on how severe the resulting condition is.
Implantable Cardiac Defibrillator (ICD)
Like a pacemaker, an implantable cardiac defibrillator (ICD) helps control an individual’s heartbeat. Specifically, an ICD senses when a person’s heart is out of rhythm, beating too fast, or irregularly. It gives the individual a shock, similar to a full-on defibrillator machine, right into your heart. Veterans receive 100 percent ratings for the entire time that they have an ICD.
Heart Valve Replacement
VA also awards a 100 percent disability rating for when veterans are being treated for this and then for six months following that treatment. From there, veterans are re-evaluated and assigned a disability rating that is consistent with their level of impairment.
Veterans who receive a heart transplant are entitled to a 100 percent temporary total rating for one year following the surgery. Again, veterans will be re-evaluated and assigned a new rating following that one-year period.
Coronary Bypass Surgery
The VA applies the same rule to coronary bypass surgery as to heart attacks — you get a 100 percent rating for three months after the surgery and then a re-rating based on additional testing.
TDIU for Heart Conditions
Total disability based on individual unemployability (TDIU) is awarded to veterans when they are unable to secure and follow substantially gainful employment as a result of their service-connected conditions. Heart conditions may impact veterans’ ability to work and do all kinds of work-related tasks. If this is the case, veterans can apply for TDIU as part of an increased rating claim. If granted TDIU, veterans will receive monthly compensation at the 100 percent level.
Compensation Amounts for Heart Conditions
The amount of your disability compensation depends on how severe the VA finds your condition. To judge your condition’s severity, the VA uses the disability rating schedule. It rates you as anywhere from 0 to 100 percent disabled. The more evidence we can produce showing how your condition limits your daily functions, the higher rating you can receive.
For heart disease, the VA will grant a 10, 30, 60, or 100 percent disability rating. These are the compensation amounts for 2020 based on those ratings:
- 10 percent disability rating: $142.29 per month
- 30 percent disability rating: $435.69 per month
- 60 percent disability rating: $1,131.68 per month
- 100 percent disability rating: $3,106.04 per month
If your rating is 30 percent or higher, you can receive additional benefits for any dependents (e.g., spouse, children, dependent parents) in your household.
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