Coronary Artery Disease VA Ratings & Compensation
CCK Law: Our Vital Role in Veterans Law
Coronary artery disease (CAD) is the leading cause of death in the United States. It is responsible for 610,000 (about 1 in 4) deaths in the US annually, and almost 18 million worldwide. There are a wide variety of causes cited for the disease.
Veterans suffering from this serious heart condition as a result of military service may qualify for compensation from the Department of Veterans Affairs (VA). This article helps veterans understand when their military service may have caused CAD, how to file a VA claim for coronary heart disease, how VA assigns “ratings” for CAD, and what the VA compensation and benefits are for a coronary artery disease VA rating.
Key points of this article include:
- Veterans who were exposed to Agent Orange in Vietnam or other theaters of war may be eligible for presumptive service connection for their CAD. This is because Agent Orange exposure has frequently been linked to the development of CAD.
- VA typically determines the severity of a veteran’s CAD by using the metabolic equivalence test, or MET. This test measures how much physical activity the veteran can undergo before experiencing heart failure symptoms.
- CAD often presents without initial or obvious symptoms. This means many adults can have CAD and not even be aware until they suffer a serious symptom like a heart attack or stroke.
What Is Coronary Artery Disease?
Coronary artery disease (CAD) is a cardiovascular condition where the arteries around the heart become blocked or narrowed, leading to less blood making it through to the heart to supply it with oxygen and nutrients.
CAD is typically caused by atherosclerosis, which is the buildup of plaque in the body’s arteries. As more and more plaque builds up within them, the arteries stiffen and narrow, leading to reduced blood flow to the heart. There are other potential causes of CAD, however, including diabetes, HIV/AIDS, and various autoimmune disorders.
Other common risk factors for developing CAD include:
- High LDL cholesterol levels
- High blood pressure
- Lack of exercise
- Smoking
- Lack of sleep or sleep disorders
- Old age
- Obesity
- Chronic stress
- Mental disorders like depression and anxiety
- Alcohol abuse
Notably, CAD and ischemic heart disease (IHD) are two terms that are often used interchangeably. There is a difference, however. IHD is a condition where the heart does not get enough blood. CAD, on the other hand, refers solely to the narrowing of the coronary arteries. While CAD often leads to IHD, it is possible to have CAD without IHD.
Symptoms of Coronary Artery Disease
It is important to keep in mind that coronary artery disease often presents without initial symptoms. This is because CAD can take years or even decades to develop as the arteries narrow bit by bit. Many people who have CAD may not know it due to the lack of obvious symptoms.
When symptoms finally do appear, they can be particularly severe. Some of the most debilitating symptoms of CAD are heart attack and stroke, which can often be fatal. This makes CAD one of the leading causes of death worldwide, sometimes dubbed “the silent killer”.
Other symptoms of CAD can include:
- Pain or a sense of tightening or squeezing in the chest (angina)
- Shortness of breath
- Arrhythmia
- Heart palpitations
- Fatigue
- Swelling in the hands or feet
Coronary Artery Disease VA Ratings Require Service Connection
The first step a veteran should take to earn a coronary artery disease VA rating is establishing service connection. In other words, they must show that something in their military service caused or contributed to their current CAD diagnosis.
There are multiple types of service connection.
Direct Service Connection for Coronary Artery Disease
Direct service connection is when a veteran can prove that their CAD was somehow caused by an event, exposure, or illness that the veteran suffered during their military service. To establish a direct service connection, veterans need to prove three things:
- A current diagnosis of CAD;
- An in-service event, exposure, or illness that may have caused their CAD to develop; and
- A medical “nexus” affirming that the current, diagnosed CAD is due to the in-service occurrence. Medical nexus opinions are usually provided by a veteran’s doctor, and state clearly the doctor’s professional assessment that the veteran’s CAD was “at least as likely as not” caused by the in-service event.
Secondary Service Connection for Coronary Artery Disease
Secondary service connection is when a veteran can prove that an already service-connected condition has caused or worsened a separate condition. If the veteran’s claim is successful, VA will assign a disability rating for the secondary condition by linking it to the veteran’s primary condition. The ratings are then combined using VA math (which reduces additional ratings due to the veteran already being impaired).
Coronary artery disease may be caused by other service-connected disabilities.
- For example, VA has stated that PTSD “might be a fast track to developing premature cardiovascular disease.” If veterans can prove that their CAD was caused by a service-connected condition like PTSD, then they should be able to obtain a VA rating for coronary artery disease as well, without needing to prove that an in-service event, exposure, or illness directly caused CAD.
- Another common source of secondary service connection claims for heart disease is medication side effects. Veterans being treated for service-connected cancer, diabetes, migraines, and other conditions can sometimes develop heart disease as a result of prescribed medications, which are eligible for a VA rating due to service connection.
Coronary artery disease may also lead to other conditions. Here is an example of a secondary service connection:
- A veteran is exposed to Agent Orange during their military service.
- Years after service, the veteran is diagnosed with coronary artery disease and files a claim for VA disability. VA recognizes service connection due to Agent Orange exposure.
- Years later, the veteran suffers a stroke and suffers several long-term effects. The stroke is directly attributable to their coronary artery disease. The veteran files another VA claim related to the stroke. VA recognizes secondary service connection.
- The stroke rating is combined with the coronary artery disease rating using VA math.
Presumptive Service Connection for Coronary Artery Disease
In certain situations, VA will automatically presume a veteran’s coronary artery disease is service connected, which means the veteran will not have to provide evidence of the cause. These VA presumptions are reserved for veterans who served in specific times and places that may have exposed them to toxins or disease.
“For CAD or ischemic heart disease, if you can show that you were exposed to an herbicide … and you have a current diagnosis of CAD, you don’t need nexus evidence,” says Emma Peterson, a partner at CCK Law. “It is going to be presumptively service connected. This eliminates part of the burden in terms of getting service connected.”
To qualify for a VA presumption for coronary artery disease (PDF), veterans have to prove that they were deployed in one of the following conflicts during the specified time period:
- Republic of Vietnam (to include territorial waters within 12 nautical miles of shore) from January 9, 1962, to May 7, 1975
- Service in the Air Force or Air Force Reserve when the individual concerned regularly and repeatedly operated, maintained, or served on board C–123 aircraft known to have been used to spray an herbicide agent during the Vietnam era
- Korean DMZ from September 1, 1967, to August 31, 1971
- Thailand at any United States or Royal Thai base, without regard to where on the base the Veteran was located or what military occupational specialty the Veteran performed, from January 9, 1962, to June 30, 1976
- Laos from December 1, 1965, to September 30, 1969
- Cambodia at Mimot or Krek, Kampong Cham Province, from April 16, 1969, to April 30, 1969
- Guam or American Samoa, or in the territorial waters thereof from January 9, 1962, to July 31, 1980
- Served on Johnston Atoll or on a ship that called at Johnston Atoll from January 1, 1972, to September 30, 1977
What Evidence Should I Submit for a Coronary Artery Disease VA Claim?
When pursuing a coronary artery disease VA rating, the success of a veteran’s claim often depends on the strength and relevance of the evidence they submit. Veterans can make their case more compelling by submitting different types of documentation:
- Service records – These documents help veterans link their condition to military service. Examples include in-service medical evaluations, personnel files, separation papers, or other official records.
- Medical evidence – Comprehensive medical documentation is vital for confirming a CAD diagnosis and detailing treatment. This may include records from VA facilities, private doctors, or written statements from medical professionals familiar with the veteran’s health.
In addition, veterans may submit lay statements from friends, family, or colleagues. While these do not carry the same weight as official records, they can provide valuable context by illustrating how the veteran’s CAD affects their daily life.
Importantly, veterans are not responsible for obtaining every record on their own. Under VA’s “duty to assist” rule, the agency must help gather relevant evidence during the claims process.
Compensation & Pension (C&P) Exams for Coronary Artery Disease
A Compensation & Pension (C&P) exam is a medical evaluation carried out by a clinician who is either employed by VA or hired through a VA contractor. The purpose of this exam is to provide VA with information about how severe a veteran’s condition is so that an appropriate disability rating can be assigned. C&P exams are also often used to help determine whether the condition is linked to the veteran’s military service.
For a C&P exam for coronary artery disease, the examiner will likely perform something called a “MET”, or “metabolic equivalent test.” Emma Peterson from CCK Law explains further:
“METs measure the energy cost on your heart for doing different physical activities. It also measures when and how you start to feel symptoms. For instance, if you are just walking and start to feel shortness of breath, that will result in a low METs rating, because at that low level of activity, you’re already feeling symptoms. The higher the METs rating, the more efficient and functional your heart is, and the lower your disability rating is going to be.”
Some other facets of a CAD C&P exam could include:
- A physical exam to evaluate the veteran’s general health.
- A questionnaire section where the examiner asks the veteran questions about how their condition impacts their everyday life.
- Additional medical tests like chest x-rays, blood tests, heart MRIs, or electrocardiograms (EKG) to confirm the CAD diagnosis.
How Does VA Rate Coronary Artery Disease?
A VA coronary artery disease rating is determined by 38 CFR § 4.104, Ratings of the Cardiovascular System – Diseases of the Heart, Diagnostic Code 7005. The rating criteria for CAD are the same as the General Rating Formula for Diseases of the Heart, which uses “metabolic equivalents” (METs) to measure how much physical activity is needed to induce heart failure symptoms in a veteran. (One MET is the energy cost of standing quietly at rest and represents an oxygen uptake of 3.5 milliliters per kilogram of body weight per minute.) Symptoms that VA will consider may include shortness of breath, dizziness, syncope, angina, and more.
Using these criteria, it is possible for veterans to earn ratings of 10, 30, 60, or 100 percent. The rating criteria are as follows:
- 100 percent – Workload of 3.0 METs or less results in heart failure symptoms
- 60 percent – Workload of 3.1-5.0 METs results in heart failure symptoms
- 30 percent – Workload of 5.1-7.0 METs results in heart failure symptoms; or evidence of cardiac hypertrophy or dilatation confirmed by echocardiogram or equivalent (e.g., multigated acquisition scan or magnetic resonance imaging)
- 10 percent – Workload of 7.1-10.0 METs results in heart failure symptoms; or continuous medication required for control
How Much Compensation Can I Receive for Coronary Artery Disease?
VA uses the ratings above to determine the severity of a veteran’s disability and issue corresponding payments. The higher a veteran’s rating, the greater their monthly compensation will be.
As of 2025, the VA disability rate benefit amounts are as follows:
- 0 percent disability rating: $0.00 per month
- 10 percent disability rating: $175.51 per month
- 20 percent disability rating: $346.95 per month
- 30 percent disability rating: $537.42 per month
- 40 percent disability rating: $774.16 per month
- 50 percent disability rating: $1,102.04 per month
- 60 percent disability rating: $1,395.93 per month
- 70 percent disability rating: $1,759.19 per month
- 80 percent disability rating: $2,044.89 per month
- 90 percent disability rating: $2,297.96 per month
- 100 percent disability rating: $3,831.30 per month
Importantly, a rating of 30 percent or higher also qualifies veterans to receive additional benefits on behalf of dependents in their household.
Special Monthly Compensation (SMC) for Coronary Artery Disease
Special Monthly Compensation (SMC) is a higher level of compensation available to veterans who live with severe disabilities or challenging medical conditions. These enhanced payments are designed to cover needs and expenses that standard VA disability compensation may not adequately meet.
For example, if a veteran’s coronary artery disease is severe enough to render them housebound, the veteran may be eligible for SMC(s), which pays significantly more than even a 100 percent disability rating.
Can I Get Total Disability for Coronary Artery Disease?
Yes, you can. There are two routes by which this usually occurs.
- VA ratings for coronary artery disease can go up to 100 percent.
- Also, if it is impossible for a veteran to work with their condition, VA may assign a total disability rating based on Total Disability Based on Individual Unemployability (TDIU), even if the veteran’s actual rating is not 100 percent.
TDIU allows VA to pay veterans at the 100 percent disability rate when their conditions prevent them from securing and keeping substantially gainful employment.
There are two main avenues to qualify:
- Schedular TDIU – Available when VA’s rating thresholds are met. A veteran must either:
- Have a single disability rated at 60 percent or higher, or
- Hold a combined disability rating of 70 percent or more, with at least one disability rated at 40 percent (the 70/40 rule).
- Extraschedular TDIU – If a veteran does not meet the percentage requirements, they may still be considered for TDIU if their service-connected conditions keep them from working. In these cases, the Director of Compensation Services reviews the claim individually.
Because of how different TDIU requirements and evidence can be compared to the regular claim, many veterans benefit from working with a VA-accredited attorney or representative to navigate their TDIU claim. If you think you may qualify for TDIU, consider reaching out to CCK Law for an evaluation of your case.
Was Your CAD Claim Denied or Underrated? Contact CCK Law
VA is a large bureaucracy operating with a highly complex set of rules and regulations. Mistakes are very common, and you should not surrender your benefits if you receive an incorrect decision on your VA disability claim.
If you suspect that VA has mistakenly denied or underrated your coronary artery disease disability claim, or your condition has advanced over time, then the attorneys at Chisholm Chisholm & Kilpatrick may be able to help you get the benefits you need. Our team of VA-accredited representatives have assisted tens of thousands of veterans and helped recover over $1 billion in wrongfully denied compensation.
Call CCK Law today at (800) 544-9144 or contact us online for a free case evaluation.
