Veterans with coronary artery disease often assume the diagnosis itself sets the rating. DC 7005 runs on METs, the workload at which symptoms appear, with two floors most veterans miss: continuous daily medication meets 10 percent on its own, and documented cardiac hypertrophy or dilatation reaches 30 regardless of the treadmill number. For qualifying Agent Orange exposure, the connection itself is presumed.
How VA rates coronary artery disease
Coronary artery disease, also called arteriosclerotic or ischemic heart disease, is rated under diagnostic code 7005 in the cardiovascular schedule (38 CFR 4.104). It does not have its own percentage table. Instead it uses the General Rating Formula for Diseases of the Heart, which is built around a workload measure called METs (metabolic equivalents).
What a MET is
One MET is the energy your body uses sitting quietly at rest. Activities cost more: slow walking is a few METs, climbing stairs or shoveling snow is more. VA looks for the workload, expressed in METs, at which you develop heart failure symptoms such as shortness of breath, fatigue, angina, dizziness, or fainting. When an exercise test cannot be done for medical reasons, the examiner may estimate functional capacity using reported daily activities, published MET equivalency tables, or other clinical evidence. Document exactly what exertion triggers your symptoms.
The percentage levels
- 10 percent: a workload of 7.1 to 10.0 METs brings on heart failure symptoms, or continuous medication is required for control.
- 30 percent: a workload of 5.1 to 7.0 METs brings on symptoms, or there is evidence of cardiac hypertrophy or dilatation confirmed by echocardiogram or an equivalent study.
- 60 percent: a workload of 3.1 to 5.0 METs brings on symptoms.
- 100 percent: a workload of 3.0 METs or less brings on symptoms.
Continuous medication and the 10 percent rating
The detail veterans overlook is that continuous medication required for control meets the 10 percent level on its own, even when the workload number looks better than 7 METs. If you take daily medication to manage the heart disease, that fact belongs in your record. It sets a floor under the rating.
After a heart attack, bypass, or stent
A myocardial infarction (heart attack) carries a 100 percent rating during and for three months after the event, then the General Rating Formula applies. Coronary bypass surgery carries 100 percent for three months following hospital admission, then the formula. These windows are written into the schedule, so the dates of the event and any surgery matter.
The Agent Orange and burn pit connection
Ischemic heart disease is a presumptive condition for veterans with qualifying herbicide (Agent Orange) exposure under 38 CFR 3.309, and the PACT Act expanded the locations and time periods that qualify. For a veteran who meets the exposure and diagnosis requirements, the connection is presumed without a separate nexus opinion.
Common rating details veterans overlook
- The rating is driven by METs, the workload at which heart failure symptoms appear, not by the diagnosis alone.
- Continuous daily medication meets 10 percent by itself, so make sure it is documented.
- Cardiac hypertrophy or dilatation confirmed by echocardiogram or an equivalent study can reach 30 percent independent of the METs number.
- Heart attack and bypass carry temporary 100 percent windows, so the event and surgery dates matter.
- Ischemic heart disease is Agent Orange presumptive for qualifying veterans, and the PACT Act widened who qualifies.