Coronary Artery Disease (Ischemic Heart Disease)
Coronary artery disease is narrowing of the heart's arteries that limits blood flow. VA rates it under the General Rating Formula for Diseases of the Heart, based on the exercise workload (in METs) at which heart failure symptoms appear.
Presumptive condition — Agent Orange - ischemic heart disease (herbicide exposure)
Ischemic heart disease (which includes coronary artery disease) has been an Agent Orange presumptive condition since 2010. Veterans with qualifying herbicide exposure do not need to prove a medical nexus.
How the VA rates it
Rated under DC 7005 using the General Rating Formula for Diseases of the Heart. The key measure is METs (metabolic equivalents) - the workload at which you develop symptoms such as breathlessness, fatigue, angina, dizziness, arrhythmia, palpitations, or syncope. The 2021 cardiovascular revision keys all tiers to METs testing, confirmed cardiac hypertrophy or dilatation, or continuous medication; if exercise testing cannot be done for medical reasons, the examiner may estimate your METs level from daily activities. A heart attack (DC 7006) rates 100 percent during and for three months after the event, and coronary bypass surgery (DC 7017) rates 100 percent for three months after hospital admission, before returning to the general formula.
Rating criteria by percentage
Rated up to 100%A workload of 3.0 METs or less produces heart failure symptoms (breathlessness, fatigue, angina, dizziness, arrhythmia, palpitations, or syncope).
A workload of 3.1 to 5.0 METs produces heart failure symptoms.
A workload of 5.1 to 7.0 METs produces heart failure symptoms; or there is cardiac hypertrophy or dilatation confirmed by echocardiogram or equivalent imaging (MUGA scan or cardiac MRI).
A workload of 7.1 to 10.0 METs produces heart failure symptoms; or continuous medication is required for control.
What those terms mean
- METs
- — Metabolic equivalents — a measure of how much physical activity your heart can handle before symptoms start. Lower METs = worse heart function = higher rating.
Secondary condition strategy
Commonly claimed secondary to this
Conditions veterans often develop from this one — each can be its own rating under 38 CFR 3.310.
- Erectile Dysfunction — ED is commonly claimed secondary to coronary artery disease and to cardiac medications such as beta blockers.
- Major Depressive Disorder — Depression following heart attacks or chronic cardiac disease is commonly claimed as secondary.
This is often secondary to
If you already have one of these service-connected, it may support connecting this condition.
- Hypertension — CAD is commonly claimed secondary to long-standing service-connected hypertension.
- Diabetes Type 2 — Diabetes accelerates coronary artery disease; CAD is one of the most common secondaries to service-connected diabetes.
- Sleep Apnea — Untreated sleep apnea strains the cardiovascular system; CAD is sometimes claimed as secondary with supporting medical opinion.
Evidence that strengthens this claim
- Get a stress test (exercise METs) or, if you medically cannot exercise, ask the examiner to record an estimated METs level with specific activity examples - the METs number drives the rating.
- Submit echocardiogram or cardiac imaging reports; documented cardiac hypertrophy or dilatation alone supports 30 percent.
- Keep records of all cardiac medications - continuous medication alone supports the 10 percent floor.
- If you had a heart attack, stent, or bypass, submit the hospital records - heart attacks and bypass surgery carry temporary 100 percent ratings.
Rating rules to know
Hypertension is rated separately from heart disease (Note 3 to DC 7101), so CAD and hypertension can be rated at the same time. Only one rating is assigned for the heart disease itself under the general formula.
Related diagnostic codes
More heart & circulatory conditions
Hypertension (High Blood Pressure)
Hypertension is chronically elevated blood pressure. VA rates it on your actual documented blood pressure readings, with a minimum 10 percent rating for veterans who need continuous medication and have a history of diastolic pressure of 100 or more.
Rated up to 60%
Varicose Veins
Varicose veins are enlarged, twisted veins, usually in the legs, that can cause aching, swelling, skin changes, and ulcers. VA rates them per affected leg based on edema, skin changes, and ulceration.
Rated up to 100%
Atrial Fibrillation (AFib)
Atrial fibrillation is an irregular, often rapid heart rhythm. VA rates it under DC 7010 (supraventricular tachycardia) based on how many treatment interventions you need per year, with a maximum schedular rating of 30 percent.
Rated up to 30%
Post-Thrombotic Syndrome (Post-Phlebitic Syndrome)
Post-thrombotic syndrome is chronic leg swelling, pain, skin changes, and sometimes ulcers that develop after a deep vein thrombosis (blood clot) damages the vein. VA rates it per affected leg on edema, skin changes, and ulceration.
Rated up to 100%
Disclaimer: Valor Rating is not affiliated with the U.S. Department of Veterans Affairs. This content is for educational purposes only and does not constitute legal or medical advice. Always review your documents carefully before submitting to the VA. For official guidance, consult an accredited VSO, claims agent, or attorney.