“Heart disease is common in the United States, but the realities of military life may put veterans at an even higher risk of developing heart problems.
“Veterans experience circumstances and exposures that may make them even more likely to develop heart disease than the civilian population. One 20-year study suggested veterans may be at a higher risk of heart disease in part because they also have higher rates of other chronic health conditions and depressive symptoms, as well as more exposure to trauma.
“If you’re a veteran with a heart condition, you may be eligible for compensation.
“Hi, I’m Zack Evans, a VA disability attorney with Woods & Woods. Today we are going to break down VA claims for different types of heart disease.”
How the VA rates heart conditions
“Heart disease is an umbrella term that covers a wide range of conditions. The VA rates heart disease at 10%, 30%, 60%, or 100%, depending on the severity of the veteran’s symptoms.
“The METs used in the VA’s rating system refer to the ratio of your working metabolic rate over your resting metabolic rate. This is basically just how difficult each of these tasks are for you, and what kind of strain they place on your body and your heart.
“The VA rates heart conditions based on the amount of fatigue or breathlessness that is experienced at different levels of exertion.
“So, one example would be breathlessness that’s produced when you’re standing at the kitchen sink doing some dishes. That would be indicative of a pretty severe level of heart disease that would warrant a higher rating.
“Another level of heart disease rating could be based on breathlessness when you’re going up stairs, or when you’re mowing the grass or doing something more strenuous, like yardwork outside. Typically, lower to moderate level heart disease ratings fall in this range.
“The VA also considers any heart surgeries that are needed for the condition. Procedures such as cardiac transplant surgery, heart valve replacement, or having a pacemaker implanted can result in a temporary 100% disability rating.
“This is also known as a convalescent period, and this rating, once it’s provided to you after a surgical procedure, is subject to reexamination. The VA will reassess your heart rating based on your new METs levels following your surgery, and you could see a reduction from the 100% disability rating down to where your current baseline is following the surgery.
“However, some cardiovascular conditions have their own diagnostic codes. These conditions have their own rating criteria, like peripheral artery disease. That’s diagnostic code 7114.
“If there is not a diagnostic code, this does not mean your condition isn’t eligible for VA disability compensation. Instead, the VA will analogously rate your condition using the most similar rating criteria available under another diagnostic code.”
Coronary artery disease
“One of the heart conditions that I see most commonly in my practice is coronary artery disease, also known as CAD, or ischemic heart disease. This is a type of heart disease that occurs when arteries cannot deliver enough oxygen to the heart. One out of 20, or 5% of adults over 20 years old have coronary artery disease in some form.”
Connecting CAD to service
“There are two ways to service connect a heart condition. The first is called direct service connection, and we’ve covered that in some other videos. This essentially means that your symptoms began in service. A good example of this would be if you had persistent chest pain after exercises, breathlessness on marches, or an abnormal EKG, or ECG in service.
“Another way to service connect heart disease is through secondary service connection. This means linking it to something else that is already service connected. A secondary service connection can be made if you have a disability that was caused or aggravated by another service-connected condition.
“Veterans may be at a higher risk of developing coronary artery disease if they have high blood pressure, atherosclerosis, diabetes, autoimmune disease, or chronic kidney disease.
“Diabetes is the big condition I see most often. It often coincides with coronary artery disease, and so does hypertension. This has to do with the way diabetes affects the body systems and causes a cascade of problems.”
How the VA rates CAD
“Now we’re going to talk about how the VA rates coronary artery disease.
“The rating formula for heart conditions like coronary artery disease is largely activity driven in most cases. The big issue here is how tired or breathless you feel when doing certain activities.
“A low or moderate rating for coronary artery disease might only produce chest pain or breathlessness at a higher activity level. Climbing stairs is a great example of this.
“Coronary artery disease severity that warrants higher ratings will produce that same out of breath, whooped feeling while doing light housework like standing and doing dishes. So there’s definitely a range, and telling your individual story is critical to getting the right rating.”
Arrhythmias
“Another type of heart disease that I see in my practice are arrhythmias. A heart arrhythmia is an irregular heartbeat that occurs when there are issues with the electrical signals that prompt your heart to actually beat. This may result in your heart beating too fast, too slow, or inconsistently.
“Tachycardia is the medical term for a rapid heartbeat. If your heart rate is consistently over 100 beats a minute, you have tachycardia.
“Bradycardia is a slow heartbeat. You have bradycardia if your heart beats less than 60 times a minute.”
Connecting arrythmias to service
“Arrhythmias can be service connected in the same two ways: direct pathway and secondary.
“So, direct service connection is warranted if your arrhythmia began while you were serving. It can be rated as a secondary condition if it was caused by another service-related issue.
“Examples of conditions that can allow you to link your arrhythmia for secondary service connection are diabetes, high blood pressure, thyroid problems, sleep apnea, and anxiety.”
How the VA rates arrhythmias
“Bradycardia is rated under diagnostic code 7009. It’s only rated if it requires a pacemaker. Veterans will receive a temporary 100% rate for one month post operation. The future rating, as discussed earlier, will be determined by the general rating formula, and that’ll be based on a reassessment that’s done by the VA.
“Tachycardia can be rated under diagnostic codes 7009, 7010, and 7011 in the Schedule of Ratings. This is depending on the person’s symptoms and heart functioning.
“Tachycardia can be rated at either 10% or 30%. It’s 30% if confirmed by an ECG and it requires five or more treatments a year. It’s 10% if it’s confirmed by an ECG and requires one to four treatments a year.
“Another type of arrhythmia that can be service connected is a ventricular arrhythmia. These will be rated if they’re sustained. This type of arrhythmia is caused by issues with the heart’s lower chambers.
“If asymptomatic, you’ll get no rating. If it requires a ventricular aneurysmectomy, you’ll get a 100% rating.
“That evaluation begins on the date of the hospital admission, with a mandatory VA examination six months following the hospital discharge. Then you’ll have another reevaluation for post-surgical residuals under the general rating formula.
“If any arrhythmia is asymptomatic, it will not be rated.”
Cardiomyopathy
“Cardiomyopathy is a heart condition that causes your heart to stiffen, enlarge, or thicken, and can cause scar tissue. This inhibits your heart from effectively pumping blood to the rest of your body.”
Connecting cardiomyopathy to service
“Cardiomyopathy can be rated secondarily to diabetes, high blood pressure or hypertension, heart valve disease such as mitral valve or aortic valve regurgitation, obesity, or past drug use as a result of self-medication for mental health disorders like PTSD.
“The vast majority of these cases – all of the ones I have seen, are due to an overall cascade of physical decline from diabetes, hypertension, obesity, and substance abuse. I’ve seen a few related to chemotherapy treatment, but it is almost always a lifestyle or general health decline situation.”
How the VA rates cardiomyopathy
“The VA rates cardiomyopathy under diagnostic code 7020 using the General Rating Schedule for heart conditions that we discussed earlier.”
Postural orthostatic tachycardia syndrome (POTS)
“Postural orthostatic tachycardia syndrome, also known as POTS, is a condition of the autonomic nervous system. When a healthy person changes position, their body seamlessly balances their heart rate and blood pressure. In a person with POTS, just standing up can cause increased heart rate, dizziness, and fatigue.”
Connecting POTS to service
“Because of the nature of the illness and the variation of its symptoms, POTS can be challenging to diagnose and tie back to your military service.
“Sometimes it can be diagnosed after contracting a viral condition like COVID-19 in service. Sometimes it will be diagnosed after sustaining a head injury in service that impacts your autonomic nervous system.”
How the VA rates POTS
“POTS does not have its own diagnostic code. It is likely the VA will rate POTS under various heart conditions in the Schedule of Ratings, including diagnostic code 7010 for supraventricular tachycardia.
“The VA may also use a diagnostic code related to veterans’ dizziness or fainting spells from their condition. You would see this referred to in the diagnostic code as syncope.”
Conditions related to POTS
“Autonomic dysregulation can lead to not only POTS, but a wide range of conditions affecting other parts of the body the autonomic nervous system controls. If you’re able to service connect POTS, you may be able to claim service connections for other conditions you’re experiencing.
“Conditions POTS may be related to that can qualify for VA disability include high blood pressure, diabetes, chronic fatigue syndrome, and gastrointestinal disorders, especially irritable bowel syndrome or IBS.
“In addition to these common comorbidities, dizzy spells or even fainting from POTS can lead to sprains, fractures, and breaks that may all be able to be secondarily service connected.”
Presumptive heart conditions
“Some heart conditions are considered presumptive for VA compensation purposes. A presumptive condition is a condition that will be automatically service connected based on the details of a veteran’s service.
“Unlike other service connections, you are not required to submit a medical nexus explaining the connection between your service and condition to get compensation.
“Coronary artery disease, like we mentioned before, is a presumptive condition of Agent Orange exposure.
“Some conditions will be considered presumptively service connected if they appear within one year of separation from service. Examples of this are arteriosclerosis, cardiovascular renal disease, endocarditis, myocarditis, and Raynaud’s disease.
“Former POWs can also be awarded presumptive service connection for conditions like beriberi heart disease, which is essentially a vitamin B1 deficiency that can lead to congestive heart failure.
“Another condition for former POWs looking for presumptive service connection is hypertensive heart disease.”
TDIU for cardiovascular conditions
“Many cardiovascular conditions can contribute to TDIU. Pain, fatigue, and other symptoms may make it difficult for a veteran to work.
“TDIU requires at least one service-connected disability rated at 60% or higher or two or more service-connected disabilities with at least one disability rated at 40% or higher, with a combined rating of 70% or higher.
“Because of this, a veteran rated at 60% for ischemic heart disease, also known as coronary artery disease, could still be eligible for TDIU and receive compensation at the 100% rate.
“Something else to consider is that conditions that share a common etiology or body system are considered as one rating for TDIU determination purposes, meaning if you have a rating for something like hypertension in addition to ischemic heart disease and the combined rating of the conditions is at least 40%, you can also qualify for TDIU. We call this the underlying 40% in the 70-40 rule. So, you have to have a combined 70% and then at least one condition that is rated at 40%.
“However, if you have multiple cardiovascular conditions that can be combined to reach that 40%, then you’ve met the 70-40 rule.”
Awesome job they did for me! Call them today, you will NOT Regret it!!
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From a Facebook review for Woods & Woods
How Woods & Woods can help
“If you have more questions about VA benefits in general, watch some of the other videos on our YouTube channel.
“If you’re wondering if you qualify for an increased rating or TDIU, contact us at Woods & Woods for a free consultation.”
Let’s get started today
Zack Evans
Zack is a former prosecuting attorney. He received his law degree from Southern Illinois University. He joined Woods & Woods in 2017.
