With the recent addition of ischemic heart disease to the list of Agent-Orange related disabilities, many veterans have recently been granted service connection for this disability. In an earlier post, I discussed establishing VA service connected compensation for Ischemic Heart Disease for those veterans exposed to Agent Orange. In this post, I will focus on VA service connected compensation ratings for heart disabilities. It is important to know what kinds of information the VA needs to have in order to assign the proper disability rating for your disease.
As a threshold matter, if you are taking any type of continuous medication to treat your ischemic heart disease, the VA should provide at least the minimum rating of 10% for your heart disability. Make sure, then, that the VA is aware of any heart medications you have been prescribed by your non-VA doctors.
The higher levels of disability ratings for the heart are based on your symptoms at various levels of exertion. Every level of exercise is assigned a range of METs (or metabolic equivalents) the higher the level of exertion, the higher the METs number. In assigning a rating for heart disease, the VA specifically looks at what range of METs causes you to have certain symptoms.
The symptoms that the VA is looking for are dyspnea (shortness of breath), fatigue, angina (chest pain), dizziness, or syncope (fainting). You need not have all of these symptoms to qualify for a particular rating, but it is important to know what the possible symptoms are so that you can inform your doctors, and the VA, if you are having these symptoms.
Only a minimum rating of 10% is appropriate where the veteran experiences these symptoms after doing activities such as jogging , biking or climbing stairs quickly (a level of 7-10 METs). A higher rating of 30% is warranted where the veteran experiences the symptoms at a level of 5-7 METs. This level of activity would include heavy yard work such as digging or mowing with a pushmower and would also include recreational activities such as golfing without a cart. The 30% rating would also be appropriate where the veteran has certain test results on an electrocardiogram, echocardiogram, or X–ray, so, again, it is important to make sure that the VA is aware of these tests if you have had them performed by a non-VA doctor.
A higher rating of 60% is assigned where the veteran experiences heart symptoms at a less stringent level of exercise such as brisk walking or light yard work including weeding or mowing the lawn with a power mower (a level of 3-5 METs). A 60% rating would also be appropriate for a veteran who has had more than one episode of acute congestive heart failure in the past year.
Finally, a total rating of 100% would be the appropriate rating where the veteran experiences the symptoms of heart disease at a minimal level of exercise such as slow walking for one or two blocks, showering, dressing or eating (1-3 METs). The 100% rating would also be assigned to a veteran who has chronic congestive heart failure.
Another factor the VA will consider, outside the symptoms the veteran is experiencing, is whether the veteran has had any procedures performed on his heart which might qualify him or her for a higher rating, at least temporarily. Procedures such as heart valve replacement, coronary bypass surgery, cardiac transplant surgery, or implantation of a pacemaker require the VA to assign a temporary 100% disability rating for a period of months or sometimes indefinitely.
Finally, as with rating most disabilities, the VA must also consider whether the veteran’s heart disease prevents the veteran from maintaining employment. Knowing the symptoms of heart disease allows you to keep your doctors informed if you are having these symptoms. In addition, if your doctor is aware of your symptoms and documents them in your medical records, this makes it easier for the VA to assign the proper rating for your disability.
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