What Heart Conditions Qualify for VA Disability?

Heart conditions that qualify for VA disability include ischemic heart disease (coronary artery disease, angina, and heart attacks), arrhythmias, congestive heart failure, valvular heart disease, hypertension, cardiomyopathy, and post-surgical conditions like bypass, valve replacements, pacemakers, and transplants.¹ The list is not closed: the VA can rate any heart condition a medical examiner diagnoses and links to your service. Qualifying depends less on the diagnosis itself than on whether you can connect it to your military service, and on how much it limits you.

Heart Conditions the VA Will Rate

The VA’s Disability Benefits Questionnaire for heart conditions covers the diagnoses examiners are set up to evaluate:¹

Ischemic heart disease, including coronary artery disease, angina, and heart attack. This is the most commonly claimed category, especially among veterans exposed to Agent Orange.
Arrhythmias, whether the heartbeat is too fast, too slow, or originating from an abnormal location.
Congestive heart failure, when the heart no longer pumps blood well enough to meet the body’s needs.
Valvular heart disease affecting any of the four heart valves.
Hypertension, which the VA rates on its own scale and which can also cause or worsen other heart conditions.
Cardiomyopathy, disease of the heart muscle itself.
Post-surgical conditions: valve replacements, bypass surgery, implanted pacemakers or defibrillators, and heart transplants.

Conditions outside this list can still be rated if a diagnosis and a service connection are established. These categories simply cover most claims.

Proving the Condition Is Service-Connected

Every VA disability claim turns on the same question: can you tie the condition to your time in service? There are three ways to do that for a heart condition.

Direct Service Connection

Direct service connection means the condition started during active duty or was made worse by service. The governing regulation is broad, covering any injury or disease “incurred coincident with service” or aggravated during it.² You don’t need to have been diagnosed while in uniform. A heart condition diagnosed years after discharge can still qualify if the evidence ties it to an in-service event or exposure.

Secondary Service Connection

A heart condition that develops because of another disability you’re already service-connected for qualifies as secondary. The regulation covers any disability “proximately due to or the result of a service-connected disease or injury.”³ Many heart claims succeed this way. Service-connected diabetes can lead to coronary artery disease. Service-connected hypertension can cause atrial fibrillation. Service-connected PTSD, through sustained physiological stress, can contribute to cardiovascular disease. If a physician can draw a medical line from your existing service-connected condition to your heart disease, the secondary pathway applies.

Presumptive Service Connection

A presumption removes the hardest part of the process: you don’t have to prove the link. The VA assumes the connection based on where and when you served, and on what condition you have.

Presumptions That Do the Proving for You

Two sets of presumptions matter for heart conditions.

Chronic disease within one year of discharge. Several cardiovascular diseases sit on the VA’s chronic-disease list and are presumed service-connected if they appear to a compensable degree within one year after you leave service. The list includes arteriosclerosis, cardiovascular-renal disease (including hypertension), endocarditis (covering all forms of valvular heart disease), and myocarditis.⁴ If you were diagnosed within that window, the VA should grant the connection without requiring you to prove cause.

Agent Orange and other herbicides. Veterans with qualifying exposure have ischemic heart disease on their presumptive list.⁵ If you served in Vietnam or another qualifying location and later developed coronary artery disease, angina, or a heart attack, the VA presumes the exposure caused it.

The PACT Act change. The PACT Act of 2022 added hypertension as a presumptive condition for Agent Orange exposure.⁶ Before then, exposed veterans with high blood pressure had to prove the connection themselves, often decades later. The Act also established presumptive toxic exposure for veterans who served in Iraq, Afghanistan, Syria, and surrounding areas during the Gulf War and post-9/11 eras.⁷ The specific conditions added under the burn pit provisions are primarily cancers and respiratory illnesses rather than heart conditions, but that established exposure can support a direct or secondary heart claim if a physician links the two.

How Severe It Has to Be to Get a Rating

Even with service connection established, your monthly payment depends on how much the condition limits you. Most heart conditions and hypertension use different rating scales, both found in 38 CFR 4.104.⁸

The METs-Based General Formula

For ischemic heart disease, arrhythmias, valvular conditions, cardiomyopathy, and heart failure, the VA measures how much physical activity you can handle before symptoms start. One MET (metabolic equivalent) equals the energy cost of standing still. A lower METs threshold means a higher rating:

100%: symptoms at 3.0 METs or less, or chronic congestive heart failure, or left ventricular ejection fraction below 30%.
60%: symptoms at 3.1 to 5.0 METs, or more than one episode of acute congestive heart failure in the past year, or ejection fraction of 30% to 50%.
30%: symptoms at 5.1 to 7.0 METs, or evidence of cardiac hypertrophy or dilatation on imaging.
10%: symptoms at 7.1 to 10.0 METs, or continuous medication required for control.

In everyday terms, 3 METs is roughly slow walking or getting dressed. Around 5 METs corresponds to climbing a flight of stairs. Around 7 METs is light yard work or brisk walking. The examining doctor determines your METs level through an exercise stress test or, when a stress test would be medically unsafe, through an interview-based estimate.¹ If walking across a parking lot leaves you winded, say so. Understating symptoms costs ratings.

Left ventricular ejection fraction offers a second path to the higher ratings. LVEF measures the percentage of blood the heart pumps out with each beat; a healthy heart ejects about 55% to 70%. An LVEF below 30% warrants 100%, and 30% to 50% warrants 60%, regardless of METs results.⁸

Certain events trigger a temporary 100% rating. A heart attack gets 100% for three months following the event. A heart transplant gets 100% for at least one year from the date of hospital admission.⁸ After that period the VA re-evaluates based on ongoing functional limitations.

The Hypertension Scale

Hypertension is rated under Diagnostic Code 7101 on blood pressure readings rather than METs:⁸

60%: diastolic pressure predominantly 130 or more.
40%: diastolic pressure predominantly 120 or more.
20%: diastolic pressure predominantly 110 or more, or systolic pressure predominantly 200 or more.
10%: diastolic pressure predominantly 100 or more, systolic pressure predominantly 160 or more, or a history of diastolic pressure predominantly 100 or more requiring continuous medication.

Hypertension is rated separately from hypertensive heart disease. If uncontrolled blood pressure has also damaged your heart, you can receive separate ratings for each, which can meaningfully increase your combined percentage.

What the Percentages Pay

For 2026, a single veteran with no dependents receives:⁹

10%: $180.42 per month
30%: $552.47 per month
60%: $1,435.02 per month
100%: $3,938.58 per month

Veterans rated 30% or higher receive additional amounts for a spouse, children, and dependent parents, increasing at each rating tier.

If You Can’t Work Because of Your Heart

When a heart condition keeps you from holding steady employment but your rating is under 100%, Total Disability Based on Individual Unemployability (TDIU) can pay at the 100% rate anyway. You qualify with either a single service-connected disability rated at 60% or more, or two or more service-connected disabilities combining to 70% or more with at least one at 40%.¹⁰ The standard is that you cannot maintain substantially gainful employment; occasional odd jobs don’t disqualify you.

What to Gather Before You File

Your service treatment records are the foundation. They can show early diagnoses, elevated blood pressure readings, cardiac symptoms, or the in-service exposures and events that set the stage for later heart disease. Post-service records from your civilian cardiologists and primary care providers fill in the timeline. Request complete records from every provider who has treated you.

For direct and secondary claims, a nexus letter from a physician often makes or breaks the case. This is a written medical opinion stating that your heart condition is connected to service or to another service-connected disability, using the VA’s standard: “at least as likely as not,” meaning a 50% or greater probability.¹¹ A letter saying the condition “could be related” carries much less weight than one stating it “more likely than not” resulted from a documented in-service cause. You can get a nexus letter from your VA treating physician or a private doctor. Private cardiology nexus letters typically run $400 to $2,000 or more.

Lay statements carry real weight too. The VA accepts written observations from a spouse who has watched your exercise tolerance decline, a coworker who has seen you struggle with physical tasks, or a fellow service member who remembers events during your deployment.¹² These can be submitted as free-form statements or on VA Form 21-10210.¹³

Filing and Protecting Your Effective Date

Before you spend weeks gathering records and opinions, submit an Intent to File on VA Form 21-0966. This locks in the potential effective date used to calculate back pay if the claim is approved. You then have one full year to complete and submit the formal claim.¹⁴ On a complex heart claim, that single step can be worth thousands of dollars.

Once your evidence is together, you can file three ways:¹⁵

Online at VA.gov, which is the fastest option and lets you upload documents directly.
By mail, using VA Form 21-526EZ sent to the VA Claims Intake Center.
With help from a Veterans Service Organization, accredited claims agent, or attorney. VSO help is free and worth using for heart claims, which tend to involve complex medical evidence.

After you file, the VA will schedule a Compensation and Pension exam using the Heart Conditions Disability Benefits Questionnaire. The examiner’s report is often the single most influential document in the file, so describe your symptoms and their effect on daily activities fully and accurately.

1
Department of Veterans Affairs. Disability Benefits Questionnaire for Heart Conditions
2
eCFR. 38 CFR 3.303 – Principles Relating to Service Connection
3
eCFR. 38 CFR 3.310 – Disabilities That Are Proximately Due to, or Aggravated by, Service-Connected Disease or Injury
4
eCFR. 38 CFR 3.309 – Disease Subject to Presumptive Service Connection
5
U.S. Department of Veterans Affairs. Agent Orange Exposure and Disability Compensation
6
Veterans Affairs – VA.gov. The PACT Act and Your VA Benefits
7
Veterans Affairs. Exposure to Burn Pits and Other Specific Environmental Hazards
8
eCFR. 38 CFR 4.104 – Schedule of Ratings, Cardiovascular System
9
Veterans Affairs. Current Veterans Disability Compensation Rates
10
Veterans Affairs. Individual Unemployability if You Can’t Work
11
Board of Veterans’ Appeals. BVA Decision – Service Connection for Hypertension and Heart Conditions (Citation Nr A22001312)
12
Veterans Affairs – VA.gov. Evidence Needed for Your Disability Claim
13
Veterans Affairs. Submit a Lay Witness Statement to Support a VA Claim
14
Veterans Affairs – VA.gov. Submit an Intent to File
15
Veterans Affairs. How to File a VA Disability Claim