Five Ways to Assess a VA Heart Disability Rating

Figuring out your correct VA heart disability rating can be very difficult.  There are so many ways for VA to rate heart conditions.  Also, the ratings criteria are often based on highly technical cardiac test results.

In this article, I will try to give you an overview of cardiac and heart disabilities so you can get a better understanding of where your particular VA heart disability falls on the ratings scale.  VA uses essentially five different criteria to assign ratings levels ranging from 10% to 100%.

What if I have congestive heart failure?

To begin, let’s start at the top at the 100% rating level. One way for VA to rate your cardiac disability is if you have been diagnosed with congestive heart failure.  That is something that your doctor or cardiologist will determine and should note in your medical records as part of your cardiac assessment and diagnosis.

But, you cannot do this based on your own lay statement or personal judgment.  To establish congestive heart failure, you must have a medical opinion.

If you do have this medical evidence of chronic congestive heart failure, VA should rate you at 100% since chronic congestive heart failure is one way to obtain the highest possible schedular rating.  If you have had more than one episode of acute congestive heart failure in the past year, VA should rate you at 60%.

Does VA use METs (Metabolic Equivalent Threshold) score to assign heart disability ratings?

The second way VA rates a heart disability is your METs (Metabolic Equivalent Threshold) score.  A METs score measures how much physical activity you can withstand before you start exhibiting certain cardiac symptoms such as:

• Dizziness
• Fatigue
• Dyspnea (shortness of breath)
• Syncope (fainting), or
• Angina (chest pain).

VA uses METs to rate heart disabilities at any level – 100%, 60%, 30% or 10%.  With METs based ratings, the higher level of exertion you are able to withstand prior to having those symptoms listed above, the higher your METs score.

The higher your METs score, the lower your VA heart disability rating will be.  If you can do more physically before becoming symptomatic, then VA believes your heart is less impaired than someone who becomes symptomatic with less exertion.

VA disability ratings for left ventricular dysfunction

The third way your VA cardiac disability can be rated is based on left ventricular dysfunction.  Left ventricular dysfunction is based on your ejection fraction measurement.  That is a measurement of how much blood your heart pumps out each time it contracts.

This measurement is expressed as a percentage of all the blood in that area of the heart.  The lower the ejection fraction reading, the more dysfunction of the left ventricle of the heart.

A lower ejection fraction reading results in a higher VA heart disability rating.  Left ventricular dysfunction (i.e., left ventricular ejection fraction) is yet another way for a veteran to receive a disability rating at the 100% level or at the 60% level.

VA ratings for cardiac hypertrophy or cardiac dilatation

The fourth way VA can rate your heart disability is based on changes in the heart muscle itself.   There are two types of relevant changes:

1. Cardiac hypertrophy
2. Cardiac dilatation.

What do these types of changes to the heart muscle mean? Cardiac hypertrophy means a thickening of the heart muscle.  The inside volume of the heart gets smaller because the muscle walls have become thicker.

Cardiac dilatation means essentially the opposite. Instead of getting smaller, the heart enlarges because the heart’s walls are thinning out.

You need to show hypertrophy and dilatation by diagnostic testing.  VA’s cardiac ratings criteria allow for you to show these changes by echocardiogram, electrocardiogram, or x-ray.  If you prove you have either of these structural changes of the heart, you should be entitled to a 30% VA heart disability rating.

What if I take medication for a heart condition?

The fifth and final way VA can rate your heart disability helps those veterans who may not qualify under one of the previous 4 methods.  If you don’t qualify for a rating based on the above criteria, you should still qualify for a 10% VA heart disability rating if you must continually take medication on account of your heart condition.

Again, VA should only use this method at the 10% rating level.  But, this method will provide some benefits to those veterans whose heart problems are relatively mild (meaning they don’t have any cardiac symptoms upon exertion, congestive heart failure, or observable anatomical changes in the heart muscle).