This tool provides estimates for educational purposes only. We are not accredited by the Department of Veterans Affairs and do not file claims, provide legal advice, or represent veterans before the VA (38 U.S.C. § 5904). For official assistance, contact a VSO, CVSO, or VA-accredited attorney.
Coronary artery disease (CAD / ischemic heart disease)
- Coronary artery disease is rated under 38 CFR 4.104, Diagnostic Code 7005, with METs-based workload thresholds at 10, 30, 60, and 100 percent.
- Ischemic heart disease is a presumptive condition under 38 CFR 3.309(e) for veterans with qualifying herbicide (Agent Orange) exposure; specific in-service onset evidence is not always required when the presumption applies.
- Left ventricular ejection fraction (LVEF) on echocardiogram is the primary evidence pathway for 60 percent (LVEF 30 to 50) and 100 percent (LVEF below 30) evaluations.
- CAD is commonly filed as secondary to service-connected hypertension or diabetes mellitus type 2 under 38 CFR 3.310; a cardiologist nexus opinion is the key evidence element.
- This page is informational only. Crisis support is always available at 988 press 1, text 838255, or chat at VeteransCrisisLine.net. Content reviewed against VA public guidance as of 2026-04-19. Cardiovascular rating descriptions simplify 38 CFR 4.104 for plain-language use; always refer to a cardiologist and a CVSO for case-specific questions.
Based on VA's Schedule for Rating Disabilities (38 CFR Part 4) and related service-connection regulations. This page is a free community resource. We are not VA-accredited and do not file claims or provide legal advice (per 38 U.S.C. § 5904).
Last reviewed: April 2026 · Next review: October 2026
Maintained by: Veterans Benefits Navigator editorial team. Every citation links to a primary federal or state source. See editorial standards and our privacy posture.
Primary sources: 38 CFR Part 4 (Schedule for Rating Disabilities), VA.gov disability compensation, 38 CFR § 3.310 (secondary service connection)
Overview
Coronary artery disease — also referred to as ischemic heart disease or arteriosclerotic heart disease — is evaluated by the VA under 38 CFR 4.104, Diagnostic Code 7005. The rating is driven primarily by workload tolerance measured in metabolic equivalents (METs) on exercise testing, together with left ventricular ejection fraction (LVEF) measured on echocardiogram, and any history of heart failure or required cardiac procedures.
For veterans with qualifying herbicide (Agent Orange) exposure, ischemic heart disease is a presumptive condition under 38 CFR 3.309(e). A veteran diagnosed with CAD who served in a qualifying location and time period may not need to separately prove exposure or in-service onset for the presumption to apply. Related PACT Act expansions have added additional presumptive locations — veterans can review the current list at /benefits/disability/pact-act and the broader secondary-claim workflow at /benefits/disability/secondary-conditions.
CAD is also commonly filed as secondary to service-connected hypertension or diabetes mellitus type 2. If the VA has rated a veteran for hypertension or diabetes, a cardiologist nexus opinion linking those conditions to the subsequent development of coronary artery disease under 38 CFR 3.310 can support secondary service connection. This pathway matters because cardiovascular ratings can be substantial when METs and ejection fraction are significantly reduced.
Evidence expectations center on cardiology records, a recent exercise tolerance test (ETT) or equivalent METs measurement, an echocardiogram documenting LVEF, and documentation of any hospitalizations, coronary interventions (stent, bypass), or medications. The VA evaluates how the condition affects daily workload rather than relying on diagnosis alone, so specific METs numbers and ejection fraction values are critical to the rating.
Rating Criteria
| Rating | Criteria |
|---|---|
| 10% | A workload of greater than 7 METs but not greater than 10 METs results in documented cardiac symptoms such as dyspnea, fatigue, angina, dizziness, or syncope; or continuous medication is required. |
| 30% | A workload of greater than 5 METs but not greater than 7 METs results in documented cardiac symptoms; or there is evidence of cardiac hypertrophy or dilatation on electrocardiogram, echocardiogram, or X-ray. |
| 60% | A workload of greater than 3 METs but not greater than 5 METs results in documented cardiac symptoms; or there has been more than one episode of acute congestive heart failure in the past year; or left ventricular dysfunction with an ejection fraction of 30 to 50 percent. |
| 100% | Chronic congestive heart failure; or a workload of 3 METs or less results in documented cardiac symptoms; or left ventricular dysfunction with an ejection fraction of less than 30 percent. |
- 10%
A workload of greater than 7 METs but not greater than 10 METs results in documented cardiac symptoms such as dyspnea, fatigue, angina, dizziness, or syncope; or continuous medication is required.
- 30%
A workload of greater than 5 METs but not greater than 7 METs results in documented cardiac symptoms; or there is evidence of cardiac hypertrophy or dilatation on electrocardiogram, echocardiogram, or X-ray.
- 60%
A workload of greater than 3 METs but not greater than 5 METs results in documented cardiac symptoms; or there has been more than one episode of acute congestive heart failure in the past year; or left ventricular dysfunction with an ejection fraction of 30 to 50 percent.
- 100%
Chronic congestive heart failure; or a workload of 3 METs or less results in documented cardiac symptoms; or left ventricular dysfunction with an ejection fraction of less than 30 percent.
These criteria describe how a VA Compensation & Pension examiner evaluates the condition during a rating exam. They are not a self-test. For mental health conditions under 38 CFR 4.130, a diagnosis must be made by a qualified clinician under DSM-5. Actual ratings depend on the totality of evidence reviewed by the VA.
Evidence Checklist
Required
Cardiology records
Treatment records from cardiology documenting the diagnosis of coronary artery disease, including any catheterization findings, stress test results, and treatment history.
Exercise tolerance test (ETT) or METs measurement
A recent exercise stress test documenting workload tolerance in metabolic equivalents (METs). Under 38 CFR 4.104, METs is the primary evaluation criterion for coronary artery disease.
Echocardiogram with left ventricular ejection fraction (LVEF)
An echocardiogram documenting LVEF is required for ratings of 60 percent or 100 percent based on left ventricular dysfunction. Serial echocardiograms over time strengthen the record.
Recommended
Hospitalization and procedure records
Records of any myocardial infarction, coronary artery bypass graft (CABG), angioplasty, stent placement, or congestive heart failure hospitalization. Multiple CHF episodes in a year can support higher evaluations.
Agent Orange or PACT Act exposure documentation
For veterans claiming the 38 CFR 3.309(e) presumption, documentation of qualifying service location and time period. Personnel records, unit records, and deployment orders support the exposure element.
Nexus opinion for secondary claims
If a veteran is filing CAD as secondary to service-connected hypertension or diabetes under 38 CFR 3.310, a cardiologist opinion linking the primary condition to the development of coronary artery disease strengthens the claim.
Helpful
Daily activity impact statement
A statement describing how documented cardiac symptoms (dyspnea, angina, fatigue) limit walking distance, stair climbing, household tasks, and other activities. Concrete examples help the examiner translate daily function into a METs estimate.
Medication history
Documentation of cardiac medications (nitrates, beta blockers, statins, antiplatelets) and any side effects. Continuous medication supports the minimum compensable evaluation.
Secondary Conditions
These conditions may be claimed as secondary to Coronary Artery Disease (CAD / Ischemic Heart Disease). A nexus is the medical link between a service-connected condition and a related condition. Nexus strength indicates the level of established medical evidence supporting that connection.
Congestive Heart Failure
DC 7007, Typical range: 30%, 60%, 100%
Cardiac Arrhythmia
DC 7010, Typical range: 10%, 30%
Depression
DC 9434, Typical range: 10%, 30%, 50%, 70%
Explore all secondary conditions in the Secondary Condition Mapper tool.
Related DBQs
Search all DBQ forms in the DBQ Finder tool.
Next Steps
This information is for educational purposes only. We are not accredited by the Department of Veterans Affairs and do not file claims, provide legal advice, or represent veterans before the VA (38 U.S.C. § 5904). For official assistance, contact a VSO, CVSO, or VA-accredited attorney.