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Heart Failure VA Disability Rating
DC 7007 | 38 C.F.R. § 4.104 | M21-1, Part IV.ii.2.D
OVERVIEW
Hypertensive heart disease and congestive heart failure are rated under DC 7007 using the General Rating Formula for Diseases of the Heart at 38 C.F.R. § 4.104. Heart failure from any cause (IHD, hypertension, cardiomyopathy) is rated on METs (metabolic equivalents) — the workload at which heart failure symptoms develop. Veterans with service-connected hypertension or IHD who develop heart failure should file heart failure as a secondary condition.
RATING CRITERIA (4 LEVELS)
100% — Symptoms at ≤3.0 METs
Heart failure symptoms at workload of 3.0 METs or less. Equivalent to symptoms with slow walking or minimal exertion.
60% — Symptoms at 3.1-5.0 METs
Symptoms at 3.1-5.0 METs. Level walking at 2-3 mph, light housework.
30% — Symptoms at 5.1-7.0 METs or cardiac changes on echo
Symptoms at 5.1-7.0 METs; OR cardiac hypertrophy or dilatation confirmed by echocardiogram, MUGA, or MRI.
10% — Symptoms at 7.1-10.0 METs or continuous medication
Symptoms at 7.1-10.0 METs; OR continuous medication required (diuretics, ACE inhibitors, beta-blockers).
KEY EVIDENCE TO GATHER
-Echocardiogram documenting EF, left ventricular hypertrophy, or dilation
-Exercise stress test with METs documented
-BNP or NT-proBNP levels
-Chest X-ray documenting cardiomegaly or pulmonary congestion
-Records of hospitalizations for acute decompensated heart failure
-Medication list (diuretics, ACE-I/ARB, beta-blockers, spironolactone)
SECONDARY CONDITIONS (3 MAPPED)
DC 7502
Heart failure causes cardiorenal syndrome — renal insufficiency from low cardiac output.
DC 7010/7011
Heart failure causes atrial fibrillation and ventricular arrhythmias — file separately.
DC 9434
Heart failure causes significant depression — independently ratable.
C&P EXAM TIPS (4)
1.Demand METs-based stress test at C&P exam — without METs documentation, may only get 10-30%.
2.EF below 40% (reduced ejection fraction) should be documented — directly supports cardiac hypertrophy/dilation for 30%.
3.Heart failure secondary to service-connected hypertension or IHD is a strong claim — document the causal relationship.
4.If exercise testing is contraindicated, examiner must estimate METs based on specific activities.
RELEVANT CASE LAW
38 C.F.R. § 4.104, General Rating Formula Note (3)
Heart failure symptoms include, but are not limited to, breathlessness, fatigue, angina, dizziness, arrhythmia, palpitations, or syncope. The list is not exhaustive.
DOLLAR IMPACT
Heart failure with EF <40%: typically 30-60% = $524-$1,131/mo. Severe CHF with symptoms at rest: 100% = $3,938.58/mo. Heart failure secondary to SC hypertension or IHD is one of the most impactful secondary claims.
EDUCATIONAL TOOL ONLY. NOT LEGAL OR MEDICAL ADVICE.
NOT AFFILIATED WITH THE U.S. DEPARTMENT OF VETERANS AFFAIRS.
CLAIM RECON 2026