38 CFR Part 4 — 38 CFR § 4.104
Arteriosclerotic Heart Disease
dc-7005-arteriosclerotic-heart-disease
Cardiovascular
Diagnostic code
7005
Why your DC matters: DC 7005 is the exact code the VA uses to rate this condition. It determines which symptoms unlock which percentage, what evidence the rater looks for, and which secondaries are most likely to be approved.
Last verified against 38 CFR (eCFR Part 4):
Rating criteria (38 CFR Part 4)
Diagnostic code 7005 — Arteriosclerotic Heart Disease — is listed under 38 CFR § 4.104 in 38 CFR Part 4. The paragraphs below summarize how this code is used; the official schedule text controls exact percentages, formulas, and notes.
Schedule summary (educational, not a substitute for the regulation): Educational index row from the rating schedule naming convention; confirm exact diagnostic code, effective date, and criteria in the current eCFR Part 4.
Exact rating criteria: Open Part 4 in the eCFR (link under “Official source” below). Locate your diagnostic code number (7005) in the correct body-system subpart, or use Find in Page (Ctrl+F / ⌘F) for “7005”. Copy the verbatim rating table, including any parenthetical notes, exceptions, and cross-references, for the version of Part 4 that applies to your effective date.
Effective dates & which schedule version applies
Which diagnostic code, percentage, and effective date apply depends on the facts of your claim and the version of the rating schedule in force for the period being decided. Generally, VA applies the schedule in effect at the specified time under 38 U.S.C. § 5110 and implementing rules, subject to exceptions (e.g., protected ratings, liberalizing law changes—see regulation and VA manual policy as applicable).
For older claims, the **current** eCFR may not match the text that applied years ago. If your decision references a prior percentage or code, compare against the Part 4 text **as of** your claim’s relevant dates; historical Federal Register / CFR snapshots may be needed for precise comparison.
The “Last verified” date on this page is when we last checked this educational summary against the electronic CFR—not the date of any VA policy or your personal claim decision.
Notes for your claim
Evidence: Show that your diagnosis and severity match the factors the schedule names for DC 7005 (e.g., measurements, frequency, treatment, functional loss), with medical and lay evidence as appropriate.
C&P exams: Results should reflect the schedule’s requirements (correct joints measured, correct formulas). If the exam omits required findings, consider submitting records or requesting clarification.
If you disagree with the DC, percentage, or effective date, review the Part 4 text for your period and consider a supplemental claim or appeal with a VA-accredited representative.
This site does not provide legal advice.
Official source
38 CFR Part 4 (eCFR) — locate diagnostic code 7005 in the subpart for your body system (use Find in Page if needed).
DC 7005 is rated under the General Rating Formula for Diseases of the Heart — almost entirely on METs (metabolic equivalents). The single most important vocabulary word for veterans is 'METs at which dyspnea, fatigue, angina, dizziness, or syncope occurs.' Veterans get systematically under-rated because examiners use estimated METs from a questionnaire instead of an exercise stress test, and questionnaires consistently overestimate functional capacity.
Rating Tiers — What Each Percentage Requires
| Rating | What It Takes | Evidence That Supports It |
|---|---|---|
| 100% | Chronic congestive heart failure; OR workload of 3 METs or less results in dyspnea, fatigue, angina, dizziness, or syncope; OR left ventricular ejection fraction (LVEF) less than 30%. | Stress test or estimate showing ≤3 METs symptomatic; CHF diagnosis in chart; echocardiogram LVEF <30%. |
| 60% | More than one episode of acute congestive heart failure in the past year; OR workload of 3.1–5 METs results in dyspnea, fatigue, angina, dizziness, or syncope; OR left ventricular dysfunction with LVEF of 30–50%. | Two or more CHF hospitalizations in 12 months; stress test 3.1–5 METs symptomatic; echo LVEF 30–50%. |
| 30% | Workload of 5.1–7 METs results in dyspnea, fatigue, angina, dizziness, or syncope; OR evidence of cardiac hypertrophy or dilatation on EKG, echocardiogram, or X-ray. | Stress test 5.1–7 METs symptomatic; or echo/EKG showing LVH or chamber dilation. |
| 10% | Workload of 7.1–10 METs results in dyspnea, fatigue, angina, dizziness, or syncope; OR continuous medication required. | Stress test in that range; or pharmacy records showing continuous CAD medication (statin + antiplatelet + beta-blocker is the classic combo). |
What Qualifies as 'Arteriosclerotic Heart Disease' Under DC 7005?
Documented coronary artery disease
Confirmed by angiography (cardiac cath), stress test imaging, or history of MI/stenting/CABG. Pure 'risk factors' (HTN + diabetes + hyperlipidemia) without imaging confirmation are not sufficient.
Rated under the General Rating Formula for Diseases of the Heart
Multiple parallel rating paths — apply whichever yields the higher percentage:
- • 10% — workload 7.1–10 METs symptomatic OR continuous medication
- • 30% — workload 5.1–7 METs symptomatic OR LVH/cardiac dilation on imaging
- • 60% — workload 3.1–5 METs OR > 1 acute CHF episode/yr OR LVEF 30–50%
- • 100% — chronic CHF OR workload ≤ 3 METs OR LVEF < 30%
Language Your Rater Needs to See
These are the exact (or near-exact) regulatory phrases that unlock specific tiers. If your DBQ or C&P report doesn't use this vocabulary, the rater may default to a lower percentage even when symptoms qualify.
“Cardiac hypertrophy or dilatation confirmed by echocardiogram”
LVH or chamber dilation is a 30% gate REGARDLESS of METs. If your echo shows either, you qualify for 30% even with high functional capacity. Pull every echo report and look for these findings explicitly.
“Left ventricular ejection fraction of 30–50%”
LVEF is an alternate path to 60%. If your echo shows EF 30–50% — even if you walk three miles a day — you qualify for 60%. Examiners often default to METs and miss the EF route.
“At [X] METs, the veteran experiences dyspnea / fatigue / angina / dizziness / syncope”
The rating is based on the METs at which symptoms BEGIN — not the METs you can physically reach. If you can hit 7 METs but get angina at 5, your rating is the 5-MET tier. Make sure the examiner records SYMPTOM-ONSET METs, not max METs.
Evidence Checklist — Specific to This Condition
Exercise stress test (treadmill or pharmacologic)
CRITICALGOLD STANDARD evidence. Documents actual METs at symptom onset. Far better than a questionnaire estimate. Push for a formal stress test if your file only has interview-METs.
Echocardiogram report
CRITICALLVEF, chamber sizes, wall motion, presence of LVH. Either LVEF or hypertrophy can independently support a higher rating regardless of METs.
Cardiac catheterization / angiography
IMPORTANTConfirms diagnosis of CAD and documents severity (vessel involvement, prior stents/CABG).
Continuous medication regimen
CRITICALPharmacy printout — statin, antiplatelet, beta-blocker, nitrates, ACE inhibitor. Continuous medication alone qualifies for 10% floor.
Hospitalization records (CHF episodes, MIs, stents)
IMPORTANTMI history → presumptive service connection under certain exposures (Agent Orange). CHF episodes drive 60% and 100% tiers.
Heart Conditions DBQ
CRITICALMake sure 'Interview-METs' OR stress test METs is filled in, and the SPECIFIC symptom limitation (dyspnea, fatigue, angina, etc.) is noted.
C&P Exam Tips
Push for a formal exercise stress test
Interview-METs (examiner asks 'can you walk a mile?') systematically overestimate functional capacity. A real stress test on a treadmill or with pharmacologic challenge gives objective METs. Ask your cardiologist to order one before C&P.
Describe symptom onset, not exhaustion
Don't say 'I walked a mile, but I was tired by the end.' Say 'I started getting chest pressure climbing a single flight of stairs.' Symptom onset is what determines the METs tier.
Don't minimize medication-controlled symptoms
If your nitroglycerin keeps angina away, describe what happens when it doesn't — and that you require it. 'Continuous medication required for control' is a 10% floor by itself.
Common Mistakes That Cost Veterans Points
Accepting interview-METs estimate without a stress test
VA's METs questionnaire (the 'can you walk up stairs?' interview) systematically over-estimates capacity. If your decision rests on interview-METs alone, request a real exercise tolerance test on appeal.
Not filing for LVH or LVEF separately from METs
Cardiac hypertrophy = 30% gate. LVEF 30–50% = 60% gate. Either alone qualifies — even if METs would put you lower. Audit your echo reports.
Missing Agent Orange presumptive service connection
Ischemic heart disease (which includes CAD) is presumptively service-connected for Agent Orange exposed veterans (Vietnam, certain Korean DMZ units, Thailand, blue water Navy). No nexus letter required — just exposure + diagnosis.
Not pursuing TDIU at 60% CAD
If your heart condition prevents work, TDIU pays at 100% rate. With CAD at 60% as the primary, file Form 21-8940.
Tactical Plays
⚡ Agent Orange + CAD = presumptive grant
Ischemic heart disease is a PRESUMPTIVE Agent Orange condition. If you served in Vietnam (1962–1975), certain Korean DMZ units, Thailand under specific conditions, or as blue water Navy in territorial waters, file with DD-214 + CAD diagnosis — no nexus letter required.
⚡ Echo LVEF route bypasses the stress test
If your echocardiogram shows LVEF in the 30–50% range, you qualify for 60% regardless of METs. Many veterans walking 5+ METs comfortably still have impaired EF on imaging.
⚡ 60% CAD + ED + HTN = TDIU territory
60% CAD as primary + secondaries (ED, HTN, diabetes) regularly combines to 80–90% and qualifies for TDIU. File the secondaries before the TDIU application so the rating is in place.
Secondary Conditions to File With This One
Hypertension
STRONGDC 7101
Often co-existing. If HTN preceded CAD, the CAD is sometimes secondary to HTN. Rate separately.
Diabetes mellitus
MODERATEDC 7913
If diabetes is already service-connected, CAD can be filed as secondary (well-established link via accelerated atherosclerosis).
Erectile dysfunction
STRONGDC 7522
Vascular ED is well-documented secondary to CAD and cardiac medications. Unlocks SMC-K (~$132/mo).
Depression / anxiety
MODERATEDC 9434
Chronic cardiac disease → depression. Well-accepted secondary path.
Compensation Scenarios
2026 rates (effective Dec 1, 2025, per va.gov)
10% — single, no dependents
Base rating
$180.42
TOTAL
$180.42/mo
7.1–10 METs symptomatic, OR continuous medication.
30% — single, no dependents
Base rating
$552.47
TOTAL
$552.47/mo
5.1–7 METs symptomatic OR LVH/cardiac dilation.
60% — single, no dependents
Base rating
$1,435.02
TOTAL
$1,435.02/mo
3.1–5 METs OR LVEF 30–50% OR > 1 CHF episode/yr.
100% — single, no dependents
Base rating
$3,938.58
TOTAL
$3,938.58/mo
≤ 3 METs OR chronic CHF OR LVEF < 30%.
60% CAD + 10% HTN + 0% ED + SMC-K
Base rating
$1,435.02
DC 7522 ED 0% + SMC-K
+$139.87
TOTAL
$1,574.89/mo
60 + 10 combined under § 4.25 → 64, rounds to 60% = $1,435.02 + SMC-K $139.87 = $1,574.89/mo. With TDIU eligibility, jumps to 100% rate.
Note: Amounts are approximations rounded to nearest dollar. Actual comp varies with effective date, dependents (spouse, children, parents — each adds), Aid & Attendance, and additional disabilities. Combined ratings use VA Math (§ 4.25), not simple addition.
Key Definitions
⚡What are 'METs'?
Metabolic equivalents — a measure of energy expenditure. 1 MET = resting. 4 METs = climbing one flight of stairs. 7 METs = jogging. The RATING is based on the METs at which symptoms BEGIN (not the METs you can maximally reach).
❤️What is LVEF?
Left Ventricular Ejection Fraction — the percentage of blood pumped out of the left ventricle per heartbeat. Normal ≥ 55%. LVEF 30–50% = 60% rating. LVEF < 30% = 100% rating, regardless of METs.
💪What is LVH?
Left Ventricular Hypertrophy — thickening of the heart's main pumping chamber, typically from sustained high blood pressure or cardiomyopathy. Documented on echocardiogram. Alone qualifies for 30%.
🗣️What are Interview-METs?
Examiner-estimated METs from questionnaires ('can you walk a mile? climb stairs?'). Permitted only when formal stress testing is medically contraindicated. They systematically OVERESTIMATE functional capacity. Push for a real exercise tolerance test.
How to File Your Claim
Push for a formal exercise tolerance test (stress test)
Interview-METs are permitted ONLY when stress testing is medically contraindicated. If you can safely do a treadmill stress test, ask your cardiologist to order one before C&P.
File VA Form 21-526EZ specifying 'coronary artery disease (ischemic heart disease)'
If Agent Orange exposure applies (Vietnam, certain Korean DMZ, Thailand, blue water Navy), CAD is presumptively service-connected — no nexus required.
Submit echocardiogram + cardiac cath + Heart Conditions DBQ
Echo gives LVEF, LVH, and chamber sizes — each independently can support higher ratings. Cardiac cath confirms vessel involvement.
File secondaries: HTN, diabetes (if not already SC), ED
The vascular triad commonly rates together. ED secondary to CAD or cardiac medications unlocks SMC-K.
At 60%+, file Form 21-8940 for TDIU if work is affected
Cardiac fatigue and exertional limits often prevent gainful employment. TDIU pays the 100% rate.
Typical Claim Timeline
File initial claim
Day 0–7: Submit VA Form 21-526EZ with all medical evidence on file
VA acknowledges claim
Week 1–2: Receive confirmation letter and claim tracking number
C&P examination scheduled
Month 1–3: VA contracts an exam vendor and sends you appointment notice
Attend C&P exam
Bring your full evidence package; describe symptoms on your worst days, not your best
Decision & rating notice
Month 3–6: Decision letter with rating percentage and effective date
First payment & retro back pay
Within 15 days of decision; retroactive to claim date (or effective date if earlier)
Timeline varies by case complexity and VA regional office workload. Some claims resolve faster; others take longer.
Important Considerations
Symptom-onset METs, not exhaustion METs
If you can hit 7 METs but get chest pain at 5, the RATING is the 5-MET tier. Examiners often record max METs — make sure they record SYMPTOM ONSET METs.
LVEF and LVH bypass the METs ladder
Echo LVEF 30–50% = 60% regardless of how far you can walk. LVH = 30% regardless of METs. Audit every echocardiogram for these findings.
Agent Orange + CAD = presumptive grant
Vietnam-era exposure + current CAD diagnosis = automatic service connection. No nexus letter, no in-service onset evidence required.
Continuous medication = 10% floor
Statin + antiplatelet + beta-blocker (the classic CAD combo) qualifies for 10% by itself under the 'continuous medication required' criterion. Don't accept 0%.
Additional VA Benefits You May Qualify For
🪖Agent Orange Presumptive Service Connection
Ischemic heart disease is on the Agent Orange presumptive list. Vietnam (Jan 1962 – May 1975), certain Korean DMZ units, Thailand under specific conditions, and blue water Navy — file with DD-214 + diagnosis, no nexus letter required.
🏥VA Cardiology + Cardiac Rehab
Service-connected veterans receive specialist cardiology care, cardiac rehab programs, and medications at no cost through VA.
Related Tools & Resources
Frequently Asked Questions
Is CAD presumptive for all Vietnam-era veterans?
Ischemic heart disease (which includes CAD) is presumptive for veterans with Agent Orange exposure: Vietnam (1962–1975), certain Korean DMZ units (Apr 1968 – Aug 1971), Thailand under specific conditions, and blue water Navy in territorial waters. Verify your exposure status.
Do I need a stress test or can interview-METs be used?
Interview-METs are only permitted when stress testing is medically contraindicated. If you can safely take a real treadmill or pharmacologic stress test, you should — it's far more accurate and avoids systematic over-estimation.
Can I rate CAD AND hypertension separately?
Yes, when both are documented. They're distinct conditions with different rating bases (METs/LVEF vs BP readings). Both can be combined under § 4.25.
What if my CAD is asymptomatic but I had a stent?
A history of MI or stent placement supports CAD diagnosis. The rating depends on current functional status — METs at symptom onset, LVEF, presence of LVH. Asymptomatic + continuous medication = 10% floor.
How does TDIU work for cardiac veterans?
At 60% CAD or 70%+ combined, if cardiac limitations prevent gainful employment, file Form 21-8940. Documentation: cardiologist's note on work restrictions, employment records, METs at symptom onset showing exertional limits.
Official Regulatory Source
Coronary artery disease (ischemic heart disease) is rated under 38 CFR § 4.104, Diagnostic Code 7005.
38 CFR § 4.104 — Cardiovascular System (eCFR) →The General Rating Formula for Diseases of the Heart appears at the top of § 4.104 and applies to DCs 7000–7020.
⚠️ Verify with a VSO
VA's heart rating formula (§ 4.104) was substantially updated; verify the current criteria and METs/LVEF thresholds against your effective date. Note Interview-METs estimates are explicitly permitted only when a formal stress test is medically contraindicated. If you can safely take a stress test, ask for one.
Next Steps
If your rating decision lists DC 7005, compare your current symptoms and documentation against the criteria above. Consider:
- Requesting a copy of your rating decision and C&P exam report from the VA
- Gathering all relevant medical records (VA and private providers)
- Documenting functional limitations and how they impact work and daily activities
- Obtaining a nexus letter if needed to establish or strengthen service connection
- Filing for secondary conditions that may be related to this primary condition
- Contacting a VA-accredited VSO, claims agent, or attorney to review your file
This is general educational information only — not legal or medical advice.
Also: DC code lookup (tools) lists the same index in a compact layout.
Source: 38 CFR Part 4, Diagnostic Code 7005 • va.gov
⚠️ Important Disclaimer
This page provides general educational information only based on public VA regulations (38 CFR) and va.gov resources. It is not legal, medical, or claims assistance. Ratings and service connections are decided case-by-case by the VA based on the individual veteran’s evidence. We do not prepare claims, generate documents, or provide personalized advice. Always consult a VA-accredited Veterans Service Organization (VSO), attorney, or your physician for help with your specific situation. Verify the latest rules on va.gov.