Ischemic Heart Disease (Coronary Artery Disease) VA Rating

Overview

METs measure the body's ability to perform physical work — 1 MET ≈ resting; 5 METs ≈ light yard work; 10 METs ≈ jogging.

Ejection fraction (EF) below 50% supports 60%; below 30% supports 100%.

Presumptive for Vietnam-era veterans exposed to Agent Orange (38 CFR § 3.309(e)).

In Depth

Ischemic heart disease, including coronary artery disease and arteriosclerotic heart disease, is evaluated under DC 7005 in 38 CFR § 4.104. The criteria are structured around workload measured in metabolic equivalents (METs) at which dyspnea, fatigue, angina, dizziness, or syncope develops, together with findings of cardiac hypertrophy or dilatation, ejection fraction, and episodes of congestive heart failure.

38 CFR § 4.100 governs how METs are applied: it directs that an exercise test be conducted unless a medical contraindication exists, the left ventricular ejection fraction is 50 percent or less, chronic congestive heart failure is present, or a 100-percent evaluation can be assigned on another basis. Where an exercise test is not conducted, the examiner provides an estimate of the METs level.

Ischemic heart disease is a listed herbicide-presumptive condition under 38 CFR § 3.309(e) for veterans with qualifying exposure under § 3.307(a)(6), which the PACT Act expanded to additional locations codified at 38 U.S.C. § 1116 and related provisions.

Section 4.104 also provides that separate evaluations for distinct cardiac conditions may not be combined where doing so would compensate the same manifestation, consistent with 38 CFR § 4.14.

How to Establish Service Connection

• Agent Orange / herbicide presumption for qualifying Vietnam-era and other locations.
• PACT Act expanded presumptive locations.
• Secondary: heart disease secondary to PTSD, hypertension, or diabetes.

Rating Criteria

Paraphrased from 38 CFR § 4.104, Diagnostic Code 7005

See what each percentage pays in 2026 and how it combines with your current rating →

Evidence Checklist

• Cardiac stress test with METs result.
• Echocardiogram with ejection fraction.
• Catheterization or imaging confirming coronary artery disease.
• Agent Orange / PACT Act exposure documentation.

Evidence Templates

Common formats of evidence the VA looks for in this type of claim. These describe what the documents typically include — they are not legal forms or medical opinions, and Oakridge Claims does not draft them.

Evidence VA Commonly Cites in These Claims

Descriptive summary of evidence types frequently referenced in rating decisions for this condition. Not a checklist of actions to take — every claim is decided on its own facts.

• ★An exercise stress test with a documented METs level, or an examiner's estimated METs where testing is contraindicated, is the central variable in DC 7005.
• ★Echocardiogram reports documenting ejection fraction and any hypertrophy or dilatation address findings named in the criteria.
• ★Hospitalization or treatment records for congestive heart failure episodes relate to specific tiers of the code.
• ★For herbicide presumptive theories, records establishing service in a location covered by § 3.307(a)(6) as expanded by the PACT Act are the service-connection foundation.

Common pitfalls VA sees

• Not having a METs figure in the record, when the criteria are METs-based and § 4.100 addresses how it is obtained.
• Assuming successful stent placement or bypass ends the evaluation, when the code is applied to current cardiac function.
• Claiming hypertension and ischemic heart disease as one condition, when they are separate codes (DC 7101 and DC 7005) subject to § 4.14 analysis.

Frequently Asked Questions