Agent Orange Heart Disease VA Disability Rating

What is Agent Orange heart disease and how does it affect veterans?

Agent Orange heart disease refers to ischemic heart disease that develops in veterans who were exposed to Agent Orange and other tactical herbicides during military service. Ischemic heart disease occurs when the arteries supplying blood to the heart become narrowed or blocked, reducing oxygen delivery to the heart muscle. This includes coronary artery disease, angina (chest pain), myocardial infarction (heart attack), and other conditions caused by inadequate blood supply to the heart.

Agent Orange — a mixture of the herbicides 2,4-D and 2,4,5-T contaminated with dioxin (TCDD) — was sprayed extensively during the Vietnam War to defoliate forests and destroy enemy crops. Approximately 2.6 million U.S. military personnel served in Vietnam, and many were exposed to this toxic chemical. Scientific research has established a clear link between Agent Orange/dioxin exposure and the development of ischemic heart disease, often manifesting years or decades after exposure.

The VA added ischemic heart disease to the list of Agent Orange presumptive conditions in 2010. This means that if you served in a qualifying location and have been diagnosed with ischemic heart disease, the VA presumes the disease is connected to your herbicide exposure — no nexus letter is required.

VA diagnostic code for Agent Orange heart disease

Agent Orange-related ischemic heart disease is rated under Diagnostic Code (DC) 7005 per 38 CFR § 4.104, Schedule of Ratings — Cardiovascular System. DC 7005 covers arteriosclerotic heart disease (coronary artery disease), which is the most common form of ischemic heart disease among Agent Orange veterans.

DC 7005 is evaluated under the General Rating Formula for Diseases of the Heart. The criteria are based on the workload, measured in METs (metabolic equivalents), at which heart failure symptoms appear; evidence of cardiac hypertrophy or dilatation confirmed by echocardiogram or equivalent imaging; and whether continuous medication is required for control. The VA assigns the highest level whose criteria you meet.

For this formula, heart failure symptoms “include, but are not limited to, breathlessness, fatigue, angina, dizziness, arrhythmia, palpitations, or syncope.” Ejection fraction and congestive heart failure episodes were rating criteria under the pre-2021 formula and are no longer separate paths to a rating.

Rating criteria for Agent Orange heart disease

The VA assigns Agent Orange heart disease ratings at five possible levels. Here’s what each rating requires and what it pays in 2026:

0% rating

Criteria: The rating schedule has no 0% level for heart disease. Under 38 CFR § 4.31, VA assigns 0% when ischemic heart disease is diagnosed and service-connected but you do not meet the 10% criteria — for example, you have no heart failure symptoms at a workload of 10.0 METs or less and do not need continuous medication for control.

Monthly payment: $0 (but establishes service connection, which is critical for future increases as the condition progresses and for secondary condition claims)

10% rating — $180.42/month

Criteria: A workload of 7.1-10.0 METs results in heart failure symptoms, or continuous medication is required for control.

What this looks like: You take daily heart medication (beta blockers, statins, blood thinners) and experience mild symptoms during vigorous activity. You can perform most daily activities without problems, but heavy exercise or strenuous work causes chest tightness, shortness of breath, or fatigue.

30% rating — $552.47/month

Criteria: A workload of 5.1-7.0 METs results in heart failure symptoms, or evidence of cardiac hypertrophy or dilatation confirmed by echocardiogram or equivalent (e.g., multigated acquisition scan or magnetic resonance imaging).

What this looks like: Moderate physical activities such as brisk walking, climbing a flight of stairs, mowing the lawn, or carrying groceries cause noticeable cardiac symptoms. An echocardiogram, MUGA scan, or cardiac MRI may show your heart has enlarged; an EKG or X-ray alone no longer confirms this. You take multiple medications and may have had cardiac procedures (stenting, angioplasty).

60% rating — $1,435.02/month

Criteria: A workload of 3.1-5.0 METs results in heart failure symptoms.

What this looks like: Routine daily activities cause cardiac symptoms. Walking short distances, light housework, or getting dressed may produce shortness of breath, fatigue, chest pain, or palpitations. Employment involving any physical activity is extremely difficult.

100% rating — $3,938.58/month

Criteria: A workload of 3.0 METs or less results in heart failure symptoms.

Separately, a heart attack (DC 7006) carries a temporary 100% rating during and for three months after the event, and coronary bypass surgery (DC 7017) carries 100% for three months following hospital admission for surgery. After that, the General Rating Formula applies.

What this looks like: Your heart disease is severe and life-limiting. Even minimal physical activity causes significant cardiac symptoms, and you likely need ongoing medical management. You are unable to maintain employment in any capacity, and daily activities require assistance or cause distress.

What evidence do you need?

The presumptive service connection for Agent Orange heart disease simplifies the claims process significantly, but you still need to document your condition and qualifying service:

Service records

• DD-214 confirming service in Vietnam between January 9, 1962, and May 7, 1975
• Or documentation of service on a U.S. or Royal Thai military base in Thailand (January 9, 1962, through June 30, 1976), C-123 aircraft, or herbicide test/storage sites
• Deployment records, orders, or personnel records confirming dates and locations
• Service treatment records are helpful but not required for presumptive claims

Medical evidence

• Current diagnosis of ischemic heart disease from a cardiologist or qualified physician
• Cardiac testing results — stress test showing the METs level at which symptoms begin, echocardiogram (or MUGA scan or cardiac MRI) showing any heart enlargement, EKG results
• Cardiac catheterization results if performed
• Records of any heart procedures (stenting, angioplasty, bypass surgery)
• Treatment records showing ongoing symptoms and medication use
• Documentation of any heart failure treatment, heart attacks, or hospitalizations

Nexus letter

A nexus letter is generally not required for Agent Orange presumptive conditions. The VA presumes the connection between your qualifying service and ischemic heart disease. However, if your claim is denied or if there is a question about whether your specific cardiac condition qualifies as ischemic heart disease, a cardiologist’s opinion can be valuable.

Buddy statements

Statements from family members, friends, or fellow veterans who can describe:

• Your cardiac symptoms and how they limit your activities
• Changes in your physical abilities over time
• Your service in Vietnam or other qualifying locations
• How heart disease has affected your daily life and ability to work

Personal statement

Your own detailed account of how ischemic heart disease affects your daily life. Be specific about limitations — describe how far you can walk before symptoms occur, which daily activities cause problems, and how your condition has changed over time. For example, instead of “I have heart problems,” write “I cannot walk more than one block without chest pain and shortness of breath, and I had to quit my job as a warehouse worker because I could no longer lift anything over 10 pounds without becoming dizzy.”

C&P exam tips for Agent Orange heart disease

The C&P exam for heart disease focuses heavily on objective cardiac testing, but accurately communicating your symptoms is equally important.

What the examiner evaluates

The examiner will assess:

• Your current cardiac diagnosis and history
• METs capacity — through exercise testing or, if testing cannot be done for medical reasons, an estimate based on the activities that cause your symptoms
• Echocardiogram or equivalent imaging showing whether your heart is enlarged (hypertrophy or dilatation)
• Whether you need continuous medication for control
• Current medications and treatments
• Impact on occupational and daily functioning
• History of cardiac procedures (bypass, stenting, pacemaker)

How to prepare

1. Bring all recent cardiac test results. Echocardiograms, stress tests, EKGs, and cardiac catheterization reports. Having recent results (within the past year) is important.
2. Be honest about your limitations. If you cannot climb stairs without chest pain, say so. If you stopped exercising because of your heart, explain that.
3. Know your METs level. Think about what activities cause symptoms. For reference: 1-3 METs = dressing, eating, walking slowly; 3-5 METs = light yard work, brisk walking; 5-7 METs = mowing lawn, climbing stairs; 7-10 METs = jogging, heavy yard work.
4. Report all symptoms. Chest pain, shortness of breath, fatigue, dizziness, fainting, palpitations, irregular heartbeat, swelling in legs/ankles — describe when and how often each occurs. The current formula counts arrhythmia and palpitations as heart failure symptoms.
5. Describe the trajectory. Heart disease typically worsens over time. Explain how your symptoms and limitations have progressed.

Common mistakes

• Underreporting symptoms because “it could be worse” — describe your actual limitations
• Not having recent cardiac testing (stress test, echocardiogram) — if your last test is over a year old, ask your cardiologist for updated testing before your C&P exam
• Failing to mention heart failure symptoms, heart attacks, or emergency room visits
• Not connecting symptoms to daily activities and work limitations
• Exercising or being unusually active before the exam, which can temporarily affect test results

Common secondary conditions linked to Agent Orange heart disease

Agent Orange exposure and the resulting heart disease frequently cause or aggravate other conditions. These can be claimed as secondary service-connected disabilities:

• Depression — Heart disease is strongly linked to depression. The physical limitations, medication side effects, and life changes caused by chronic heart disease frequently trigger depressive episodes. Research shows that cardiac patients have depression rates 2-3 times higher than the general population.
• Sleep apnea — Heart disease and sleep apnea share a bidirectional relationship. Heart failure can cause central sleep apnea, and the medications and reduced activity from heart disease can contribute to weight gain and obstructive sleep apnea.
• Diabetes — Many Agent Orange veterans have both heart disease and Type 2 diabetes (also a presumptive condition). Diabetes can worsen heart disease and is frequently claimed as a separate service-connected condition.
• Erectile dysfunction — Heart and blood-vessel disease and some cardiovascular medicines can cause or worsen erectile dysfunction. Reduced blood flow can affect sexual function; a clinician can assess the role of your individual medication and medical history.

How to calculate your monthly payment

Your total VA disability payment depends on your combined rating across all service-connected conditions, not just heart disease alone. Use our VA disability calculator to:

• Calculate your combined rating with multiple conditions
• See how VA math combines ratings differently than simple addition
• Estimate your monthly payment including dependents

For the full breakdown of payment amounts at every rating level, see our 2026 VA disability pay rates page.

Correction — October 21, 2026: Corrected the FAQ: hypertension is not ischemic heart disease, but it is separately presumptive for qualifying herbicide exposure. Qualified the link between heart medicines and erectile dysfunction.

Disclaimer: This content is for informational purposes only and does not constitute legal or medical advice. For personalized guidance on your VA disability claim, consult a VA-accredited Veterans Service Organization (VSO), attorney, or claims agent. You can find accredited representatives at VA.gov.