Coronary Artery Disease VA Rating 2026: DC 7005 Criteria

What is coronary artery disease and how does it affect veterans?

Coronary artery disease (CAD) is a condition where the arteries that supply blood to the heart become narrowed or blocked by plaque buildup (atherosclerosis). As plaque accumulates, blood flow to the heart muscle is reduced, causing chest pain (angina), shortness of breath, and fatigue. If a plaque ruptures and completely blocks an artery, the result is a heart attack (myocardial infarction), which can be fatal.

Veterans experience coronary artery disease at higher rates than the general population due to multiple risk factors associated with military service. Chronic stress from combat and military life, exposure to environmental hazards including Agent Orange and burn pits, disrupted sleep patterns, and the development of other cardiovascular risk factors like hypertension and obesity all contribute. Many veterans develop CAD decades after service, often as a downstream consequence of other service-connected conditions.

CAD profoundly affects daily life. As the disease progresses, the heart’s ability to pump effectively diminishes. Activities that were once easy — climbing stairs, walking moderate distances, carrying groceries — become exhausting or trigger chest pain. Veterans with advanced CAD may develop congestive heart failure, where the heart cannot pump enough blood to meet the body’s needs, causing fluid buildup in the lungs and extremities, severe fatigue, and significant physical limitations.

VA diagnostic code for coronary artery disease

Coronary artery 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) and is evaluated under the General Rating Formula for Diseases of the Heart. The criteria look at the workload, measured in METs (metabolic equivalents), at which you develop heart failure symptoms; whether cardiac hypertrophy or dilatation (an enlarged heart) is 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 episodes of congestive heart failure were rating criteria under the pre-2021 formula; they are no longer separate paths to a rating, although the same test results can still help document your symptoms.

Rating criteria for coronary artery disease

The VA assigns CAD ratings at five possible levels:

0% rating

Criteria: The condition is diagnosed and service-connected but cardiac function is normal and does not meet the criteria for a 10% rating.

Monthly payment: $0 (but establishes service connection, which is important for future increases and secondary claims)

10% rating — $180.42/month

Criteria: Workload of 7.1-10.0 METs results in heart failure symptoms; or continuous medication required for control.

What this looks like: You can perform most activities of daily living without symptoms, but sustained moderate exertion (brisk walking, cycling, heavy housework) causes shortness of breath, chest discomfort, fatigue, or dizziness. You take daily heart medication such as statins, beta blockers, or aspirin. Your cardiac function is mildly impaired but you can still function at a reasonable level with medication management.

30% rating — $552.47/month

Criteria: 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 activity causes cardiac symptoms. Walking at a normal pace on level ground is manageable, but walking uphill, climbing more than one flight of stairs, or doing moderate yard work triggers shortness of breath, angina, or fatigue. Or an echocardiogram, MUGA scan, or cardiac MRI shows your heart has enlarged (hypertrophy or dilatation). An ECG or chest X-ray alone no longer confirms enlargement for this rating. You take multiple cardiac medications and have to pace your physical activities carefully.

60% rating — $1,435.02/month

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

What this looks like: Your CAD significantly limits your physical capacity. Light activities — slow walking, getting dressed, basic cooking — are manageable, but anything more strenuous triggers symptoms. Symptoms such as breathlessness, fatigue, chest pain, dizziness, or palpitations appear at this light level of exertion, and your daily life is substantially restricted.

100% rating — $3,938.58/month

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

What this looks like: Your heart disease is severe. Even minimal physical activity — walking slowly around the house, bathing, standing for short periods — causes cardiac symptoms. You may need ongoing management with multiple medications and possibly devices. You are significantly limited in all physical activities and may require assistance with daily living.

What evidence do you need?

Service records

• Service treatment records showing cardiovascular complaints, chest pain, or cardiac risk factors during service
• Records of service in locations covered by Agent Orange presumptive (Vietnam, Thailand, etc.)
• Documentation of physical demands and stress during service
• Records of any cardiac events or hospitalizations during service
• If claiming secondary: complete records for the primary condition (hypertension, sleep apnea, etc.)

Medical evidence

• Current diagnosis of coronary artery disease from a cardiologist
• Cardiac catheterization results — The definitive test showing the location and severity of coronary artery blockages
• Echocardiogram — Shows heart chamber sizes (hypertrophy or dilatation, which can support 30%), wall motion abnormalities, and valve function
• Exercise stress test or pharmacological stress test — Documents METs capacity and ischemic changes
• ECG/EKG results — May show evidence of prior heart attack, ischemia, or arrhythmia (an ECG alone no longer confirms hypertrophy or dilatation for rating purposes)
• Treatment records showing medications (statins, beta blockers, ACE inhibitors, blood thinners)
• Records of any cardiac procedures (stenting, bypass surgery, pacemaker/defibrillator)
• Documentation of hospitalizations for heart failure or cardiac events

Nexus letter

A medical opinion connecting your CAD to service. For direct claims, the nexus should address how military stress, environmental exposures, or in-service risk factors caused or contributed to CAD. For secondary claims (hypertension leading to CAD, or sleep apnea causing cardiovascular strain), the letter should explain the established medical pathway and cite supporting literature. For Agent Orange presumptive claims, a nexus letter may not be required but can strengthen borderline cases.

Buddy statements

Statements from family members who have witnessed your physical limitations — inability to do activities you once could, shortness of breath with minimal exertion, episodes of chest pain, hospitalizations, and how cardiac disease has changed your daily life and ability to function.

Personal statement

Describe your cardiac symptoms, when they began, what triggers them, what activities you can no longer perform, and how CAD has changed your life. If you served in Vietnam or other Agent Orange-exposed locations, describe your service there in detail.

C&P exam tips for coronary artery disease

What the examiner evaluates

• Confirmation of CAD diagnosis
• Current cardiac function: the METs level at which heart failure symptoms begin
• Echocardiogram or equivalent imaging for cardiac hypertrophy or dilatation
• Current medications and treatments
• History of cardiac procedures (catheterization, stenting, bypass)
• Impact on daily functioning and occupational capacity
• If claiming secondary: the connection to the primary condition

How to prepare

1. Bring all cardiac testing results. Echocardiogram reports, stress test results, catheterization reports, and ECGs are the primary evidence the examiner reviews. Have copies of all recent cardiac testing.
2. Know your METs and imaging results. The METs level at which symptoms start drives most rating levels, and an echocardiogram (or MUGA scan or cardiac MRI) showing hypertrophy or dilatation supports 30%. Ejection fraction is no longer a separate rating criterion, but it can still help explain your symptoms.
3. Be honest about your functional capacity. The examiner may ask what activities you can perform. Be truthful but thorough — describe exactly what causes symptoms: “I can walk one block on flat ground before I need to stop for breath” is more useful than “I get tired easily.”
4. Describe typical days and flare-ups. Heart disease fluctuates. Explain your usual activity level and any worse episodes, such as chest pain or emergency room visits, and how often they happen. Use only events that are true for you.
5. List all cardiac medications. Bring a complete medication list. Multiple cardiac medications demonstrate the seriousness of your condition and the ongoing need for treatment.

Common mistakes

• Not having recent cardiac testing (the VA may order testing, but existing results speed the process)
• Underreporting symptoms because you have adapted to limitations over years
• Not reporting every heart failure symptom you have at a given activity level, including palpitations or arrhythmia, which the current formula counts
• Failing to claim secondary conditions that stem from CAD
• Not knowing your current METs level, which is the primary data point for rating
• Describing symptoms only on “good days” rather than explaining your usual activity level and any worse episodes

Common secondary conditions linked to coronary artery disease

CAD is often connected to other conditions that can increase your overall combined rating:

• Depression — Cardiac disease and depression have a well-established bidirectional relationship. The diagnosis of heart disease, physical limitations, and changes in quality of life cause depression in many veterans. Medical literature strongly supports this secondary connection.
• Sleep apnea — Sleep apnea places additional strain on the cardiovascular system through repeated oxygen desaturation. It can worsen CAD and is often found in veterans with cardiac conditions.
• Erectile dysfunction — Both CAD itself (reduced blood flow) and cardiac medications (beta blockers, diuretics) commonly cause erectile dysfunction. This is a well-supported secondary claim.
• Hypertension — While hypertension often causes CAD, the reverse relationship also exists. Heart failure from CAD can worsen blood pressure control.
• Peripheral artery disease — The same atherosclerotic process that affects coronary arteries also affects peripheral arteries, causing pain in the legs during walking and other symptoms.

Standalone rating amounts for coronary artery disease

For reference, here are the 2026 monthly payment amounts for CAD at each rating level (veteran with no dependents):

Dependent additions for an eligible spouse, child, or dependent parent apply only when your combined VA disability rating is 30% or higher. A combined rating of 10% or 20% does not receive dependent additions.

How to calculate your monthly payment

Your total VA disability payment depends on your combined rating across all service-connected conditions. CAD at 60% combined with depression, hypertension, and other conditions can produce a significantly higher combined rating.

Use our VA disability calculator to:

• Calculate your combined rating with multiple conditions
• Understand how VA math combines ratings
• 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: Clarified that dependent additions start at a 30% combined rating. Updated advice to describe your usual activity level and worse episodes.

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.