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VA Schedule for Rating Disabilities – Cardiovascular … - va disability cardiovascular system


VA Schedule for Rating Disabilities – Cardiovascular …-va disability cardiovascular system

VA Schedule for Rating Disabilities - Cardiovascular System
Side-by-Side Comparison
Handout Two
Historical Rating Schedule Updated (New) Rating Schedule
Effective July 12, 1998 - November 13, 2021 Effective November 14, 2021
? 4.100 Application of the evaluation criteria for diagnostic codes 7000-7007, ? 4.100 Application of the evaluation criteria for diagnostic codes 7000-7007, 7011,
7011, and 7015-7020. and 7015-7020.
(a) Whether or not cardiac hypertrophy or dilatation (documented by (a) Whether or not cardiac hypertrophy or dilatation (documented by electrocardiogram,
electrocardiogram, echocardiogram, or X-ray) is present and whether or not there is echocardiogram, or X-ray) is present and whether or not there is a need for continuous
a need for continuous medication must be ascertained in all cases. medication must be ascertained in all cases.
(b) Even if the requirement for a 10% (based on the need for continuous medication) (b) Even if the requirement for a 10% (based on the need for continuous medication) or
or 30% (based on the presence of cardiac hypertrophy or dilatation) evaluation is 30% (based on the presence of cardiac hypertrophy or dilatation) evaluation is met, METs
met, METs testing is required in all cases except: testing is required in all cases except:
(1) When there is a medical contraindication. (1) When there is a medical contraindication.
(2) When the left ventricular ejection fraction has been measured and is 50% or less. (2) When a 100% evaluation can be assigned on another basis.
(3) When chronic congestive heart failure is present or there has been more than
one episode of congestive heart failure within the past year.
(4) When a 100% evaluation can be assigned on another basis.
(c) If left ventricular ejection fraction (LVEF) testing is not of record, evaluate based
on the alternative criteria unless the examiner states that the LVEF test is needed in
a particular case because the available medical information does not sufficiently
reflect the severity of the veteran's cardiovascular disability.
?? 4.101-4.103 [Reserved] ?? 4.101-4.103 [Reserved]
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? 4.104 Schedule of ratings - cardiovascular system
Diseases of the Heart
Unless otherwise directed, use this general rating formula to evaluate diseases of the
heart.
Note (1): Evaluate cor pulmonale, which is a form of secondary heart disease, as Note (1): Evaluate cor pulmonale, which is a form of secondary heart disease, as part of
part of the pulmonary condition that causes it. the pulmonary condition that causes it.
Note (2): One MET (metabolic equivalent) is the energy cost of standing quietly at Note (2): One MET (metabolic equivalent) is the energy cost of standing quietly at rest and
rest and represents an oxygen uptake of 3.5 milliliters per kilogram of body weight represents an oxygen uptake of 3.5 milliliters per kilogram of body weight per minute.
per minute. When the level of METs at which dyspnea, fatigue, angina, dizziness, or When the level of METs at which breathlessness, fatigue, angina, dizziness, or syncope
syncope develops is required for evaluation, and a laboratory determination of METs develops is required for evaluation, and a laboratory determination of METs by exercise
by exercise testing cannot be done for medical reasons, an estimation by a medical testing cannot be done for medical reasons, a medical examiner may estimate the level of
examiner of the level of activity (expressed in METs and supported by specific activity (expressed in METs and supported by specific examples, such as slow stair
examples, such as slow stair climbing or shoveling snow) that results in dyspnea, climbing or shoveling snow) that results in those symptoms.
fatigue, angina, dizziness, or syncope may be used.
Note (3): For this general formula, heart failure symptoms include, but are not limited to,
breathlessness, fatigue, angina, dizziness, arrhythmia, palpitations, or syncope.
General Rating Formula for Diseases of the Heart:
Workload of 3.0 METs or less results in heart failure symptoms 100
Workload of 3.1-5.0 METs results in heart failure symptoms 60
Workload of 5.1-7.0 METs results in heart failure symptoms; or evidence of 30
cardiac hypertrophy or dilatation confirmed by echocardiogram or equivalent
(e.g., multigated acquisition scan or magnetic resonance imaging)
Workload of 7.1-10.0 METs results in heart failure symptoms; or continuous 10
medication required for control
7000 Valvular heart disease (including rheumatic heart disease): 7000 Valvular heart disease (including rheumatic heart disease):
During active infection with valvular heart damage and for three months 100 During active infection with cardiac involvement and for three months following 100
following cessation of therapy for the active infection cessation of therapy for the active infection
Thereafter, with valvular heart disease (documented by findings on Thereafter, with diagnosis confirmed by findings on physical examination and either
physical examination and either echocardiogram, Doppler echocardiogram, Doppler echocardiogram, or cardiac catheterization, use the General
echocardiogram, or cardiac catheterization) resulting in: Rating Formula.
Chronic congestive heart failure, or; workload of 3 METs or less results in 100
dyspnea, fatigue, angina, dizziness, or syncope, or; left ventricular
dysfunction with an ejection fraction of less than 30 percent
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More than one episode of acute congestive heart failure in the past year, 60
or; workload of greater than 3 METs but not greater than 5 METs results in
dyspnea, fatigue, angina, dizziness, or syncope, or; left ventricular
dysfunction with an ejection fraction of 30 to 50 percent
Workload of greater than 5 METs but not greater than 7 METs results in 30
dyspnea, fatigue, angina, dizziness, or syncope, or; evidence of cardiac
hypertrophy or dilatation on electro-cardiogram, echocardiogram, or X-ray
Workload of greater than 7 METs but not greater than 10 METs results in 10
dyspnea, fatigue, angina, dizziness, or syncope, or; continuous medication
required
7001 Endocarditis: 7001 Endocarditis:
For three months following cessation of therapy for active infection with 100 During active infection with cardiac involvement and for three months following 100
cardiac involvement cessation of therapy for the active infection
Thereafter, with endocarditis (documented by findings on physical Thereafter, with diagnosis confirmed by findings on physical examination and either
examination and either echocardiogram, Doppler echocardiogram, or echocardiogram, Doppler echocardiogram, or cardiac catheterization, use the General
cardiac catheterization) resulting in: Rating Formula.
Chronic congestive heart failure, or; workload of 3 METs or less results in 100
dyspnea, fatigue, angina, dizziness, or syncope, or; left ventricular
dysfunction with an ejection fraction of less than 30 percent
More than one episode of acute congestive heart failure in the past year, 60
or; workload of greater than 3 METs but not greater than 5 METs results in
dyspnea, fatigue, angina, dizziness, or syncope, or; left ventricular
dysfunction with an ejection fraction of 30 to 50 percent
Workload of greater than 5 METs but not greater than 7 METs results in 30
dyspnea, fatigue, angina, dizziness, or syncope, or; evidence of cardiac
hypertrophy or dilatation on electrocardiogram, echocardiogram, or X-ray
Workload of greater than 7 METs but not greater than 10 METs results in 10
dyspnea, fatigue, angina, dizziness, or syncope, or; continuous medication
required
7002 Pericarditis: 7002 Pericarditis:
For three months following cessation of therapy for active infection with 100 During active infection with cardiac involvement and for three months following 100
cardiac involvement cessation of therapy for the active infection
Thereafter, with documented pericarditis resulting in: Thereafter, with diagnosis confirmed by findings on physical examination and either
echocardiogram, Doppler echocardiogram, or cardiac catheterization, use the General
Rating Formula.
Chronic congestive heart failure, or; workload of 3 METs or less results in 100
dyspnea, fatigue, angina, dizziness, or syncope, or; left ventricular
dysfunction with an ejection fraction of less than 30 percent.
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