VA Disability for Cardiovascular Issues
While cardiovascular disease continues to be a leading cause of death among Americans, research shows that Veterans are especially susceptible. In fact, almost 50% of Veterans receiving care have reported at least one cardiovascular event according to the VA, and the department’s Health Systems Research (HSR) division is actively focused on both treatment and prevention programs in response.
As with most illnesses, there are a number of factors that can cause, contribute to, and even exacerbate heart disease, many of which are often directly related to military service. Understanding how to connect these dots is the key to securing the disability benefits you deserve, and the team at Capovilla & Williams can help.
Our military-defense firm works with Veterans at all stages of the claim process, and we can help you navigate the many challenges that can arise along the way. We can review your claim, identify potential gaps in evidence, and help develop a strategy that is tailored to your circumstances. Whether you’re filing an initial claim, seeking an increased rating, or appealing an unfavorable decision, we work to present your best case and protect your rights at every turn.
And there’s no out-of-pocket expense to you.
You served your country, and you deserve a fair evaluation of your benefits. If you have questions, concerns, or simply want guidance on your next steps, call us. Call us today at 866-951-0466 or chat with us online.
What Kind of Cardiovascular Issues Does the VA Recognize?
The term “heart disease” covers a long and complex list of conditions and ailments, from the more commonly-recognized heart attacks and congestive heart failure to a broad spectrum of heart and vascular issues, including:
- Ischemic heart disease
- Coronary artery disease (CAD)
- Arrhythmias
- Valvular heart disease
- Myocardial infarction
- Bradycardia
- Implantable cardiac pacemakers
- Coronary bypass surgery
This section of the Code also extends to diseases of the arteries and veins, such as thrombo-angiitis obliterans (Buerger’s Disease), aneurysms, and hypertensive vascular disease.
It’s also worth noting that multiple conditions can have separate ratings, even if they are both cardiac-related (we’ll cover this more below), so it’s essential to give the VA a full picture of your health challenges. Secondary claims and multiple ailments can change both your rating and your benefits.
How Are Cardiovascular Issues Rated?
The VA uses a general rating system of Metabolic Equivalents (METs) that measures oxygen uptake during physical activity to both gauge the severity of the condition and determine benefits.
One MET represents an oxygen uptake of 3.5 milliliters per kilogram of body weight per minute, and is the equivalent of standing quietly at rest. These “equivalents” represent the amount of physical energy needed to perform a specific task without experiencing any heart-disease symptoms, such as:
- Syncope (fainting or briefly losing consciousness)
- Breathlessness
- Fatigue
- Angina
- Dizziness
- Arrhythmia
- Palpitations
The conditions are then rated as follows:
| Number of METs Producing Symptoms | Rating |
|---|---|
| <= 3.0 | 100 |
| 3.1 to 5.0 | 60 |
| 5.1-7.0 (or evidence of cardiac hypertrophy or dilation) | 30 |
| 7.1 – 10.0 (or continuous medication required to manage symptoms) | 10 |
In addition, many conditions provide for an initial 100% disability rating to allow for surgery and other necessary treatments, with a mandatory follow-up to reassess after the patient has had time to recover.
For example, if you require coronary bypass surgery, you will be rated at 100% at the time of hospital admission and for three months following the surgery, before being re-evaluated. A cardiac transplantation surgery carries a disability rating of 100% at the time of admission and for at least one year after the procedure. You’ll also qualify for a minimum rating of 30% once you have recovered and the general rating system becomes applicable again.
You can find a full list of cardiovascular conditions and their respective ratings in the Code of Federal Regulations, 38 CFR Part 4, Section 4.104.
Does it Matter When I Receive My Diagnosis for Cardiovascular Disease?
The short answer is yes—you can receive disability benefits well after you’ve been discharged. Your benefits aren’t solely tied to a diagnosis date—in fact, the VA recognizes that many illnesses and conditions may not show up until years later. The key is to show how the illness is connected to your service, and as with any other kind of condition, there are a few different ways to make this connection for the VA:
Direct Connection – The cardiovascular event happened while you were on active duty.
Presumptive Connection – The cardiovascular event is known to be tied to a service-related exposure or event and is therefore presumed to be service-related without any additional proof. An example of this would be Veterans who were exposed to Agent Orange while in service.
A comprehensive list of presumptive conditions is outlined in 38 CFR 3.309(a).
Secondary Connection – The condition is a result of a previous service-related condition. Both sleep apnea and hypertension are known to cause coronary heart disease, for example.
Aggravated Connection – The condition existed prior to service but was exacerbated by in-service conditions, events, or exposure.
With the exception of presumptive conditions, you’ll need to provide proof of the service connection in each of these instances. This typically requires three key pieces of evidence:
- Documentation of the in-service event alleged to have caused (or aggravated) your condition;
- A current diagnosis from a licensed healthcare professional; and
- A medical nexus opinion from a qualified specialist that confirms the condition meets the VA’s 50/50 medical standard of proof.
In addition to these items, the VA typically requires a variety of other documents, including your medical records, your service records, and statements from other Veterans in your unit, as well as your C&P exam.
Having an experienced legal team to help you assemble these documents and present your case to the VA can be essential to finally getting the benefits you deserve. We understand the challenges you’re facing and have the experience to help you navigate your disability claim. Call us today at 866-951-0466 or chat with us online.
Understanding the VA’s Medical Standard of Proof for Cardiovascular Disease
The VA utilizes a minimum 50/50 standard of proof to determine a service connection and trigger your benefits. You’ll typically see this standard expressed as at least as likely as not’ in your medical nexus letter.
This means a service event is at least as likely (if not more likely) to have caused or aggravated your condition. This letter is crucial to establishing your cause of action and should be completed by a medical professional with some level of specialized knowledge (such as a cardiologist) for the best results. A nexus opinion from a VA examiner is also acceptable.
What Makes a Great Nexus Letter for Veterans With Heart Disease?
The nexus letter is a key component of your disability claim. It connects your disability to a specific in-service event, injury, or illness, and it does so with clear medical language and solid rationale. This rationale includes the 50/50 standard of proof mentioned above, but then also ties everything together in a practical and logical way.
It should be written by a qualified professional who has reviewed your full medical and service history, and it should include a statement of that review as further proof that your healthcare provider is fully informed to make the claim.
Other components of a strong medical nexus letter include:
- Medical References: Citing medical journals, trusted research, and other forms of “expert proof” helps to support your physician’s conclusions.
- A Statement of Credentials: The letter should be written by a licensed physician or specialist and should also detail the credentials they’re relying on to make such an opinion.
- Confirm the Standard of Proof: Using the statement “at least as likely as not” to connect the service event to your heart disease is the minimum level of proof required. Other acceptable variations would include “more likely than not” and a direct “this was caused by” to illustrate the certainty of the physician.
- Clear, Plain Language Statement: While some medical lingo will likely be necessary, writing as much of the statement as possible in clear, layman’s terms will help in the processing of your claim. Your doctor should tie your condition to the service event in a way that is clear and easy to understand by non-medical professionals.
What If I’m Suffering From Multiple Conditions?
It’s actually not uncommon to find that Veterans suffer from more than one serious ailment, and this is not just limited to secondary cardiac conditions as mentioned above. Conditions such as depression and anxiety can result from prolonged cardiac disease, for example, and PTSD can exacerbate a variety of ailments.
In any event, don’t discount your well-being by “lumping” your illnesses together. Each related illness could raise your level of disability and increase your benefits.
That said, rather than simply adding ratings for each illness together, the VA will use the Combined Ratings Table to calculate an overall rating that accounts for all of your conditions.
Can I Get Special Monthly Compensation for Heart Disease?
Some conditions are so severe that the VA provides an additional “special monthly compensation” (SMC) amount to help supplement your regular disability payments.
This supplemental compensation does not require that you apply for it separately, but it is a complex animal all its own and is often overlooked or miscalculated by the VA. Different levels apply to different conditions and can range from documented illnesses with a high rating (including some heart conditions) to amputations, blindness, and loss of use. In addition, the calculations will also factor in other illnesses that may not be eligible for SMC on their own, but together meet a certain threshold and raise your overall eligibility.
Having an attorney experienced with Veteran disability claims can help ensure that all of your conditions are fully documented and correctly calculated.
How Can Capovilla & Williams Help With My Disability Claim?
Filing for disability benefits can be a frustrating and stressful experience. But you don’t have to do this alone.
The attorneys at Capovilla & Williams work exclusively with Veterans, and we’ve been doing it for many years. We understand the unique challenges that can arise throughout the claims process—from gathering medical evidence and documenting service connections to responding to VA requests and navigating appeals. Our firm brings focused experience and insight to the table, and we can guide you through every stage of your claim while working to ensure your rights as a United States Veteran are protected.
If the idea of filing for your benefits feels overwhelming, call us. If you don’t feel that you’re getting a fair evaluation or your benefits have been unnecessarily reduced or delayed, call us. If you’re simply not sure where to start or how to respond to a denial, we’re here to help.
You’ve earned your benefits. Let us fight for your right to claim them. Call us today at 866-951-0466 or use our online chat to talk about your case.
