Coronary artery disease (CAD) is rated by the VA under 38 CFR 4.104, Diagnostic Code 7005, which covers arteriosclerotic heart disease. The rating is not based on a diagnosis alone. It is based on how your heart actually performs under a workload test measured in metabolic equivalents, or METs, along with ejection fraction and congestive heart failure history. Ratings run from 10 percent to 100 percent, and the difference between tiers can mean over $3,700 a month in 2026 compensation.
This guide covers the exact DC 7005 criteria, how the METs test works, what evidence the VA looks for, and how to file or appeal a claim. It does not cover hypertensive heart disease, which is rated under a separate code (DC 7007) and is covered in our guide to VA disability ratings for hypertensive heart disease.
What Diagnostic Code 7005 Covers
DC 7005 applies to arteriosclerotic heart disease, more commonly called coronary artery disease or ischemic heart disease. This is the buildup of plaque in the coronary arteries that restricts blood flow to the heart muscle. It is distinct from:
- DC 7006 (myocardial infarction), used for a discrete heart attack event and its immediate aftermath
- DC 7007 (hypertensive heart disease), used when high blood pressure is the primary driver of heart damage
- DC 7017 (coronary bypass surgery), which provides an automatic temporary 100 percent rating after CABG surgery before the condition is re-rated under the general heart formula
Many veterans move between these codes over time. A veteran might get an automatic 100 percent rating under DC 7017 immediately after bypass surgery, then get re-evaluated and rated under DC 7005 once recovery stabilizes.
VA Rating Criteria for Coronary Artery Disease (DC 7005)
All cardiovascular diagnostic codes in the 7000 series use the same general rating formula for diseases of the heart. Here is how it applies to CAD specifically.
| Rating | Criteria (any ONE qualifies) |
|---|
| 100% | Chronic congestive heart failure, or workload of 3 METs or less causes dyspnea, fatigue, angina, dizziness, or syncope, or left ventricular dysfunction with ejection fraction less than 30 percent |
| 60% | More than one episode of acute congestive heart failure in the past year, or workload of greater than 3 METs but not greater than 5 METs causes symptoms, or left ventricular dysfunction with ejection fraction of 30 to 50 percent |
| 30% | Workload of greater than 5 METs but not greater than 7 METs causes symptoms, or evidence of cardiac hypertrophy or dilatation on ECG, echocardiogram, or X-ray |
| 10% | Workload of greater than 7 METs but not greater than 10 METs causes symptoms, or continuous medication is required to control the condition |
A veteran only needs to meet ONE of the listed criteria at a given tier to be rated at that level. The VA rates you at the highest tier where any single criterion is met, not the lowest.
Source: 38 CFR 4.104, general rating formula for diseases of the heart, as applied to Diagnostic Code 7005.
How the METs Test Works
METs stands for metabolic equivalents of task. One MET is roughly the energy your body uses sitting quietly. The VA's compensation and pension (C&P) examiner either administers an exercise stress test or, when a stress test would be medically risky, estimates your METs capacity from your reported activity level and other testing.
Rough real-world reference points examiners use:
| METs level | Example activity |
|---|
| 1 to 2 METs | Eating, dressing, resting |
| 3 to 4 METs | Walking slowly on level ground, light housework |
| 5 to 7 METs | Climbing a flight of stairs, moderate yard work, brisk walking |
| 8 to 10 METs | Jogging, carrying groceries upstairs, heavy yard work |
If you experience chest pain, shortness of breath, or dizziness at a lower METs level, that indicates more severe disease and a higher rating. If a formal stress test is contraindicated because of your cardiac risk, the VA examiner is required to estimate your METs level using the medical record, echocardiogram results, and your reported functional limits. Do not assume a missed stress test means you cannot get a higher rating. If your file shows an examiner estimated your METs level without a documented rationale, that is a common and appealable error.
Ejection Fraction and Congestive Heart Failure
Ejection fraction (EF) measures the percentage of blood pumped out of the left ventricle with each heartbeat. A normal EF is generally 55 to 70 percent. Under DC 7005:
- EF under 30 percent supports a 100 percent rating on its own, regardless of METs results
- EF of 30 to 50 percent supports a 60 percent rating on its own
- Chronic congestive heart failure supports 100 percent
- More than one acute CHF episode in the past year supports 60 percent
Because any single qualifying criterion is enough, a veteran with a normal METs test result but a low ejection fraction reading should still be rated at 60 percent or 100 percent based on the EF number alone. This is one of the most common points missed in VA rating decisions, and it is worth checking your own C&P exam report for the EF value the examiner recorded.
Filing a Claim for Coronary Artery Disease
1. Establish service connection. You need a current CAD diagnosis, an in-service event, exposure, or aggravating condition, and a medical nexus linking the two. Common service-connection paths for CAD include:
- Presumptive connection for veterans exposed to herbicides (Agent Orange) during qualifying service in Vietnam, Thailand, Korea DMZ, and other listed locations, since ischemic heart disease is on the Agent Orange presumptive list
- Presumptive connection under the PACT Act for veterans with qualifying burn pit or airborne hazard exposure
- Secondary service connection, where CAD develops as a result of an already service-connected condition such as PTSD, diabetes, or hypertension
- Direct service connection with documented in-service symptoms or diagnosis
2. File your claim. Submit VA Form 21-526EZ through VA.gov, by mail, or with help from a Veterans Service Organization (VSO) accredited representative. Filing online through VA.gov is generally the fastest option and lets you upload medical evidence directly.
3. Attend the C&P exam. The examiner will review your medical records, may order or review a stress test and echocardiogram, and will document your METs level, ejection fraction, and any CHF history. Bring a written symptom log if you have one. Documenting exactly what activities trigger chest pain, shortness of breath, or dizziness, and at what point, helps the examiner assign an accurate METs estimate.
4. Wait for your rating decision. The VA will issue a decision letter with your assigned percentage and effective date. If you disagree with the rating, you have options to appeal.
Appealing a Low CAD Rating
If your rating decision does not match your medical evidence, you have three main paths under the modernized appeals system:
- Supplemental Claim — submit new and relevant evidence, such as a more recent echocardiogram or a private cardiologist's opinion
- Higher-Level Review — request a senior VA reviewer re-examine the same evidence for legal or factual error, without adding new evidence
- Board Appeal — appeal directly to the Board of Veterans' Appeals, with or without a hearing
A common reason to appeal a CAD rating: the C&P examiner's report does not mention ejection fraction at all, or estimates METs without citing a stress test or documented rationale. Requesting your claims file and reviewing the actual C&P exam report before deciding whether to appeal is worth the time.
2026 VA Disability Compensation Rates
Monthly payments below reflect the rates effective December 1, 2025, which include the annual cost-of-living adjustment tied to Social Security.
| Rating | Veteran with no dependents (monthly) |
|---|
| 10% | $180.42 |
| 30% | $552.47 |
| 60% | $1,435.02 |
| 100% | $3,938.58 |
Additional dependent compensation (spouse, children, dependent parents) generally applies starting at the 30 percent rating and higher. A 10 percent rating does not add dependent pay. Combined ratings for veterans with multiple service-connected conditions, including CAD plus other conditions like PTSD or diabetes, use VA's combined ratings table rather than simple addition, so a 60 percent heart rating plus a 30 percent secondary condition does not equal 90 percent overall.
Frequently Asked Questions
What is the highest VA rating for coronary artery disease?
100 percent. This applies if you have chronic congestive heart failure, a workload of 3 METs or less produces symptoms, or your ejection fraction is below 30 percent. Only one of these needs to be present.
Does a stent or bypass surgery automatically get you 100 percent?
Coronary bypass surgery (CABG) is rated under DC 7017 and does provide an automatic 100 percent rating for three months following hospital admission for the surgery. After that period, the VA re-evaluates the condition under the general heart disease formula, which is the same one used for DC 7005, and assigns whatever percentage the current METs, ejection fraction, and CHF history support. A stent placement alone does not carry the same automatic temporary 100 percent provision as bypass surgery.
Can I get VA disability for coronary artery disease from Agent Orange exposure?
Yes. Ischemic heart disease, which includes coronary artery disease, is on the VA's list of conditions presumptively connected to Agent Orange exposure for veterans who served in qualifying locations during the Vietnam era. You generally do not need to prove a direct medical link if you meet the presumptive exposure criteria.
What if my stress test result does not match how I feel day to day?
Tell your C&P examiner and your treating cardiologist directly. If a formal stress test is not safe for you, the examiner must estimate your METs level based on your medical history and functional reports rather than skip the analysis. If the exam report does not explain how the METs estimate was reached, that is a reasonable basis for a Higher-Level Review or Supplemental Claim.
How does ejection fraction affect my rating if my METs test looks fine?
Ejection fraction and METs are independent, alternative criteria. Even with a normal or borderline METs result, an ejection fraction under 50 percent can qualify you for a 60 percent or 100 percent rating on its own. Check both figures in your C&P exam report.
Is coronary artery disease the same as hypertensive heart disease for VA rating purposes?
No. Coronary artery disease is rated under DC 7005, while hypertensive heart disease, where high blood pressure is the primary cause of heart damage, is rated under DC 7007. Both use similar METs-based criteria, but they are separate diagnostic codes with separate service-connection requirements. See our guide on VA disability ratings for hypertensive heart disease for that code specifically.
