Heart valve disease is rated by the VA under 38 CFR 4.104, Diagnostic Code 7000 (valvular heart disease, including rheumatic heart disease). If you have had a valve replaced with a prosthesis, the condition moves to Diagnostic Code 7016, which carries an automatic 100 percent rating starting the day you were admitted to the hospital for the surgery. In both cases, the long-term percentage is set by the General Rating Formula for Diseases of the Heart, which runs 10, 30, 60, and 100 percent based on the workload in metabolic equivalents (METs) that triggers heart failure symptoms. In 2026, those tiers pay $180.42, $552.47, $1,435.02, and $3,938.58 per month for a veteran with no dependents.
This guide covers DC 7000 through 7004 and DC 7016 specifically. Adjacent heart conditions are rated under separate codes and are covered in their own guides: coronary artery disease under DC 7005, hypertensive heart disease under DC 7007, arrhythmias under DC 7009, 7010, and 7011, and hypertension under DC 7101.
What Counts as Heart Valve Disease Under DC 7000
Valve disease means one of your four heart valves either fails to open fully (stenosis) or fails to close fully (regurgitation, also called insufficiency). DC 7000 is written broadly. It covers valvular heart disease of any type, and the regulation specifically names rheumatic heart disease as included. Conditions commonly rated under it:
- Mitral stenosis and mitral regurgitation
- Aortic stenosis and aortic regurgitation
- Tricuspid and pulmonary valve disease
- Mitral valve prolapse with documented regurgitation
- Bicuspid aortic valve with valve dysfunction
- Rheumatic heart disease, meaning valve scarring left behind by rheumatic fever
- Valve damage from a past episode of infective endocarditis
The regulation requires the diagnosis be confirmed by findings on physical examination plus one of three objective tests: an echocardiogram, a Doppler echocardiogram, or cardiac catheterization. A murmur heard on a stethoscope is not enough on its own. If your file does not contain an echo report, that is usually the first gap to close before filing.
The Diagnostic Code Family: DC 7000 Through 7004
DC 7000, 7001, and 7002 are grouped together in the regulation and share the same structure. DC 7003 and 7004 sit in the same neighborhood and are evaluated straight off the general formula.
| Code | Condition | How it is rated |
|---|
| 7000 | Valvular heart disease, including rheumatic heart disease | 100% during active infection with cardiac involvement and for three months after therapy ends. Thereafter, General Rating Formula, with the diagnosis confirmed by physical exam plus echocardiogram, Doppler echocardiogram, or cardiac catheterization |
| 7001 | Endocarditis | Same structure as 7000 |
| 7002 | Pericarditis | Same structure as 7000 |
| 7003 | Pericardial adhesions | General Rating Formula |
| 7004 | Syphilitic heart disease | General Rating Formula. Syphilitic aortic aneurysms are evaluated instead under DC 7110 |
| 7016 | Heart valve replacement (prosthesis) | 100% for an indefinite period from the date of hospital admission for the valve replacement, then General Rating Formula after a mandatory VA exam six months post-discharge |
Source: 38 CFR 4.104, schedule of ratings for the cardiovascular system.
The three-month 100 percent provision under DC 7000 applies to an active infection with cardiac involvement, which is most relevant to veterans who had infective endocarditis attacking a valve. It is not a general grace period for chronic valve disease. A veteran with long-standing mitral regurgitation and no active infection is rated under the general formula from the start.
The General Rating Formula for Diseases of the Heart
Every long-term rating in this family runs through the same four-tier formula. The criteria are the same ones applied to coronary artery disease and hypertensive heart disease, which is why the METs numbers in this guide match those articles exactly.
| Rating | Criteria |
|---|
| 100% | Workload of 3.0 METs or less results in heart failure symptoms |
| 60% | Workload of 3.1 to 5.0 METs results in heart failure symptoms |
| 30% | Workload of 5.1 to 7.0 METs results in heart failure symptoms, or evidence of cardiac hypertrophy or dilatation confirmed by echocardiogram or equivalent imaging such as a MUGA scan or cardiac MRI |
| 10% | Workload of 7.1 to 10.0 METs results in heart failure symptoms, or continuous medication is required for control |
The regulation defines heart failure symptoms as including, but not limited to, breathlessness, fatigue, angina, dizziness, arrhythmia, palpitations, and syncope. Only one criterion at a tier has to be met. A veteran on lifelong anticoagulation or a rate-control drug for valve disease meets the 10 percent criterion on medication alone, regardless of the METs result. A veteran whose echocardiogram shows left ventricular hypertrophy or chamber dilatation meets the 30 percent criterion on imaging alone.
How METs Testing Works
One MET is the energy your body uses standing quietly at rest, roughly 3.5 milliliters of oxygen per kilogram of body weight per minute. A stress test measures the workload level at which your symptoms appear.
| METs level | Rough activity equivalent |
|---|
| 1 to 3 METs | Eating, dressing, walking slowly on level ground |
| 3 to 5 METs | Light housework, walking at a moderate pace, golfing with a cart |
| 5 to 7 METs | Climbing a flight of stairs, brisk walking, moderate yard work |
| 7 to 10 METs | Jogging, carrying groceries upstairs, shoveling snow |
Under 38 CFR 4.100, METs testing is required in every case with two exceptions: when it is medically contraindicated, and when a 100 percent evaluation can be assigned on another basis. Severe aortic stenosis is a well-known contraindication to exercise stress testing, so many veterans with valve disease legitimately cannot complete one. When that happens, the regulation authorizes the examiner to estimate the METs level, and it requires the estimate be supported by specific examples such as slow stair climbing or shoveling snow. A C&P report that lists a METs estimate with no examples and no explanation is a documented shortfall in the exam, and that is one of the most common grounds for a successful Higher-Level Review on a heart claim.
38 CFR 4.100 also requires the examiner to determine, in every case, whether cardiac hypertrophy or dilatation is present and whether continuous medication is needed. If your exam report is silent on either point, the examiner skipped a mandatory step.
Valve Replacement: DC 7016 and the Six-Month Exam
DC 7016 applies once a diseased valve is replaced with a prosthesis, whether mechanical or bioprosthetic (tissue). The rating rules are unusually generous at the front end:
- 100 percent begins on the date of hospital admission for the valve replacement, not the date of discharge, and runs for an indefinite period.
- Six months after discharge from inpatient hospitalization, the VA is required to schedule a mandatory examination and re-evaluate you under the General Rating Formula.
- Any reduction from 100 percent is subject to 38 CFR 3.105(e), which means the VA must issue a proposed reduction, give you 60 days to respond and the chance to request a hearing, and then wait before the lower rate takes effect.
Two practical points. A valve repair, such as an annuloplasty or valvuloplasty, is not a replacement. No prosthesis, no DC 7016, so repairs stay under DC 7000 throughout. And transcatheter aortic valve replacement (TAVR) does implant a prosthetic valve, so it falls within the plain language of DC 7016, but because TAVR often involves a much shorter hospital stay than open surgery, the effective date and the six-month clock hinge on the admission and discharge dates in your hospital record.
You cannot hold separate ratings under both DC 7000 and DC 7016 for the same valve. That would be pyramiding under 38 CFR 4.14. The replaced valve is rated under 7016.
The 2021 Rule Change That Still Affects Older Claims
VA rewrote the cardiovascular rating schedule effective November 14, 2021. The revision removed left ventricular ejection fraction and chronic congestive heart failure from the General Rating Formula, leaving the METs thresholds, cardiac hypertrophy or dilatation, and continuous medication as the operative criteria shown in the table above.
This matters if your claim has been pending a long time or you are appealing an older decision. When a rating regulation changes while a claim is open, the VA is required to consider both the old and the new criteria and apply whichever is more favorable, with the old criteria available for the period before the change and the new criteria from the effective date forward. Under the pre-November 2021 formula, an ejection fraction below 30 percent supported 100 percent on its own, and an ejection fraction of 30 to 50 percent supported 60 percent on its own. If your echocardiogram shows a reduced ejection fraction and your claim predates the change, raise that argument explicitly. Do not assume the rater will do it for you.
Getting Service Connection for Valve Disease
The one-year presumptive most veterans miss
Under 38 CFR 3.309(a), "endocarditis" is on the list of chronic diseases eligible for presumptive service connection, and the regulation adds a parenthetical: "This term covers all forms of valvular heart disease." That means if your valvular heart disease became manifest to a degree of 10 percent or more within one year of separation from qualifying service, it is presumed service connected under 38 CFR 3.307, with no nexus opinion required. Rheumatic heart disease that surfaced within the first year after discharge fits this path cleanly.
Direct service connection
You need a current diagnosis confirmed by echocardiogram or catheterization, an in-service event or illness, and a medical nexus. Common in-service origins include a documented episode of rheumatic fever, strep infection, or endocarditis during service, or a murmur or valve abnormality noted in your service treatment records or separation physical.
Secondary service connection
Valve disease can develop or worsen as a consequence of an already service-connected condition. The nexus letter needs to state it is at least as likely as not (a 50 percent or greater probability) that the service-connected condition caused or aggravated the valve disease. Aggravation counts. If you entered service with a bicuspid aortic valve noted on your entrance exam and service worsened it beyond natural progression, that is an aggravation claim, not a bar to service connection.
One regulatory note worth knowing: DC 7005 instructs that when non-service-connected coronary artery disease is superimposed on service-connected valvular heart disease, the VA must request a medical opinion on which condition is producing your current symptoms. If you have both, make sure your cardiologist addresses it.
Evidence That Moves a Valve Disease Claim
- Echocardiogram or Doppler echocardiogram report, including valve area, gradient, regurgitation severity, ejection fraction, and any hypertrophy or dilatation findings
- Cardiac catheterization report, if you have had one
- Exercise stress test with recorded METs, or a written statement from your cardiologist explaining why testing is contraindicated
- Operative report plus hospital admission and discharge dates for any valve replacement or repair
- Medication list showing continuous anticoagulants, diuretics, beta blockers, or rate-control drugs
- Service treatment records documenting rheumatic fever, endocarditis, strep infection, or a murmur
- A nexus letter from a cardiologist for direct or secondary claims
- A symptom log naming the activities that bring on breathlessness, fatigue, dizziness, or palpitations, which gives the examiner concrete examples to anchor a METs estimate
How to File
- Collect your cardiac records first. An echocardiogram report is the single most important document in a DC 7000 claim, because the regulation names it as a required confirmatory test.
- File VA Form 21-526EZ through VA.gov, by mail, or with an accredited Veterans Service Organization representative. Filing an intent to file first locks in your effective date while you gather evidence.
- Attend the C&P exam. The examiner completes the Heart Conditions Disability Benefits Questionnaire, which asks specifically about valve findings, METs, hypertrophy or dilatation, and continuous medication.
- Read the exam report. Request a copy of your claims file and check that the examiner recorded a METs level, addressed hypertrophy and dilatation, and noted your medications, all three of which 38 CFR 4.100 requires.
- Appeal if the decision does not fit the evidence. A Supplemental Claim adds new and relevant evidence, a Higher-Level Review asks a senior reviewer to correct an error on the existing record, and a Board Appeal goes to the Board of Veterans' Appeals.
2026 VA Disability Compensation Rates
Rates below reflect the 2.8 percent cost-of-living adjustment effective December 1, 2025, first paid on December 31, 2025.
| Rating | Veteran alone | Veteran with spouse | Veteran with spouse and 1 child |
|---|
| 10% | $180.42 | $180.42 | $180.42 |
| 30% | $552.47 | $617.47 | $665.47 |
| 60% | $1,435.02 | $1,569.02 | $1,656.02 |
| 100% | $3,938.58 | $4,163.16 | $4,254.16 |
Additional dependent compensation starts at the 30 percent tier, so a 10 percent rating pays the same regardless of dependents. Veterans with more children or dependent parents receive more than shown. VA disability compensation is not taxable at the federal or state level.
If your valve disease combines with other service-connected conditions and you cannot hold substantially gainful employment, Total Disability based on Individual Unemployability (TDIU) pays at the 100 percent rate even when your schedular combined rating is lower. The usual thresholds are one condition rated at least 60 percent, or a combined rating of 70 percent with at least one condition at 40 percent.
Frequently Asked Questions
What is the highest VA rating for heart valve disease?
100 percent. Under the current General Rating Formula, that requires a workload of 3.0 METs or less to produce heart failure symptoms. Separately, a heart valve replacement under DC 7016 carries an automatic 100 percent rating from the date of hospital admission until a mandatory re-examination six months after discharge.
Does a valve replacement give you a permanent 100 percent rating?
No. DC 7016 assigns 100 percent for an indefinite period starting at hospital admission, but the regulation requires a mandatory VA examination six months after discharge, and the rating is then set by the General Rating Formula. Some veterans stay at 100 percent because their post-surgical function supports it. Many are reduced. Any reduction has to follow the due process rules in 38 CFR 3.105(e), including a proposed reduction notice and a 60-day response window.
Is rheumatic heart disease service connected automatically?
Not automatically, but valvular heart disease has a favorable presumptive path. 38 CFR 3.309(a) lists endocarditis as a chronic disease and states the term covers all forms of valvular heart disease, so if the condition became manifest to at least 10 percent within one year of separation, service connection is presumed without a nexus opinion.
Can I get a rating if I cannot complete a stress test?
Yes. Severe valve disease, especially aortic stenosis, is often a medical contraindication to exercise testing. 38 CFR 4.100 exempts those cases from the testing requirement and directs the examiner to estimate your METs level, supported by specific activity examples. Give the examiner concrete examples from your own life, such as how many stairs you can climb before you have to stop.
Can I be rated separately for valve disease and coronary artery disease?
Generally no, when the same cardiac impairment is being measured. Rating the same disability twice is pyramiding under 38 CFR 4.14, and both conditions run through the same METs-based formula. The regulation at DC 7005 also directs the VA to obtain a medical opinion on which condition is causing your symptoms when non-service-connected coronary artery disease is superimposed on service-connected valve disease.
Does being on blood thinners after valve surgery get me a rating?
Continuous medication required for control satisfies the 10 percent criterion in the General Rating Formula. Lifelong warfarin after a mechanical valve replacement is a clear example. That sets a floor, not a ceiling. Your actual percentage is whichever tier your METs level, hypertrophy or dilatation findings, and medication needs support, whichever is highest.
How often will the VA re-examine my heart valve rating?
Ratings that are not designated static are typically re-examined every two to five years. Valve replacement carries a specific mandatory exam six months after hospital discharge. If your condition has been stable for years and further improvement is not expected, you can ask the VA to designate the rating static so routine future exams stop.
