The exam form
The examiner fills out VA's "Heart Conditions (Including Ischemic and Non-Ischemic Heart Disease, Arrhythmias, Valvular Disease and Cardiac Surgery)" form (a Disability Benefits Questionnaire, or DBQ). See the form on VA.gov
Form version checked: Updated on 2024-07-11 (v24_1).
What the exam is for
The exam records your heart diagnosis and tests. It also records how much activity brings on your symptoms. Ischemic heart disease, such as coronary artery disease or a heart attack, is on VA's Agent Orange presumptive list (conditions VA presumes are linked to exposure).
What the examiner will ask and measure
- Your heart diagnoses. Examples are coronary artery disease, a past heart attack (myocardial infarction) and heart failure. Heart disease caused by high blood pressure is called hypertensive heart disease.
- How your heart condition started and changed, and what caused it, if known.
- Whether any of your conditions fits the medical definition of ischemic heart disease.
- Medicine: whether you need it all the time for your heart, and which condition each medicine treats.
- Dates and hospitals for each heart attack, procedure and heart hospital stay. Procedures include angioplasty, bypass surgery, and a pacemaker or defibrillator.
- A physical exam: heart rate, blood pressure, rhythm, heart sounds, lungs, pulses in your feet, and swelling in your lower legs.
- Heart size: every heart exam must check if your heart is thick or enlarged (hypertrophy or dilatation). The form suggests an EKG first, then a chest X-ray. A heart ultrasound is needed only if those two don't show it.
- Recent test results that show how you are now, such as an EKG, a heart ultrasound, a MUGA scan or an angiogram (a test of your heart's arteries).
- METs testing: nearly every heart exam needs it. The one exception is a type of fast heart rhythm (supraventricular arrhythmia). It can be an exercise stress test, from your records or done at the exam. If an exercise test can't be done for medical reasons, the examiner asks you about your activities instead.
- For that interview, the lowest activity that brings on symptoms: shortness of breath, tiredness, chest pain (angina), dizziness or fainting. The form's examples: 1 to 3 METs is eating, dressing, showering or walking slowly for 1 to 2 blocks. More than 3 to 5 is light yard work, mowing with a power mower or brisk walking. More than 5 to 7 is walking up 1 flight of stairs, golfing without a cart, mowing with a push mower or digging. More than 7 to 10 is climbing stairs quickly, moderate bike riding, sawing wood or jogging.
- Your heart alone: if other health problems also limit you, the examiner estimates the METs level from your heart condition alone.
- How your heart condition affects work tasks like standing, walking, lifting and sitting.
Be ready to describe
- The lowest level of activity that brings on symptoms, and which symptoms. For example: climbing one flight of stairs, walking a few blocks, mowing the lawn or doing yard work.
- How far you can walk, and how many stairs you can climb, before you have to stop.
- What you've stopped doing, or now do more slowly, because of your heart.
- Every heart medicine, how often you take it, and which condition it treats.
- Dates and hospitals for heart attacks, procedures and other heart hospital stays.
- Where and when you had stress tests, heart ultrasounds and other heart tests.
Common mistakes
- Saying you're fine because you avoid what brings on symptoms. Tell the examiner what happens when you try, and what you've stopped doing.
- Being vague about activity. "I get tired" says less than how far you can walk, or how many stairs you can climb, before you stop.
- Leaving a medicine off your list. VA's heart rules count medicine you need all the time.
- Not making sure VA has your recent heart test results, such as a stress test or heart ultrasound.
How VA rates it
VA rates coronary artery disease, heart disease caused by high blood pressure, and a heart attack (after the first three months) on one scale: the General Rating Formula for Diseases of the Heart. It looks mostly at the lowest workload, in METs, that brings on heart failure symptoms. It also counts a thick or enlarged heart shown on a scan, and needing medicine all the time. VA changed its rules for heart conditions in November 2021.
In plain English
- What METs mean: One MET is the energy you use standing quietly at rest. A lower METs number means less activity brings on symptoms. If an exercise test can't be done for medical reasons, an examiner may estimate your METs from specific examples of activity, such as slow stair climbing or shoveling snow.
- Heart failure symptoms for this formula include, but aren't limited to, shortness of breath, tiredness (fatigue), chest pain (angina), dizziness, an irregular heartbeat (arrhythmia), a pounding or racing heartbeat (palpitations) or fainting (syncope).
- 10%: Heart failure symptoms at a workload of 7.1 to 10.0 METs; or you need medicine all the time (continuous medication) for control.
- 30%: Heart failure symptoms at a workload of 5.1 to 7.0 METs; or a thick or enlarged heart (cardiac hypertrophy or dilatation) confirmed by an echocardiogram or an equal test, such as a MUGA scan or MRI.
- 60%: Heart failure symptoms at a workload of 3.1 to 5.0 METs.
- 100%: Heart failure symptoms at a workload of 3.0 METs or less.
- Heart attack (myocardial infarction): 100% during the heart attack and for three months after it, confirmed by lab tests. After that, VA uses the formula above.
- If coronary artery disease that isn't service-connected develops on top of a service-connected heart valve problem or other heart disease, VA asks for a medical opinion on which condition is causing your current symptoms.
- Heart strain from lung disease (cor pulmonale) is rated as part of the lung condition that causes it.
The regulation, word for word
Quoted from 38 CFR Part 4 (current as of October 16, 2026). This is what VA applies. The plain-English version above is our summary of it.
38 CFR 4.104, diagnostic code 7005: Arteriosclerotic heart disease (coronary artery disease) Open in the Rating Criteria Lookup
| Criteria | Rating |
|---|
| 7005 Arteriosclerotic heart disease (coronary artery disease). | |
| Note: If non-service-connected arteriosclerotic heart disease is superimposed on service-connected valvular or other non-arteriosclerotic heart disease, request a medical opinion as to which condition is causing the current signs and symptoms. | |
| Criteria | Rating |
|---|
| 7006 Myocardial infarction: | |
| During and for three months following myocardial infarction, confirmed by laboratory tests | 100 |
| Thereafter, use the General Rating Formula. | |
VA rates this code with the formula below.
GENERAL RATING FORMULA FOR DISEASES OF THE HEART
| Criteria | Rating |
|---|
| 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 cardiac hypertrophy or dilatation confirmed by echocardiogram or equivalent (e.g., multigated acquisition scan or magnetic resonance imaging) | 30 |
| Workload of 7.1-10.0 METs results in heart failure symptoms; or continuous medication required for control | 10 |
Related
About every C&P exam
What is it?
After you file a claim, VA may ask you to have a claim exam, also called a compensation and pension (C&P) exam. It helps VA decide whether your condition is connected to your service, and how severe it is. It isn't treatment: the examiner won't treat you, prescribe medicine or refer you to anyone.
Who does it?
A VA provider or a provider from one of VA's exam contractors (Loyal Source, OptumServe, QTC or VES). VA picks; you can't choose. Hearing, mental health, eye and dental exams are done by specialists. For a reproductive, breast, rectal or mental health exam, or a claim related to military sexual trauma, you can ask for a male or female examiner.
How long does it take?
VA says anywhere from 15 minutes to an hour or more, depending on what you claimed. Some exams are by phone or video. If you claimed more than one condition, VA tries to schedule them on the same day.
Does the examiner decide my claim?
No. The examiner writes a report on a standard form (a Disability Benefits Questionnaire, or DBQ) and sends it to VA. VA decides your claim using all the evidence: the report, your medical and service records, and statements from you and others. The examiner can't tell you the results or answer questions about your claim.
Does everyone get one?
No. If your records already have what VA needs, VA can decide from the records alone (VA calls this Acceptable Clinical Evidence, or ACE).
What if I can't make it?
Call the number on your appointment letter at least 48 hours ahead to reschedule. Missing an exam delays your claim. VA may decide your claim on the evidence it already has, and some claims, such as a claim for an increase, are denied (38 CFR 3.655). If you had a good reason, such as being in the hospital or a death in your family, tell VA and ask for a new exam.
What should I bring?
VA says you don't need to bring anything. Send any new medical records to VA before the exam, because the examiner can't send them in for you. Arrive 15 minutes early and wear clothes you can move in. Many veterans find it helps to bring a short list of their symptoms, medicines and side effects, and key dates, so nothing is forgotten.
Can someone come with me?
You can ask the examiner. They may ask family members or caregivers to wait outside. For a sensitive physical exam, you can ask for a chaperone in the room.
Can I get a copy of the report?
Yes. Ask VA with a Freedom of Information Act or Privacy Act request (VA Form 20-10206). VetEZ Claim can help you fill it out and send it.
Can my own doctor fill out the form instead?
For many conditions, yes. VA publishes the exam forms (DBQs) your own doctor can fill out and you can send in. VA doesn't pay for this. A few exam forms are for VA's own examiners.
Checked against VA's forms and rules on October 20, 2026. General information only, not medical or legal advice about your claim. VA decides every claim.
