VA Disability Rating for Cardiac Transplantation (DC 7019)
Diagnostic Code 7019 · 38 CFR §4.104
What Is It?
Cardiac transplantation is a heart transplant — the replacement of a failing heart with a healthy donor heart. This is typically a last-resort treatment for end-stage heart failure that has not responded to other treatments. Veterans who require a heart transplant due to service-connected heart disease receive a 100 percent disability rating for a minimum of one year from the date of hospital admission for the transplant. After that period, the VA reassesses based on heart function, but the minimum permanent rating is 30 percent.
Rating Criteria
| Rating | Criteria |
|---|---|
| 100% | Assigned for a minimum of one year from the date of hospital admission for the transplant. Thereafter, the General Rating Formula applies: a workload of 3.0 METs or less results in heart failure symptoms. Heart failure symptoms include, but are not limited to, breathlessness, fatigue, angina, dizziness, arrhythmia, palpitations, or syncope. |
| 60% | A workload of 3.1 to 5.0 METs results in heart failure symptoms. |
| 30% | The minimum rating following cardiac transplantation. A workload of 5.1 to 7.0 METs results in heart failure symptoms; or there is evidence of cardiac hypertrophy or dilatation confirmed by echocardiogram or equivalent, such as a multigated acquisition scan or magnetic resonance imaging. DC 7019 prints a minimum of 30 percent, so the Formula's 10 percent level is not reached under this code. |
Evidence Needed
- Operative report from the transplant surgery
- Hospital discharge summary with dates
- Post-transplant cardiology follow-up records including biopsy results for rejection monitoring
- Echocardiogram of the transplanted heart documenting any cardiac hypertrophy or dilatation
- Stress test or METs estimation after the one-year recovery period
- Immunosuppression medication records
- Service connection documentation for the heart disease that led to transplant
C&P Exam Tips
- The initial 100 percent evaluation should be straightforward: make sure the VA has the hospital admission date, which is when the evaluation begins, and the discharge date, which starts the clock on the mandatory examination one year later
- For the post-recovery evaluation, bring all follow-up cardiology records including rejection monitoring biopsy results
- Describe your current activity level and any limitations honestly
- Report all medications, especially immunosuppressants, as these have significant side effects that affect your daily life
- Note any rejection episodes, infections, or other complications since the transplant
How to File
File on VA Form 21-526EZ with the transplant surgical records, hospital dates, and evidence connecting the original heart failure to military service. The 100 percent evaluation runs from the date of hospital admission for the transplant rather than the date of the operation, so submit the admission record along with the operative report. The mandatory VA examination falls one year following discharge from that hospitalization.
Common Mistakes
Not filing immediately after the transplant File as soon as possible so the 100 percent evaluation runs from the date of hospital admission for the transplant rather than from the claim date. Ignoring medication side effects Immunosuppressive drugs cause serious side effects. Track and report these as they may be ratable as secondary conditions. Not preparing for the post-recovery evaluation Gather current cardiology testing before the mandatory examination one year after discharge so your permanent rating accurately reflects your condition.
Frequently Asked Questions
Is a heart transplant always rated at 100 percent?
You receive 100 percent for at least one year. After that, the VA evaluates your heart function. The minimum permanent rating is 30 percent, but many transplant recipients continue at 60 or 100 percent due to ongoing complications.
What about the anti-rejection medications?
You will take immunosuppressive drugs for life after a transplant. The side effects of these medications — kidney damage, infection risk, diabetes — can be claimed as secondary conditions.
Can the VA reduce my rating below 30 percent after a transplant?
No. The minimum permanent rating after cardiac transplantation is 30 percent, regardless of how well you recover.