VA Disability Rating for Cardiomyopathy (DC 7020)

Diagnostic Code 7020 · 38 CFR §4.104

What Is It?

Cardiomyopathy is a disease of the heart muscle itself that makes it harder for the heart to pump blood effectively. There are several types: dilated cardiomyopathy (the heart chambers enlarge and weaken), hypertrophic cardiomyopathy (the heart muscle thickens abnormally), and restrictive cardiomyopathy (the heart muscle becomes stiff). Veterans may develop cardiomyopathy from toxic exposures during service, physical stress, infections, alcohol use, or other service-related causes. This condition can range from mild with few symptoms to severe heart failure requiring transplant.

Rating Criteria

Evidence Needed

• Echocardiogram showing the type and severity of cardiomyopathy and any cardiac hypertrophy or dilatation
• Stress test results or METs estimation
• Cardiac MRI if available, which can show scar tissue and detailed heart muscle condition
• Cardiology records documenting the diagnosis and treatment history
• Evidence linking the cardiomyopathy to service — toxic exposure records, infection history, or medical opinion
• Pharmacy records showing heart failure medications
• Any hospital records for heart failure episodes

C&P Exam Tips

• Bring your most recent exercise stress test — the workload in METs at which heart failure symptoms develop is the single most important number for your rating, and bring the echocardiogram report as well, because cardiac hypertrophy or dilatation is its own route to 30 percent
• If you have had heart failure episodes requiring hospitalization, bring those records — multiple episodes in a year support a 60 percent rating
• Describe your daily limitations in detail: how far you can walk, what household tasks you cannot do, how often you rest
• If you were exposed to toxic substances during service (burn pits, chemicals, solvents), emphasize this connection
• Make sure the examiner documents the specific type of cardiomyopathy you have

How to File

File on VA Form 21-526EZ. Include echocardiogram results, cardiology records, and a nexus letter linking the cardiomyopathy to your military service. If linked to toxic exposure, include deployment records and any toxic exposure documentation.

Common Mistakes

Not getting a current exercise stress test Your METs level is the most important factor. Make sure you have a recent stress test, and a recent echocardiogram — within the past year — before filing, because cardiac hypertrophy or dilatation is its own route to 30 percent. Underreporting the symptoms that come on with exertion Keep a log of the activities that bring on breathlessness, fatigue, angina, dizziness, arrhythmia, palpitations, or syncope, because the METs rows are read against the level of activity that produces them. Not establishing the service connection for toxic exposure If your cardiomyopathy is related to burn pit exposure or other toxic substances, file a PACT Act claim and include your deployment records.

Frequently Asked Questions

Is cardiomyopathy covered under the PACT Act?

If your cardiomyopathy is related to toxic exposures during service, such as burn pits, Agent Orange, or other hazardous substances, it may be eligible under the PACT Act with a presumptive service connection.

What METs level qualifies for 100 percent?

A workload of 3.0 METs or less that results in heart failure symptoms meets the criteria for a 100 percent rating. A workload of 3.1 to 5.0 METs that results in heart failure symptoms supports a 60 percent rating. The 2021 revision to 38 CFR 4.104 removed ejection fraction from the General Rating Formula, so it is no longer a criterion.

Can my rating increase if my cardiomyopathy gets worse?

Yes. Cardiomyopathy is often progressive. If your heart function declines or you develop heart failure, file for an increased rating with updated medical evidence.