VA Disability Rating for Hypertensive Heart Disease (DC 7007)
Diagnostic Code 7007 · 38 CFR §4.104
What Is It?
Hypertensive heart disease is heart damage caused by long-term high blood pressure. When blood pressure stays elevated over years, the heart has to work harder to pump blood, which causes the heart muscle to thicken and eventually weaken. This can lead to heart failure, irregular heart rhythms, and other serious complications. Many veterans develop hypertension during or after service due to stress, diet, environmental exposures, or other service-related factors, and the resulting heart damage can qualify for disability compensation.
Rating Criteria
| Rating | Criteria |
|---|---|
| 100% | 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% | 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. |
| 10% | A workload of 7.1 to 10.0 METs results in heart failure symptoms; or continuous medication is required for control. |
Evidence Needed
- Medical records showing a diagnosis of hypertension during or shortly after military service
- Cardiology records documenting hypertensive heart disease — left ventricular hypertrophy, diastolic dysfunction, or heart failure
- Echocardiogram documenting any cardiac hypertrophy or dilatation, with notes on cardiac structure
- Stress test results or documented METs estimation based on activity level
- Blood pressure monitoring records over time showing the progression
- Pharmacy records showing continuous use of cardiac and blood pressure medications
C&P Exam Tips
- Bring a complete medication list showing all heart and blood pressure drugs you take
- Describe your daily activity limitations in specific terms — how far you can walk, what tasks cause symptoms
- If you cannot do an exercise stress test, make sure the examiner estimates your METs based on your reported activities
- Ask the examiner to review your echocardiogram and note any cardiac enlargement or reduced function
- Do not minimize your symptoms — describe what happens on your worst days, not just average days
How to File
File on VA Form 21-526EZ. If you already have a service-connected rating for hypertension, file hypertensive heart disease as a secondary condition. Include cardiology records, echocardiogram results, and a medical opinion explaining that your long-standing hypertension caused the heart damage.
Common Mistakes
Claiming heart disease without an established hypertension rating Establish service connection for hypertension first, then claim the heart disease as secondary to it. Relying only on blood pressure readings without cardiac evidence You need evidence of actual heart damage — an echocardiogram or equivalent showing cardiac hypertrophy or dilatation, which is the finding the 30 percent level turns on. Not getting a current stress test METs capacity is the primary rating factor. Get an exercise stress test or make sure your doctor provides a detailed METs estimate.
Frequently Asked Questions
Can I get separate ratings for hypertension and hypertensive heart disease?
Yes. Hypertension is rated under DC 7101 and hypertensive heart disease under DC 7007. They use different criteria and can be rated separately, though the VA may combine them depending on the specific facts.
What if my heart looks normal on an echocardiogram?
If there is no structural heart damage yet, you may not qualify under DC 7007 specifically, but your hypertension alone can still be rated under DC 7101.
Does being on heart medication automatically qualify me?
Continuous medication use supports at minimum a 10 percent rating, but you still need a diagnosis of hypertensive heart disease, not just hypertension alone.