VA Disability Rating for Pericardial Adhesions (DC 7003)
Diagnostic Code 7003 · 38 CFR §§4.104
What Is It?
Pericardial adhesions are bands of scar tissue that form between the heart and the surrounding pericardial sac, or between the pericardium and nearby chest structures. These adhesions restrict the heart's normal movement, potentially reducing its ability to fill and pump effectively. In veterans, adhesions typically develop after cardiac surgery, chest trauma, radiation therapy, or following pericarditis episodes. DC 7003 assigns no percentages of its own — its rating cell in 38 CFR 4.104 is empty — so the General Rating Formula for diseases of the heart supplies the evaluation, on the workload in METs at which heart failure symptoms develop.
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
- Cardiac imaging (echocardiogram, CT, or MRI) showing pericardial adhesions
- Surgical records if adhesions were discovered or treated during surgery
- Exercise stress test or METs estimation documenting functional limitation
- Documentation of the event that caused adhesion formation
- Cardiology assessment of how adhesions affect cardiac function
C&P Exam Tips
- Bring imaging that demonstrates the adhesions
- Have a METs assessment from a recent stress test or cardiology evaluation
- Describe symptoms during physical activity
- If adhesions formed after cardiac surgery during service, bring surgical records
- Explain how the condition limits your daily activities and exercise tolerance
How to File
File under DC 7003 with imaging evidence of adhesions and functional testing. Connect the adhesions to the service-related event that caused them (surgery, trauma, pericarditis). The rating comes from the General Rating Formula, so the METs figure at which heart failure symptoms develop — measured on a stress test, or estimated by the examiner where testing is not medically possible — is what sets the percentage.
Common Mistakes
Not obtaining imaging that specifically identifies the adhesions Failing to get METs testing to quantify the functional impact Not connecting the adhesions to a specific in-service event or surgery Accepting a minimal rating without documenting how adhesions limit activity
Frequently Asked Questions
How do pericardial adhesions form?
Adhesions form when inflammation causes the pericardium to stick to the heart or surrounding structures. Common causes include open heart surgery, chest trauma, and pericarditis. The body's healing process creates scar tissue bands that can restrict the heart's normal movement.
Can adhesions be treated?
Surgical lysis (cutting) of adhesions is possible but complex and carries risks. Many cases are managed with medication to control symptoms rather than surgery. The VA rates based on the current functional impact regardless of whether surgery has been attempted.