VA Disability Rating for Syphilitic Heart Disease (DC 7004)
Diagnostic Code 7004 · 38 CFR §4.104
What Is It?
Syphilitic heart disease is cardiovascular damage caused by late-stage (tertiary) syphilis infection. The syphilis bacteria can damage the aorta and aortic valve over many years, sometimes decades after the original infection. This can lead to aortic regurgitation, aortic aneurysm, and narrowing of the coronary artery openings. Veterans who contracted syphilis during military service and later developed heart complications may be eligible for service-connected 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
- Service medical records showing syphilis diagnosis or treatment during active duty
- Cardiology records documenting aortic valve disease or aortic damage attributed to syphilis
- Echocardiogram results showing valve function and any cardiac hypertrophy or dilatation
- Exercise stress test or METs estimation results
- Serology records confirming syphilis history (RPR, VDRL, or FTA-ABS tests)
- Medical opinion linking current heart disease to the prior syphilis infection
C&P Exam Tips
- Bring records showing your syphilis diagnosis and any treatment history from military service
- Be prepared to describe how heart symptoms limit your daily activities and physical capacity
- The examiner will likely order an echocardiogram and may arrange a stress test if one has not been done recently
- Make sure the examiner documents the connection between your syphilis history and current cardiac problems
- Report all symptoms honestly, including on your worst days — do not downplay limitations
How to File
File a claim for syphilitic heart disease on VA Form 21-526EZ. Include your syphilis treatment records from service, current cardiology records, and a medical nexus letter connecting the two. If you already have a rating for syphilis, you can file this as a secondary condition.
Common Mistakes
Not establishing the syphilis service connection first Make sure your original syphilis infection is documented as service-connected before or simultaneously with your heart disease claim. Missing the link between old infection and current heart problems Get a medical opinion that specifically explains how tertiary syphilis caused your cardiac damage, since the conditions can appear decades apart. Submitting outdated cardiac testing Get a current echocardiogram and stress test within the last year to show your present level of disability.
Frequently Asked Questions
Can I get rated for syphilitic heart disease if my syphilis was treated and cured?
Yes. Even if the syphilis infection was successfully treated, the damage it caused to your heart and blood vessels can be permanent and ratable.
What if my syphilis was diagnosed after service?
You would need to show that the infection was actually contracted during service, even if not diagnosed until later. Syphilis can remain latent for years before causing symptoms.
Is this rated differently from other heart conditions?
The rating criteria are the same as for other heart conditions under 38 CFR 4.104: the General Rating Formula, which turns on the workload in METs at which heart failure symptoms develop, and at the 30 percent level on cardiac hypertrophy or dilatation confirmed by echocardiogram or equivalent.