The VA provides benefits for service-connected heart problems, including heart attack disability benefits. Veterans’ heart attack benefits include a temporary 100% disability rating after you experience a heart attack. The difficulty is showing that your heart attack was the result of service-connected heart disease. Fortunately, the VA’s rules establish a presumptive service connection for some veterans like former prisoners of war (POWs) and Vietnam veterans exposed to Agent Orange.
In This Article About VA Disability After a Heart Attack:
- How Are Veterans’ Heart Attack Benefits Rated?
- Does a Heart Attack Qualify for Disability?
- Is Heart Disease a Disability?
- Tests Needed for VA Heart Disability Benefits
- Heart Attack VA Disability Rating
- Veterans’ Survivor Payments for Heart Disease Disability Benefits
- Establishing a Service Connection to Support a Claim for Veterans’ Heart Attack Benefits
- Facts to Support a Service Connection
- Secondary Service-Connected Heart Disease
- What to Tell the VA After You Have a Heart Attack to Support a Claim for Veterans’ Heart Attack Benefits
How Are Veterans’ Heart Attack Benefits Rated?
The VA provides a rating schedule for a wide range of heart disease diagnoses. However, most of the VA disability ratings follow the same pattern – a temporary rating during and immediately following a heart incident or surgery, then a reassessment for an ongoing VA disability rating due to the underlying heart condition.
Does a Heart Attack Qualify for Disability?
Yes. When a veteran experiences a heart attack that is connected to his or her military service, veterans’ heart attack benefits may be claimed from the VA. Veterans’ heart attack benefits include a 100% disability rating for three months following the heart attack. In other words, the VA presumes that you are totally disabled for three months after a heart attack regardless of the severity of the heart attack.
There are a few explanations as to why the VA assigns a temporary total disability rating after a heart attack:
- Stabilization: A heart attack, or myocardial infarction, occurs when blood flow to the heart is interrupted by a blood clot. Heart attacks can result from ischemic heart disease, also known as coronary artery disease or atherosclerosis, a plaque in the arteries caused by a buildup of fat and cholesterol. Arteries narrowed by ischemic heart disease are prone to blockage by blood clots, and the plaque built up in the arteries can break off and create a blood clot. The lack of blood flow during a heart attack may cause heart tissue to weaken or die. Your condition will take time to stabilize after this traumatic event.
- Hospitalization: Most patients spend between two and seven days in the hospital after a heart attack. Heart attacks that require coronary artery bypass surgery or other procedures like angioplasty or stent placement may require longer hospital stays.
- Diagnosis: A heart attack is not the same as cardiac arrest. Cardiac arrest occurs when the heart stops beating. Causes of cardiac arrest can include arrhythmia, heart valve disease, congenital heart defect, high blood pressure, cardiomyopathy (a thickening of the heart muscle), endocarditis (an infection of the heart lining), illegal drug use, or even scar tissue caused by a previous heart attack. Diagnosing whether you suffered a heart attack or cardiac arrest and the underlying cause will help your doctors develop a treatment plan and permit the VA to assign a disability rating for your condition.
- Rehabilitation: Cardiac rehabilitation is prescribed for most veterans after a heart attack. These exercise programs are designed to help you recover from the heart attack and reduce your risk of a subsequent episode. During your time in cardiac rehab, your available time to work may be limited.
- Complications: A heart attack can damage and scar your heart. This can result in congestive heart failure, a condition in which your heart is no longer strong enough to pump blood throughout your body. Damaged or scarred heart tissue can cause arrhythmia and cardiomyopathy. Similarly, weakened heart tissue may lead to an aneurysm, a bulging, or rupture. The heart attack and open-heart surgery necessitated by the heart attack can cause pericarditis, an inflammation of the sac surrounding the heart.
- Stroke or second heart attack: People who experience a heart attack have a much higher risk of stroke or another heart attack than someone who has not previously had a heart attack. The blood clots that caused the heart attack can also block arteries leading to the brain, causing an ischemic stroke contemporaneous with the heart attack. New blood clots can form, leading to a second heart attack or stroke even after you have recovered from the first heart attack. Blood-thinners may be prescribed to reduce the chance of new blood clots, but these drugs can increase the risk of hemorrhagic stroke.
- Impact on work: Any heart attack, regardless of severity, will affect your ability to earn a living. Most patients can return to work two to four weeks after being released from the hospital. However, your doctor may recommend a change in work schedule or work duties to minimize the stress on your heart. This may result in a loss of income that makes VA disability benefits essential for avoiding financial hardship.
Is Heart Disease a Disability?
Yes. Whether or not you have had a heart attack, the VA can pay disability benefits for heart disease in vets. Disability ratings for heart disease range from 10% to 100%, depending on the level of heart function as measured by an exercise stress test. If you are unable to take an exercise stress test, a diagnosis of congestive heart failure or an imaging examination may substitute.
Tests Needed for VA Heart Disability Benefits
The VA rating schedule for heart disease uses the same criteria to rate almost all VA disability benefits claims regardless of the specific diagnosis. The common thread through each of the rating levels is the exercise stress test.
An exercise stress test is usually conducted on a treadmill or, less frequently, on an exercise bike. Your heart is monitored with an electrocardiograph (EKG) and blood pressure cuff.
During the test, the speed and incline of the treadmill increase at set intervals. The test ends when you are unable to continue, or your EKG shows signs that your heart is struggling.
The longer you can continue the test before experiencing fatigue, chest pain or tightness, fainting, shortness of breath, or dizziness, the more functional your heart is. A low functioning heart will cause you to quit the test early while a high functioning heart may permit you to complete the test without experiencing any of these effects.
When rating heart disease, including the state of your heart after the temporary total disability period ends three months after a heart attack, a score of three METs or less is rated at 100% disability. A score of four or five METs is rated at 60% disability. A score of six or seven METs is rated at 30% disability. A score of eight to ten METs is rated at 10% disability. A score greater than ten METs is not considered a ratable disability.
An exercise stress test is required in all cases in which a VA disability rating for heart disease is claimed (except supraventricular arrhythmias) unless:
- The veteran is medically unable to take the exercise stress test.
- Imaging tests show a left ventricular ejection fraction of 50% or less.
- The veteran has experienced congestive heart failure at least once during the preceding year.
- A 100% disability rating can be assigned without the exercise stress test.
When a veteran is medically unable to take the exercise stress test, a 100% disability rating will be assigned if the veteran has chronic congestive heart failure or a left ventricular ejection fraction of less than 30%. A 60% disability rating will be assigned if the veteran has experienced acute congestive heart failure at least once in the preceding year or has a left ventricular ejection fraction of 30% to 50%.
Regardless of whether you can complete an exercise stress test, you must include images of the heart to determine whether the heart muscle is abnormally thickened, or the heart chambers are enlarged. Moreover, your claim for VA disability benefits for heart disease must state whether continuous medication is needed to control the heart condition.
Heart Attack VA Disability Rating
To summarize, when you have a heart attack, you would be entitled to a 100% disability rating for veterans’ heart attack benefits. This 100% disability rating would continue for three months until the VA orders a reevaluation.
During the reevaluation, you would be required to take an exercise stress test to assign a disability rating for your post-heart attack condition. The results of the exercise stress test would determine the rating for your veterans’ heart attack benefits at 10% (eight to ten METs), 30% (six or seven METs), 60% (four or five METs), or 100% (three METs or less).
|VA Disability Rating||METS on Stress Test|
|100%||3 or less|
If you are medically unable to take a stress test, you would be assigned a rating of 100% for veterans’ heart attack benefits if you have chronic congestive heart failure or a left ventricular ejection fraction less than 30%. You would be assigned a rating of 60% for veterans’ heart attack benefits if you have experienced acute congestive heart failure within the preceding year or have a left ventricular ejection fraction between 30% and 50%. A rating of 30% would be assigned for veterans’ heart attack benefits if you have thickening of the heart muscle or enlargement of the heart chambers. You will receive a rating of 10% for veterans’ heart attack benefits if you require continuous medication to treat your heart condition.
Veterans’ Survivor Payments for Heart Disease Disability Benefits
When a veteran suffers a fatal heart attack, his or her veterans’ heart attack benefits may be paid to a survivor with a few limitations. First, the veteran must be receiving VA disability benefits at the time of the heart attack or must have a pending VA disability claim.
Second, if the veteran was already receiving disability benefits at the time of the heart attack, only the final month of VA disability benefits will be paid before the disability benefits payments end. This is referred to as the “month of death payment.”
Third, if the veteran had a pending VA disability claim that is eventually granted, the disability benefits that had accrued from the effective date of the claim until the veteran’s month of death will be paid to the veteran’s survivors. This is also called “back benefits” or “back pay” and is paid in a single lump sum.
Back benefits and month of death payments are not ongoing. These are one-time payments meant to bring the disability payments current as of the veteran’s date of death. When a veteran’s survivors require ongoing support, a claim for dependency indemnity compensation (DIC) must be filed with the VA.
Establishing a Service Connection to Support a Claim for Veterans’ Heart Attack Benefits
All claims for VA disability benefits must connect the disability to the veteran’s military service. For most veterans, this means that your service records, military medical records, and post-discharge medical records must show that the disability manifested during your military service, was caused by, or was worsened by your service.
However, some veterans are entitled to a presumption of service connection for their heart disease. These veterans are not required to prove a service connection to receive veterans’ heart attack benefits. Rather, they are only required to prove they are eligible for the presumptive service connection.
Facts to Support a Service Connection
A presumptive service connection for heart disease is available to all former POWs regardless of the duration of captivity. If your service records show that you were a former POW, the VA will presume your heart disease is service-connected unless they can find evidence against your claim.
A service connection is also presumed for ischemic heart disease in Vietnam vets who were exposed to Agent Orange. Agent Orange exposure is established by your service records, which show where and when you were stationed in Vietnam.
If you are not entitled to a presumptive service connection, you must present facts to support a service connection. The clearest way to establish a service connection is with military medical records showing that you were diagnosed with heart disease, experienced a heart attack, or underwent a heart procedure during your military service.
If your diagnosis occurred after discharge, you might be able to establish a service connection if your heart disease manifested during your military service but was misdiagnosed. Likewise, you may be able to establish a service connection if you experienced an event, such as an injury or environmental exposure, during your service that is linked to heart disease.
Secondary Service-Connected Heart Disease
Heart disease can arise as a secondary service-connected disability from other service-connected disabilities. For example, heart disease can be caused by hypothyroidism, which, in turn, can be caused by chemical exposure during active duty and medications used to treat PTSD and depression.
A veteran can establish a primary service connection for hypothyroidism. Heart disease may then be claimed as a secondary service-connected disability resulting from hypothyroidism. This connection between hypothyroidism and heart disease can support a VA benefits claim for heart disease in Afghanistan vets, in Iraq vets, and in Gulf War vets.
One of our VA Disability Lawyers talks about how a Nexus Letter serves as the missing link for your service-connected or secondary connected disability.
What to Tell the VA After You Have a Heart Attack to Support a Claim for Veterans’ Heart Attack Benefits
Does a heart attack qualify you for disability? Yes, but you need to communicate clearly with the VA to explain the nature of your heart condition.
People often use the term heart attack loosely. From a medical standpoint, angina, cardiac arrest, and heart attack are not the same. Since the VA rates heart incidents differently depending on what happened and what caused it, the VA may deny a claim if the basis for the claim is unclear. The best way to avoid miscommunication is to include copies of your medical records.
Moreover, you must show facts to support a service connection. Again, to minimize the risk of miscommunication, you will likely include copies of your service records along with an explanation, if necessary, explaining how your condition relates to your service. If you can get that statement written by a doctor familiar with VA Disability Law like somebody on our staff, even better.
Veterans’ heart attack benefits are available for a heart attack arising from service-connected heart disease. Contact a VA attorney regardless of where you are currently located and whether you were deployed to discuss your heart condition and whether you can claim VA disability benefits.
Yes, you should apply for VA disability for the 3 months following your heart attack. Even if you are alright now, if your heart problems were related to your service and caused you to miss work or income, it’s worth talking to a VA attorney about getting some back pay.
Yes, if your husband’s heart attack was service-connected, that is just one way you can get VA benefits for survivors. There may be other issues that appear on his health record that deserved VA benefits also. Let’s look at his file.