Cardiac Pacemaker Implant

DC 7018Cardiovascular38 CFR 4.104, DC 7018

A small device implanted in the chest to help control abnormal heart rhythms by sending electrical pulses to the heart. The VA rates based on a temporary 100% rating after implant, then ongoing rating based on heart function and exercise capacity.

Rating Levels

You have chronic congestive heart failure, or your workload capacity is 3 METs or less resulting in symptoms, or your left ventricular ejection fraction is less than 30 percent. Note: for 2 months following hospital discharge for pacemaker implantation, a 100% temporary rating is assigned.

What the VA looks for

Chronic congestive heart failure
Workload capacity of 3 METs or less
Left ventricular ejection fraction less than 30%
Hospital discharge records for pacemaker implantation
Severe exercise limitation documented

Common Pitfalls

⚠Not filing immediately after implant to capture the automatic 100% temporary rating for 2 months — keep your hospital admission and discharge records to document the exact dates.
⚠Not getting a follow-up METs test after the recovery period to establish the ongoing rating — without a stress test or METs estimation, the VA may assign a lower rating.
⚠Not documenting any device-related complications such as infections, lead problems, or device recalls — these support additional claims or higher ratings.
⚠Not filing for the surgical scar as a separate condition if it is painful, tender, or unstable — scars from pacemaker implantation are independently ratable.

Related DBQ Forms

DBQ Heart Conditions

View evidence checklist →See secondary conditions →

Condition Rating Guides

Understand what the VA looks for at each rating level — loading conditions…

Rating Levels

What the VA looks for

Chronic congestive heart failure
Workload capacity of 3 METs or less
Left ventricular ejection fraction less than 30%
Hospital discharge records for pacemaker implantation
Severe exercise limitation documented

Common Pitfalls

⚠Not filing immediately after implant to capture the automatic 100% temporary rating for 2 months — keep your hospital admission and discharge records to document the exact dates.

⚠Not getting a follow-up METs test after the recovery period to establish the ongoing rating — without a stress test or METs estimation, the VA may assign a lower rating.

⚠Not documenting any device-related complications such as infections, lead problems, or device recalls — these support additional claims or higher ratings.

⚠Not filing for the surgical scar as a separate condition if it is painful, tender, or unstable — scars from pacemaker implantation are independently ratable.