Cardiac Sarcoidosis

DC 7020Cardiovascular38 CFR 4.104, DC 7020

An inflammatory condition where granulomas form in the heart tissue, potentially causing arrhythmias, heart block, heart failure, and sudden cardiac death. The VA rates cardiac sarcoidosis based on residual cardiac dysfunction including METs capacity, ejection fraction, and the presence of congestive heart failure.

How the VA rates this condition

The VA rates this condition based on objective clinical measurements and test results. The examiner will use standardized tests or lab values to determine the severity of your condition rather than relying primarily on subjective symptom reports.

Diagnostic code

DC 7020

Rating range

30% – 100%

Rating levels

Rating criteria are defined in 38 CFR 4.104, DC 7020. This guide presents a plain-language summary and is not a substitute for the full regulatory text. Always consult a VSO or VA-accredited attorney for case-specific advice.

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. Or you have active disease requiring immunosuppressive therapy with significant cardiac involvement.

What the VA looks for

Chronic congestive heart failure documented
Workload capacity of 3 METs or less
Left ventricular ejection fraction less than 30%
Active granulomatous disease on cardiac MRI or PET scan
Implantable cardioverter-defibrillator (ICD) placement records

Common Pitfalls

⚠Not getting a cardiac MRI with late gadolinium enhancement — this is the gold standard for detecting cardiac sarcoidosis involvement and documenting myocardial scarring.
⚠Not connecting cardiac sarcoidosis to systemic sarcoidosis already service-connected — if you have a service-connected pulmonary sarcoidosis diagnosis, cardiac involvement should be claimed as secondary.
⚠Not documenting arrhythmias and conduction abnormalities — heart block and ventricular arrhythmias from sarcoidosis may warrant separate ratings or support the need for a pacemaker or ICD.
⚠Not preserving records of immunosuppressive treatment — corticosteroid or other immunosuppressive therapy for active cardiac sarcoidosis supports the severity of the condition.

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…

Cardiac Sarcoidosis

How the VA rates this condition

Diagnostic code

DC 7020

Rating range

30% – 100%

Rating levels

Rating Levels

What the VA looks for

Chronic congestive heart failure documented
Workload capacity of 3 METs or less
Left ventricular ejection fraction less than 30%
Active granulomatous disease on cardiac MRI or PET scan
Implantable cardioverter-defibrillator (ICD) placement records

Common Pitfalls

⚠Not getting a cardiac MRI with late gadolinium enhancement — this is the gold standard for detecting cardiac sarcoidosis involvement and documenting myocardial scarring.

⚠Not connecting cardiac sarcoidosis to systemic sarcoidosis already service-connected — if you have a service-connected pulmonary sarcoidosis diagnosis, cardiac involvement should be claimed as secondary.

⚠Not documenting arrhythmias and conduction abnormalities — heart block and ventricular arrhythmias from sarcoidosis may warrant separate ratings or support the need for a pacemaker or ICD.

⚠Not preserving records of immunosuppressive treatment — corticosteroid or other immunosuppressive therapy for active cardiac sarcoidosis supports the severity of the condition.