Cardiomyopathy

DC 7020Cardiovascular38 CFR 4.104, DC 7020

A disease of the heart muscle that makes it harder for your heart to pump blood. The VA rates cardiomyopathy based on your heart workload capacity measured in METs, ejection fraction, and whether you have congestive heart failure.

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.

What the VA looks for

Chronic congestive heart failure
Workload capacity of 3 METs or less
Left ventricular ejection fraction less than 30%
Severe exercise limitation
Ongoing heart failure management

Common Pitfalls

⚠Not getting an exercise stress test or METs estimation — the rating depends on measurable workload capacity.
⚠Not requesting an echocardiogram to document ejection fraction — LVEF of 30-50% qualifies for 60%.
⚠Not connecting cardiomyopathy to Agent Orange exposure (presumptive for ischemic heart disease in Vietnam veterans) or other service-connected conditions.
⚠Not documenting all congestive heart failure episodes including ER visits and hospitalizations.

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…