Cor Pulmonale

DC 7020Cardiovascular38 CFR 4.104, DC 7020

Enlargement and failure of the right side of the heart caused by lung disease that increases blood pressure in the pulmonary arteries. Common causes include COPD, sleep apnea, and pulmonary embolism. The VA rates cor pulmonale based on your heart workload capacity in METs, ejection fraction, and whether you have 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 causing symptoms, or your ejection fraction is less than 30 percent.

What the VA looks for

Chronic right-sided congestive heart failure
Workload capacity of 3 METs or less
Severe right ventricular dysfunction
Continuous supplemental oxygen requirement
Severe peripheral edema and ascites

Common Pitfalls

⚠Not connecting cor pulmonale to the underlying lung disease — if your COPD, sleep apnea, pulmonary embolism, or other lung condition is already service-connected, cor pulmonale should be claimed as a secondary condition.
⚠Not getting a right heart catheterization or echocardiogram with right ventricular pressure estimates — these tests document pulmonary hypertension and right heart strain, which are essential for the rating.
⚠Not documenting peripheral edema, liver enlargement, and jugular vein distension — these signs of right-sided heart failure support a higher rating and should be noted at every medical visit.
⚠Not claiming the lung condition and cor pulmonale separately — the underlying respiratory condition and the resulting heart condition may each warrant their own rating under different diagnostic codes.

Related DBQ Forms

DBQ Heart Conditions

View evidence checklist →See secondary conditions →

Condition Rating Guides

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Cor Pulmonale

How the VA rates this condition

Diagnostic code

DC 7020

Rating range

30% – 100%

Rating levels

Rating Levels

You have chronic congestive heart failure, or your workload capacity is 3 METs or less causing symptoms, or your ejection fraction is less than 30 percent.

What the VA looks for

Chronic right-sided congestive heart failure
Workload capacity of 3 METs or less
Severe right ventricular dysfunction
Continuous supplemental oxygen requirement
Severe peripheral edema and ascites

Common Pitfalls

⚠Not connecting cor pulmonale to the underlying lung disease — if your COPD, sleep apnea, pulmonary embolism, or other lung condition is already service-connected, cor pulmonale should be claimed as a secondary condition.

⚠Not getting a right heart catheterization or echocardiogram with right ventricular pressure estimates — these tests document pulmonary hypertension and right heart strain, which are essential for the rating.

⚠Not documenting peripheral edema, liver enlargement, and jugular vein distension — these signs of right-sided heart failure support a higher rating and should be noted at every medical visit.

⚠Not claiming the lung condition and cor pulmonale separately — the underlying respiratory condition and the resulting heart condition may each warrant their own rating under different diagnostic codes.