Myocardial Infarction Residuals

DC 7006Cardiovascular38 CFR 4.104, DC 7006

Lasting heart damage after a heart attack (myocardial infarction). The VA rates heart attack residuals based on your heart workload capacity measured in METs, ejection fraction, and whether you have congestive heart failure. A temporary 100% rating is assigned for 3 months following a documented heart attack.

Rating Levels

You have ongoing congestive heart failure, or your workload capacity is 3 METs or less causing symptoms, or your heart pumps at less than 30 percent of normal (ejection fraction). Note: a 100% temporary rating is automatically assigned for 3 months after a documented heart attack hospitalization.

What the VA looks for

Chronic congestive heart failure
Workload capacity of 3 METs or less
Left ventricular ejection fraction less than 30%
Hospital records documenting myocardial infarction
Cardiac enzyme lab results (troponin) from acute event
Severe exercise limitation

Common Pitfalls

⚠Not knowing about the automatic 100% temporary rating for 3 months after a heart attack — make sure the VA assigns this from the date of your hospitalization. Keep your hospital admission and discharge records.
⚠Not getting an exercise stress test or METs estimation after recovery — the rating depends on your measured workload capacity. If you cannot exercise, the examiner can estimate METs based on your daily activities.
⚠Not requesting an echocardiogram to document ejection fraction — heart attacks often leave lasting damage that reduces how well your heart pumps. An ejection fraction of 30-50% qualifies for 60% even without a low METs score.
⚠Not connecting the heart attack to other service-connected conditions — heart attacks are commonly secondary to hypertension, diabetes, coronary artery disease, or Agent Orange exposure (presumptive for Vietnam veterans).
⚠Failing to document all congestive heart failure episodes after the heart attack — even one hospitalization or ER visit for CHF matters. More than one CHF episode per year supports the 60% rating.

Related DBQ Forms

DBQ Ischemic Heart Disease
DBQ Heart Conditions

View evidence checklist →See secondary conditions →

Condition Rating Guides

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

Myocardial Infarction Residuals

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 records documenting myocardial infarction
Cardiac enzyme lab results (troponin) from acute event
Severe exercise limitation

Common Pitfalls

⚠Not knowing about the automatic 100% temporary rating for 3 months after a heart attack — make sure the VA assigns this from the date of your hospitalization. Keep your hospital admission and discharge records.

⚠Not getting an exercise stress test or METs estimation after recovery — the rating depends on your measured workload capacity. If you cannot exercise, the examiner can estimate METs based on your daily activities.

⚠Not requesting an echocardiogram to document ejection fraction — heart attacks often leave lasting damage that reduces how well your heart pumps. An ejection fraction of 30-50% qualifies for 60% even without a low METs score.

⚠Not connecting the heart attack to other service-connected conditions — heart attacks are commonly secondary to hypertension, diabetes, coronary artery disease, or Agent Orange exposure (presumptive for Vietnam veterans).

⚠Failing to document all congestive heart failure episodes after the heart attack — even one hospitalization or ER visit for CHF matters. More than one CHF episode per year supports the 60% rating.