Evidence Checklist: Coronary Artery Disease

Exercise stress test or nuclear stress test with METs resultCritical

Stress test documenting your maximum exercise capacity in METs (metabolic equivalents). The VA uses METs to assign ratings: 3 METs or less = 100%, 3-5 METs = 60%, 5-7 METs = 30%, more than 7 METs = 10%.

Echocardiogram documenting ejection fraction (EF%)Critical

Echocardiography showing left ventricular ejection fraction. An EF below 30% or chronic congestive heart failure supports the 100% rating; EF 30-50% may support 60%.

Cardiac catheterization or coronary angiography reportCritical

Cath report documenting the degree of coronary artery stenosis, number of vessels involved, and any interventions (stent, balloon angioplasty). Establishes objective diagnosis.

Nexus opinion linking CAD to service ("at least as likely as not")Critical

A medical opinion connecting CAD to military service. For veterans with Agent Orange exposure, ischemic heart disease is a presumptive condition — document qualifying service instead.

Ongoing cardiology treatment records

Follow-up records from your cardiologist documenting symptoms, medication adjustments, and functional status over time.

Personal symptom log (chest pain episodes, dyspnea, fatigue)

A personal log documenting frequency and severity of cardiac symptoms — chest tightness, exertional dyspnea, palpitations — that affect daily function.

Buddy statement from spouse, family, or fellow service member

A written statement from someone who can describe observable symptoms and how your condition affects daily life.

Personal statement describing symptoms and functional impact

Your own written account of how this condition affects your daily activities, work, and relationships. Describe your worst days.

Completed DBQ Heart Conditions (Ischemic Heart Disease)Critical

Standardized form capturing METs capacity, ejection fraction, workload tolerance, and functional class. Raters rely on this form to determine rating level.

Service treatment records (STRs)Critical

Military medical records showing in-service treatment, complaints, or injuries related to this condition.