Ischemic Heart Disease: VA Presumptive Condition (Agent Orange)
VeteranHQ lists Ischemic Heart Disease as a presumptive condition in the Agent Orange and Other Herbicides group. The exposure it is tied to is: Herbicide Agent (Agent Orange/TCDD). This condition was added to the presumptive list effective August 31, 2010. That is the date the statute or final rule that added it took effect, not the effective date of any individual award, which VA decides claim by claim. It is governed by 38 CFR § 3.309(e); 38 USC § 1116; VA Final Rule, 75 FR 53202 (August 31, 2010); 38 CFR § 3.307(a)(6); 38 USC § 1116A; 38 USC § 1116B.
A presumption removes one requirement and one only: the veteran does not have to prove a medical link between the condition and service. Everything else still applies. There must be a current disability, which for most conditions means a diagnosis from a medical provider. The service has to meet the requirements below, and VA decides the claim on the evidence in the record.
What qualifies: Ischemic Heart Disease
- Service era
- January 9, 1962 to May 7, 1975 (Republic of Vietnam, including its inland waterways, and the separate 38 USC § 1116A(d) offshore area); September 1, 1967 to August 31, 1971 (service in or near the Korean DMZ); January 9, 1962 to June 30, 1976 (a United States or Royal Thai base in Thailand)
- Service location
- Republic of Vietnam (including inland waterways); the separate offshore area defined by 38 USC § 1116A(d), within 12 nautical miles seaward of the line in that subsection; Thailand (U-Tapao, Ubon, Nakhon Phanom, Udorn, Takhli, Korat, and Don Muang bases); Korean DMZ; Johnston Island; specific test and storage sites in the United States
- Exposure
- Herbicide Agent (Agent Orange/TCDD)
- Added to presumptive list
- August 31, 2010
- Filing deadline
- No statutory deadline
- Diagnostic code
- 7005
Service required for this presumption
Qualifying service includes service in the Republic of Vietnam between January 9, 1962, and May 7, 1975, or other qualifying herbicide exposure locations. Independently, 38 USC § 1116A covers active military, naval, or air service offshore of the Republic of Vietnam in the area defined by § 1116A(d) during the period beginning on January 9, 1962, and ending on May 7, 1975. Offshore service requires no in-country duty or visitation and no inland-waterway service. Section 1116A(a) makes service connection "subject to section 1113 of this title" and covers "a disease covered by section 1116 of this title becoming manifest as specified in that section". Section 1116A(b) states: A veteran who, during active military, naval, or air service, served offshore of the Republic of Vietnam during the period beginning on January 9, 1962, and ending on May 7, 1975, shall be presumed to have been exposed during such service to an herbicide agent unless there is affirmative evidence to establish that the veteran was not exposed to any such agent during that service. Each route has its own authority: the Republic of Vietnam route is 38 CFR § 3.307(a)(6)(iii); the Korean DMZ route is 38 USC § 1116B(a)(2), which covers a veteran who served in or near the Korean Demilitarized Zone (DMZ) between September 1, 1967 and August 31, 1971, and names no unit requirement (38 CFR § 3.307(a)(6)(iv) still reads April 1, 1968 and speaks of service in a unit that, as determined by the Department of Defense, operated in or near the DMZ, but 1116B was added by the Blue Water Navy Vietnam Veterans Act of 2019, Public Law 116-23, effective January 1, 2020, and the statute controls); and the Thailand route of January 9, 1962 to June 30, 1976 at any United States or Royal Thai base is 38 USC § 1116(d)(2). The Vietnam ERA of 38 CFR § 3.2(f) is a wider window than this presumption and does not set its bounds.
About this presumption
Ischemic heart disease (IHD), including coronary artery disease (CAD), coronary heart disease, arteriosclerotic heart disease, unstable angina, myocardial infarction, and sudden cardiac death, is presumptively service-connected for herbicide-exposed veterans. TCDD is a known cardiovascular toxin that promotes atherosclerosis through oxidative stress, endothelial dysfunction, and lipid metabolism disruption. The National Academy of Medicine found "limited/suggestive evidence" sufficient to support presumptive status. Covers all forms of IHD including stable angina, NSTEMI, STEMI, and heart failure resulting from ischemic cardiomyopathy. The offshore area of 38 USC § 1116A(d), captured verbatim: Notwithstanding any other provision of law, for purposes of this section, the Secretary shall treat a location as being offshore of Vietnam if the location is not more than 12 nautical miles seaward of a line commencing on the southwestern demarcation line of the waters of Vietnam and Cambodia and intersecting the following points: Points Geographic Names Latitude North Longitude East At Hon Nhan Island, Tho Chu Archipelago Kien Giang Province 9°15.0′ 103°27.0′ At Hon Da Island southeast of Hon Khoai Island Minh Hai Province 8°22.8′ 104°52.4′ At Tai Lon Islet, Con Dao Islet in Con Dao-Vung Toa Special Sector 8°37.8′ 106°37.5′ At Bong Lai Islet, Con Dao Islet 8°38.9′ 106°40.3′ At Bay Canh Islet, Con Dao Islet 8°39.7′ 106°42.1′ At Hon Hai Islet (Phu Qui group of islands) Thuan Hai Province 9°58.0′ 109°5.0′ At Hon Doi Islet, Thuan Hai Province 12°39.0′ 109°28.0′ At Dai Lanh point, Phu Khanh Province 12°53.8′ 109°27.2′ At Ong Can Islet, Phu Khanh Province 13°54.0′ 109°21.0′ At Ly Son Islet, Nghia Binh Province 15°23.1′ 109° 9.0′ At Con Co Island, Binh Tri Thien Province 17°10.0′ 107°20.6′
Evidence still needed
A presumption does not remove the evidence requirement. VA still needs evidence of a current disability, which for this condition means a current diagnosis from a medical provider, and service records that show the qualifying service above. What it removes is the medical opinion connecting the two.
Service records; cardiology records documenting IHD (EKG, stress test, cardiac catheterization, coronary angiogram, echocardiogram); documentation of myocardial infarction if applicable; current treatment records. Hypertensive heart disease alone does NOT qualify, must be ischemic in nature.
Controlling legal authority
38 CFR § 3.309(e); 38 USC § 1116; VA Final Rule, 75 FR 53202 (August 31, 2010); 38 CFR § 3.307(a)(6); 38 USC § 1116A; 38 USC § 1116B
Related on VeteranHQ
- Arteriosclerotic Heart Disease (Coronary Artery Disease): 38 CFR Part 4 rating criteriaThe percentage tiers VA applies once service connection is established, under DC 7005.
- VA presumptive conditions, explainedHow presumptive service connection works, and what it does not cover.
- All presumptive conditions by exposureAgent Orange, PACT Act, Camp Lejeune, Gulf War, and ionizing radiation.
Questions About Ischemic Heart Disease and Presumptive Service Connection
Is Ischemic Heart Disease a VA presumptive condition?
Yes. VeteranHQ lists Ischemic Heart Disease as presumptive in the Agent Orange and Other Herbicides group, added to the list effective August 31, 2010, under 38 CFR § 3.309(e); 38 USC § 1116; VA Final Rule, 75 FR 53202 (August 31, 2010); 38 CFR § 3.307(a)(6); 38 USC § 1116A; 38 USC § 1116B. A presumption removes the requirement to prove a medical link to service. A current disability (for most conditions, a diagnosis) and qualifying service are still required, and VA decides the claim.
What service qualifies for the Ischemic Heart Disease presumption?
Qualifying service includes service in the Republic of Vietnam between January 9, 1962, and May 7, 1975, or other qualifying herbicide exposure locations. Independently, 38 USC § 1116A covers active military, naval, or air service offshore of the Republic of Vietnam in the area defined by § 1116A(d) during the period beginning on January 9, 1962, and ending on May 7, 1975. Offshore service requires no in-country duty or visitation and no inland-waterway service. Section 1116A(a) makes service connection "subject to section 1113 of this title" and covers "a disease covered by section 1116 of this title becoming manifest as specified in that section". Section 1116A(b) states: A veteran who, during active military, naval, or air service, served offshore of the Republic of Vietnam during the period beginning on January 9, 1962, and ending on May 7, 1975, shall be presumed to have been exposed during such service to an herbicide agent unless there is affirmative evidence to establish that the veteran was not exposed to any such agent during that service. Each route has its own authority: the Republic of Vietnam route is 38 CFR § 3.307(a)(6)(iii); the Korean DMZ route is 38 USC § 1116B(a)(2), which covers a veteran who served in or near the Korean Demilitarized Zone (DMZ) between September 1, 1967 and August 31, 1971, and names no unit requirement (38 CFR § 3.307(a)(6)(iv) still reads April 1, 1968 and speaks of service in a unit that, as determined by the Department of Defense, operated in or near the DMZ, but 1116B was added by the Blue Water Navy Vietnam Veterans Act of 2019, Public Law 116-23, effective January 1, 2020, and the statute controls); and the Thailand route of January 9, 1962 to June 30, 1976 at any United States or Royal Thai base is 38 USC § 1116(d)(2). The Vietnam ERA of 38 CFR § 3.2(f) is a wider window than this presumption and does not set its bounds. Service era: January 9, 1962 to May 7, 1975 (Republic of Vietnam, including its inland waterways, and the separate 38 USC § 1116A(d) offshore area); September 1, 1967 to August 31, 1971 (service in or near the Korean DMZ); January 9, 1962 to June 30, 1976 (a United States or Royal Thai base in Thailand). Service location: Republic of Vietnam (including inland waterways); the separate offshore area defined by 38 USC § 1116A(d), within 12 nautical miles seaward of the line in that subsection; Thailand (U-Tapao, Ubon, Nakhon Phanom, Udorn, Takhli, Korat, and Don Muang bases); Korean DMZ; Johnston Island; specific test and storage sites in the United States.
What evidence is still needed for a Ischemic Heart Disease claim?
Service records; cardiology records documenting IHD (EKG, stress test, cardiac catheterization, coronary angiogram, echocardiogram); documentation of myocardial infarction if applicable; current treatment records. Hypertensive heart disease alone does NOT qualify, must be ischemic in nature. A presumption removes the requirement to prove a medical link to service. A current disability (for most conditions, a diagnosis) and qualifying service are still required, and VA decides the claim.
Is there a filing deadline for Ischemic Heart Disease?
No statutory deadline
VeteranHQ publishes VA rules and the citations behind them. It does not prepare, file, or represent claims, and nothing here is legal advice or a prediction of what VA will decide.