Heart valve replacement (prosthesis) — VA Rating Criteria (38 CFR DC 7016)
The VA rates Heart valve replacement (prosthesis) under 38 CFR 38 CFR § 4.104, Diagnostic Code 7016, from 100% to 100% based on the frequency and functional severity of symptoms. The maximum 100% rating requires For an indefinite period following date of hospital admission for valve replacement. Related conditions in the Cardiovascular body system share this rating framework.
What are the VA rating criteria for Heart valve replacement (prosthesis)?
For an indefinite period following date of hospital admission for valve replacement
“For an indefinite period following date of hospital admission for valve replacement”
How does the VA rate Cardiovascular conditions?
Common Questions About Heart valve replacement (prosthesis) VA Ratings
What is the VA disability rating for Heart valve replacement (prosthesis)?
The VA rates Heart valve replacement (prosthesis) under Diagnostic Code 7016 at the following tiers: 100%. The minimum 100% rating requires: For an indefinite period following date of hospital admission for valve replacement. The maximum 100% rating requires: For an indefinite period following date of hospital admission for valve replacement.
What is Diagnostic Code 7016?
Diagnostic Code 7016 is the VA rating identifier for Heart valve replacement (prosthesis) within 38 CFR 38 CFR § 4.104. It defines the specific symptom criteria and percentage thresholds a VA adjudicator uses to assign a disability rating. The diagnostic code is listed on a veteran's rating decision letter.
What is the highest rating for Heart valve replacement (prosthesis)?
The highest schedular rating for Heart valve replacement (prosthesis) under DC 7016 is 100%. This tier requires: For an indefinite period following date of hospital admission for valve replacement. Veterans who cannot secure substantially gainful employment due to Heart valve replacement (prosthesis) alone or in combination with other service-connected conditions may also qualify for TDIU at the 100% compensation rate under 38 CFR § 4.16.
What 38 CFR section governs Heart valve replacement (prosthesis) ratings?
Heart valve replacement (prosthesis) is rated under 38 CFR 38 CFR § 4.104, Diagnostic Code 7016. This section is part of the Schedule for Rating Disabilities (38 CFR Part 4) and can be read in full at the eCFR website.
Which conditions are commonly secondary to Heart valve replacement (prosthesis)?
Secondary conditions caused or aggravated by Heart valve replacement (prosthesis) may be ratable under 38 CFR § 3.310. Veterans should work with a VSO or accredited claims agent to document the medical relationship.
What evidence do I need to establish service connection for Heart valve replacement (prosthesis)?
Service connection for Heart valve replacement (prosthesis) requires three elements: (1) a current diagnosis of the condition, (2) an in-service event, injury, or disease that may have caused or aggravated it, and (3) a medical nexus connecting the current diagnosis to that in-service event. A nexus letter from a treating physician or independent medical examiner is the most reliable nexus evidence. C&P exam findings can also establish nexus if adequately documented.
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