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Congestive Heart Failure and VA Disability

Picture of Leah Bucholz

Leah Bucholz

Leah Bucholz, PA-C, is a Board-Certified Physician Assistant, U.S. Army combat veteran, and nationally recognized medical expert in veterans’ disability claims. A former VA Compensation & Pension examiner, she founded Prestige Veteran Medical Consulting to provide independent, regulation-based medical opinions (“nexus” letters) grounded in the VA’s Schedule for Rating Disabilities (38 CFR). Leah’s work is frequently cited in favorable Board of Veterans’ Appeals decisions, and her content draws directly from authoritative sources such as VA.gov, the eCFR, and the Federal Register.
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Congestive Heart Failure and VA Disability

At Prestige Veteran Medical Consulting, our blogs are written and reviewed by licensed medical professionals or military veterans with direct experience in the VA claims process. Our team has served as healthcare providers, combat veterans, and former VA examiners — giving us unique insight into both the medical and regulatory side of benefits. Every article is designed to provide accurate, trustworthy, and practical guidance so that veterans and their families can make informed decisions with confidence.

Congestive Heart Failure, commonly known as CHF, is one of the most serious chronic conditions affecting veterans today. While many people think of it simply as “heart trouble,” CHF is far more complex. It affects energy levels, mobility, and even life expectancy. Because of this, veterans living with CHF may qualify for significant VA disability benefits.

Leah explains what CHF is, how the VA rates it, what medical research says about its causes, the role of toxic exposures, and how secondary service connections can increase a veteran’s compensation. You’ll also find guidance for filing a claim and essential resources available to veterans who live with this life-changing condition.

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What Is Congestive Heart Failure?

Congestive heart failure occurs when the heart cannot pump blood effectively enough to meet the body’s needs. Contrary to what some think, it does not mean the heart has stopped working. Instead, the heart may be weaker than normal, or the walls may be too stiff to pump efficiently.

Common symptoms include:

  • Shortness of breath, even during light activity or rest

  • Swelling in the legs, feet, or ankles

  • Fatigue and weakness

  • Difficulty exercising or completing routine daily activities

  • Sudden weight gain due to fluid retention

For many veterans, these symptoms become daily obstacles. Walking, standing for long periods, or even lying flat to sleep can become difficult. CHF is typically progressive, meaning it requires lifelong monitoring and treatment.

What Research Shows About CHF in Veterans

Heart disease is one of the leading health concerns among the veteran population. Several studies show why CHF is particularly common among veterans:

Higher Rates of Underlying Conditions

Research from the Journal of the American Heart Association shows that veterans are more likely to have:

  • Hypertension

  • Diabetes

  • Obesity

All of these conditions significantly increase the risk of heart failure.

PTSD and Heart Disease

A 2021 study in Circulation: Heart Failure found that veterans with PTSD have a much higher likelihood of developing cardiovascular disease. Chronic stress and systemic inflammation appear to play major roles.

Toxic Exposures

Service-related exposures have also been linked to heart problems:

  • Agent Orange

  • Burn pits

  • Other toxic airborne hazards

Some of these exposures are already recognized as presumptive by the VA, meaning veterans do not have to prove a direct connection between exposure and illness.

Together, these factors demonstrate that CHF in veterans is not simply a result of aging. It is often tied directly to the unique risks associated with military service.

How the VA Rates Congestive Heart Failure

CHF is evaluated under the VA’s cardiovascular rating system, primarily using:

  • METs (Metabolic Equivalent Tests)

  • Left Ventricular Ejection Fraction (LVEF)

  • Frequency of CHF episodes

Below is a breakdown of the common rating levels.

100 Percent Rating

You may receive 100 percent if you have:

  • Chronic congestive heart failure

  • LVEF under 30%

  • Symptoms at 3 METs or less, such as shortness of breath after dressing or performing very light activity

This rating is for severe, limiting CHF that impacts nearly every aspect of daily life.

60 Percent Rating

Typically awarded for:

  • More than one acute CHF episode within the last year

  • Symptoms at 3–5 METs

  • LVEF between 30% and 50%

This is still considered significant cardiac impairment.

30 Percent Rating

This level may apply if:

  • Symptoms appear at 5–7 METs, such as brisk walking or climbing stairs

  • There is medical evidence of heart enlargement

10 Percent Rating

Usually applies when:

  • Symptoms occur at 7–10 METs, such as during jogging or heavy lifting

  • Continuous medication is required

As with most VA ratings, the lower your heart function and the greater your daily limitations, the higher the disability percentage.

Secondary Service Connections and CHF

Many veterans qualify for CHF service connection through related or underlying conditions. Sometimes CHF is the result of an already service-connected illness. Other times, CHF itself can cause additional health problems.

Conditions That Can Lead to CHF

These may serve as the foundation for a secondary service connection:

  • Hypertension – Frequently service connected for veterans exposed to Agent Orange

  • Type 2 diabetes – Also linked to Agent Orange

  • PTSD and chronic stress – Known contributors to cardiovascular disease

  • Sleep apnea – Can raise blood pressure and strain the heart

  • Ischemic heart disease – Often precedes CHF

Conditions Caused by CHF

CHF doesn’t just result from other issues; it can also be the cause of other disabilities. These too may qualify for secondary service connection:

  • Chronic kidney disease

  • Depression or anxiety

  • Musculoskeletal deconditioning

  • Reduced mobility leading to obesity

Obesity is often an intermediate factor. For example:

  • A veteran may gain weight due to reduced mobility caused by CHF

  • The weight gain may then worsen other service-connected conditions

  • This creates a chain of medically recognized secondary connections

Understanding these links is essential because they can significantly increase your VA compensation.

Daily Challenges for Veterans with CHF

Living with CHF can affect nearly every aspect of life.

Veterans may experience:

  • Difficulty completing simple household tasks

  • Trouble walking long distances

  • Frequent hospitalizations

  • Medication side effects

  • Emotional strain and anxiety about their health

Because CHF is progressive, many veterans also worry about long-term independence and future medical needs. Emotional health often becomes just as important as physical treatment.

Filing a VA Disability Claim for CHF

Veterans filing for CHF should gather clear and thorough medical documentation. You can file on your own through VA.gov, or you can get help from a Veteran Service Organization.

Key components of a strong claim include:

1. A Confirmed Diagnosis

Typically supported by:

  • Echocardiogram results

  • Stress test results

  • METs testing

  • Ejection fraction measurements

2. Explanation of Service Connection

Show how your CHF is:

  • Directly caused by service, or

  • Secondary to a different service-connected condition

3. Medical Records

Include:

  • Hospitalization records

  • Treatment notes

  • Test results

  • Documentation of secondary symptoms (kidney issues, depression, sleep apnea, etc.)

4. Compensation and Pension (C&P) Exam

If the VA orders a C&P exam, the examiner will:

  • Review your medical history

  • Ask questions about limitations and symptoms

  • Assess whether your CHF is linked to military service

Their opinion becomes part of your claim file, so accuracy and clarity are crucial.

Resources Available to Veterans

Veterans with CHF are not alone. Several organizations and services can help:

  • VA Cardiology Clinics – Diagnosis, medications, and follow-up care

  • Primary Care Providers – Ongoing management and referrals

  • Veteran Service Organizations (DAV, VFW, American Legion) – Help with filing and appealing claims

  • American Heart Association – Education and patient support

  • Veterans Crisis Line (988, press 1) – Support during emotional or mental health struggles

Final Thoughts

Congestive heart failure is a serious and life-changing condition, but the VA does recognize its impact on veterans’ lives. Whether your CHF is directly related to service or worsened by conditions such as hypertension, diabetes, PTSD, or toxic exposures, you may qualify for meaningful disability compensation.

Understanding the rating criteria, gathering the right medical evidence, and exploring secondary connections can make a significant difference in the outcome of your claim. With the right support and resources, veterans living with CHF can secure the benefits they deserve.

Also Read: Benign Prostate Hyperplasia (BPH) and VA Disability

At Prestige Veteran Medical Consulting, a veteran-owned company, we specialize in Independent Medical Opinions (IMOs) known as Nexus letters.

Our purpose is to empower YOU, the veteran, to take charge of your medical evidence and provide you with valuable educational tools and research to guide you on your journey.

Understanding the unique challenges veterans face, our commitment lies in delivering exceptional service and support.

Leveraging an extensive network of licensed independent medical professionals, all well-versed in the medical professional aspects of the VA claims process, we review the necessary medical evidence to incorporate in our reports related to your VA Disability Claim.

Prestige Veteran Medical Consulting is not a law firm, accredited claims agent, or affiliated with the Veterans Administration or Veterans Services Organizations. However, we are happy to discuss your case with your accredited VA legal professional.

Picture of Alan Bucholz, PA-C

Alan Bucholz, PA-C

Board-Certified Physician Assistant | U.S. Army Combat Veteran | Co-founder & CFO, Prestige Veteran Medical Consulting

This article was medically reviewed and fact checked by Alan Bucholz, PA-C, a board-certified Physician Assistant and retired U.S. Army combat veteran with experience in emergency medicine and two combat deployments (Iraq & Afghanistan). As Co-founder of Prestige Veteran Medical Consulting, Alan provides evidence-based medical opinions to support veterans’ VA disability claims with accuracy, compliance, and ethics.

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​“It is essential to remember that there is no greater honor than caring for service members on the battlefield. Continuing to care for Veterans after separation is an opportunity that I have been afforded to extend that care in this new battlefield related to service-incurred disabilities.”

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