VA Coronary Artery Disease Ratings in 2026: METs and Ejection Fraction
A VA CAD rating can change monthly compensation, but the VA usually looks past the diagnosis and into two numbers, METs and ejection fraction. That matters because a veteran can have real symptoms and still land in the wrong percentage if the medical record is thin.
The rating schedule can feel clinical, almost like a chart with too many moving parts. Once you see how the VA reads those parts, the picture gets clearer. Coronary artery disease claims often come down to how far you can go, how hard you can work, and how well the heart pumps.
How the VA reads coronary artery disease records
For a broader look at how VA disability ratings and compensation work, coronary artery disease fits the same percentage system the VA uses for other service-connected conditions. The VA is not rating the diagnosis alone. It is comparing test data, symptoms, and treatment history to the schedule.
A VA CAD rating often rises when the heart cannot handle ordinary exertion. A veteran who gets chest pain after light activity may fit a different bracket than someone who only needs medication and shows stable test results. The key is whether the medical file shows a limit that can be measured.
The VA also looks at whether your records line up. If one test is old and another says something different, the newer, better-supported record often matters more. That is why a heart claim needs more than a summary note. It needs reports that show what the heart did under stress.
When METs drop or ejection fraction falls, the rating usually climbs.
The 2026 VA coronary artery disease rating chart
Here is the current rating pattern in plain English. These are the thresholds that show up most often in VA coronary artery disease claims.
| VA rating | METs result | Ejection fraction result | What it usually means |
|---|---|---|---|
| 10% | 7.1 to 10 METs causes symptoms | Not required | Often daily medication controls the condition |
| 30% | 5.1 to 7 METs causes symptoms | Not required | May also show heart enlargement or thickening |
| 60% | 3.1 to 5 METs causes symptoms | 30% to 50% | Heart function is clearly limited |
| 100% | 3 METs or less causes symptoms | Less than 30% | May also involve chronic congestive heart failure |
The pattern is simple. Lower METs mean more limitation. Lower ejection fraction means a weaker pump. The 10% level can also rest on daily medication, while 100% can be supported by chronic congestive heart failure.
The VA considers symptoms like chest pain, shortness of breath, dizziness, and fatigue when they show up with exertion. Those symptoms matter because they help show how much strain the heart can handle before it gives out.
What METs mean on a heart test
METs stand for metabolic equivalents. In plain language, they show how much work your body can do before symptoms begin. A stress test often gives the number, but a doctor can also estimate it if exercise testing is unsafe. That matters because some veterans cannot be pushed on a treadmill after a heart event.
The VA uses the point where symptoms start, not just the fact that symptoms exist. If shortness of breath begins at a low workload, the METs score may support a higher rating. Chest pain, fatigue, and dizziness count too when they appear with exertion.
A score in the 5.1 to 7 range can support 30% when symptoms show up there. A score in the 3.1 to 5 range can support 60%. At 3 METs or less, the claim moves into 100% territory if the symptoms match. That is why even a small change in the number can matter so much.
A veteran might think the number is only for the cardiologist. It is not. It is one of the main pieces the VA uses to decide how limited the heart really is.
Why ejection fraction matters in a VA claim
Ejection fraction is the percentage of blood the left ventricle pushes out with each beat. It is usually measured on an echocardiogram, and sometimes on another imaging test. Lower percentages mean the heart pumps less efficiently.
For VA purposes, EF can carry a claim even when METs are not the most severe finding. An EF between 30% and 50% can support 60%. An EF below 30% can support 100%. Chronic congestive heart failure can also support 100%, even when the record includes more than one test.
This is why a veteran should never focus on only one result. A normal-looking EF does not erase low exercise tolerance. Likewise, a lower EF can outweigh a less dramatic METs result. The VA looks at the whole file, so the strongest number may come from whichever test shows the clearer limit.
That said, EF is not a guess. It should come from a real test, usually ordered by a cardiologist or other treating doctor. If the claim file only says “heart disease” without the number, the VA has less to work with.
Medical evidence that supports a stronger claim
The strongest claims usually follow medical documentation requirements for VA compensation. When the file is complete, the VA has less room to guess. The goal is to connect the diagnosis, the tests, and the day-to-day symptoms.
Useful records often include:
- A recent stress test or exercise tolerance report
- An echocardiogram, nuclear scan, or cath report that lists EF
- Cardiology notes that describe symptoms during activity
- Medication records, especially when daily medicine controls symptoms
- Hospital or ER records after chest pain or a heart event
If another service-connected condition is part of the picture, such as hypertension, VA hypertension rating criteria may matter too. Heart claims often sit beside other cardiovascular records, and the VA reads those files together. The more the records line up, the easier it is to show the true severity of the condition.
A clean file also helps when the VA asks how the condition affects ordinary life. If the same symptoms appear in clinic notes, test results, and treatment records, the claim reads as consistent. That kind of consistency carries weight.
Common mistakes that can pull a rating down
The biggest mistake is treating the diagnosis as enough. A coronary artery disease diagnosis proves the condition exists, but it does not prove the rating level. The VA still wants the numbers.
Another problem is using old tests after the condition has changed. If the latest echo or stress test is worse, it should be in the claim file. Old records can make a claim look milder than it really is.
Some veterans also leave out how symptoms show up in daily life. If walking across a parking lot leaves you winded, say so. If stairs bring on chest pain or dizziness, make that part of the record. Those details help the VA match the medical data to the real limit.
A VA CAD rating can also stall when the file is incomplete. If the evidence is thin, the VA may pick the lower supported level until better proof appears. That is why consistency matters from the first cardiology note to the last test.
Conclusion
In 2026, METs and ejection fraction still drive most coronary artery disease ratings. Those two numbers tell the VA how much strain the heart can handle and how well it pumps.
A clean file makes the decision easier. When the test results, symptoms, and treatment notes point in the same direction, the rating has a much clearer path. The diagnosis matters, but the numbers carry the most weight.