Body system: Cardiovascular SystemRegulation: 38 CFR § 4.104DBQ: DBQ CARDIO Heart
Coronary bypass surgery (coronary artery bypass graft, CABG) creates new blood-flow pathways around blocked coronary arteries using blood vessels harvested from other parts of the body (internal mammary artery, radial artery, saphenous vein). The VA rates this condition at 100% for THREE MONTHS following the date of hospital admission for the surgery. After that 3-month window, the rating transitions to the General Rating Formula for Diseases of the Heart (38 CFR § 4.104), based on MET workload at which heart failure symptoms appear and any cardiac structural changes. Continuous cardiac medication required for control (very common after CABG) supports a 10% minimum rating.
Rating levels
- 100% — You qualify for 100% for THREE MONTHS following the date of HOSPITAL ADMISSION for coronary artery bypass graft (CABG) surgery. The 100% rating covers the surgical event plus the immediate 3-month recovery period. After that 3-month window, the rating transitions to the General Rating Formula for Diseases of the Heart tiers below, based on workload tolerance and any residual cardiac structural changes.
- 100% — After the 3-month post-CABG window, you qualify for 100% under the General Rating Formula if exercise testing shows a workload of 3.0 METs or less brings on heart failure symptoms. 3.0 METs is roughly slow walking on a level surface.
- 60% — You qualify for 60% if a workload of 3.1 to 5.0 METs brings on heart failure symptoms. The 3-5 MET range covers light housework, slow walking, and dressing.
- 30% — You qualify for 30% if a workload of 5.1 to 7.0 METs brings on heart failure symptoms, OR you have evidence of cardiac hypertrophy or dilatation on echocardiogram, Doppler echo, MUGA, or cardiac MRI.
- 10% — You qualify for 10% if a workload of 7.1 to 10.0 METs brings on heart failure symptoms, OR you require continuous cardiac medication (statins, beta blockers, ACE inhibitors, anti-anginal agents, antiplatelet therapy, etc.) for control. Note: nearly all post-CABG patients require continuous cardiac medication, which by itself supports the 10% minimum even with otherwise normal METs.