Body system: Cardiovascular SystemRegulation: 38 CFR § 4.104
Cardiac transplantation covers veterans who have received a heart transplant. The VA rates this condition at 100% for AT LEAST ONE YEAR from the date of hospital admission for the transplantation surgery. After that 1-year minimum window, the rating transitions to the General Rating Formula for Diseases of the Heart (38 CFR § 4.104) based on the transplant function: 100% if heart failure symptoms appear at ≤3.0 METs; 60% at 3.1-5.0 METs. A 30% MINIMUM rating applies INDEFINITELY for as long as the transplant is in place, regardless of how well the new heart is functioning, because lifelong immunosuppressive therapy and ongoing transplant monitoring are required.
Rating levels
- 100% — You qualify for 100% for AT LEAST ONE YEAR from the date of hospital admission for cardiac transplantation. The 100% rating covers the surgery, immediate post-operative period, and the first full year of recovery. After that 1-year minimum, the rating transitions to the General Rating Formula for Diseases of the Heart based on transplant function and residuals, with a 30% MINIMUM floor that applies indefinitely.
- 100% — After the 1-year post-transplant 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, so this rating means even minimal activity provokes symptoms.
- 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% — The 30% MINIMUM rating under DC 7019 is a floor that applies INDEFINITELY for as long as you have the cardiac transplant, regardless of how well the new heart is functioning under the General Rating Formula. If the General Formula MET-based evaluation would yield a higher percentage (60% or 100%), the higher value applies. If it would yield less than 30% (10% or no compensable rating), the 30% floor still applies. Lifelong immunosuppressive therapy is required after cardiac transplantation, which alone supports continued compensation.