Diagnostic Code 7016 · 38 CFR §4.104
Heart valve replacement involves surgical implantation of a prosthetic (mechanical or biological) valve to replace a diseased or damaged natural heart valve. The most commonly replaced valves in veterans are the aortic and mitral valves, often due to conditions that developed during or were aggravated by military service. The VA provides a mandatory 100 percent rating for one year following valve replacement surgery to allow for recovery. After one year, the condition is re-evaluated based on residual symptoms and exercise capacity. Most veterans with prosthetic heart valves require lifelong anticoagulation medication (for mechanical valves) or ongoing cardiac monitoring, and many experience persistent exercise limitations. The long-term rating depends on METs capacity, ejection fraction, and whether congestive heart failure is present.
| Rating | Criteria |
|---|---|
| 100% | |
| 60% | |
| 30% | |
| 10% |
Operative report documenting the valve replacement surgery and type of prosthetic valve implanted. Post-surgical cardiology records showing recovery progress and any complications. Exercise stress test with METs measurement performed after the one-year recovery period. Echocardiogram showing valve function, ejection fraction, and any structural abnormalities. Records of anticoagulation therapy and INR monitoring for mechanical valves. Documentation of any congestive heart failure episodes. Service treatment records or medical opinions connecting the underlying valve disease to military service.