Can I obtain VA disability benefits for congestive heart failure?

Yes, VA disability benefits for your congestive heart failure may be available.

You will need to prove that (a) you were in the military, (b) your congestive heart failure originated or was aggravated while you were on active duty, (c) you were continuously treated for your congestive heart failure since leaving the service (unless you are filing your disability claim within one year of leaving the service or your condition has been chronic), and (d) you are currently disabled by your congestive heart failure.

The cardiovascular system

Before discussing heart failure, a brief description of the cardiovascular system is needed. The heart is normally a four-chambered muscle situated behind and to the left of the sternum (breast bone). The upper chambers are the left atrium and right atrium. The lower chambers are the left and right ventricles. The ventricles are much larger than the atria.

Figure 1: An anterior view of the heart, featuring the atria, ventricles, and arteries.

Oxygen depleted blood from the veins returns to the heart from the body’s tissues. It enters the right atrium and flows through the tricuspid valve into the right ventricle. The right ventricle pumps blood through the pulmonary valve and into the pulmonary arteries for re-oxygenation by the lungs.

Oxygenated blood from the lungs returns to the left atrium of the heart by pulmonary veins and passes through the mitral valve into the left ventricle. From the left ventricle, newly oxygenated blood is ejected through the aortic valve into the aorta, which is the parent artery of all of the body’s other arteries.

Figure 2: The heart during contraction.

The arterial system of the body that receives blood pumped out of the left ventricle is known as the systemic circulation. The blood moving from the right ventricle through the lungs is called the pulmonary circulation. The valves are important because they open only in one direction, so that blood flow always moves the right way when the heart contracts.

About congestive heart failure and disability

Congestive heart failure, also known as chronic heart failure, is the inability of the heart to pump enough oxygenated blood to the body tissues. Congestive or chronic heart failure (CHF) affects about 5 million people in the U.S., and is increasing due to the aging of the population.

The heart’s ability to pump blood may be impaired by a variety of causes including myocardial infarction (heart attack), ischemic heart disease (decreased blood flow to heart muscle, usually as a result of coronary artery disease), and cardiomyopathy. The failure of the ventricles to pump blood efficiently results in blood accumulating in the heart, and enlargement of the ventricles.

Symptoms and signs of congestive heart failure

To establish that you have chronic heart failure for the purpose of receiving VA disability benefits, your medical history and physical examination should describe characteristic symptoms and signs of pulmonary or systemic congestion or of limited cardiac output. And these signs and symptoms should be associated with the abnormal findings on appropriate medically acceptable imaging.

Symptoms of congestion or of limited cardiac output include:

  • Easy fatigue
  • Weakness
  • Shortness of breath on exertion
  • Coughing
  • Chest discomfort at rest or with activity
  • Shortness of breath on lying flat
  • Sudden shortness of breath while sleeping
  • Cardiac arrhythmias resulting in palpitations, lightheadedness, or fainting

Signs of congestion may include:

  • An enlarged liver
  • Fluid accumulation in the abdomen
  • Increased jugular vein distention or pressure
  • Rales (abnormal breath sounds heard with a stethoscope listening over the lungs, especially the bases of the lungs)
  • Peripheral edema (fluid retention and swelling in the extremities)
  • Rapid weight gain

However, these signs need not be found on all examinations because fluid retention may be controlled by treatment.

Categories of limitations for heart disease

Whatever the nature of heart disease, limitations on your ability to work will always fall into certain broad categories. You may have limitations from:

  1. Anginal chest pain
  2. Shortness of breath
  3. Weakness
  4. Easy fatigability
  5. Life-threatening arrhythmia
  6. Environmental factors