Coronary artery disease VA claims: Agent Orange, secondary conditions and what the Board grants

Where VA presumes the link

Is coronary artery disease presumptive for Agent Orange?

Yes. Ischemic heart disease is on the herbicide list in 38 CFR 3.309(e), and the list names coronary artery disease, heart attacks (myocardial infarction), coronary bypass surgery and angina. For a veteran with presumed herbicide exposure, VA presumes the link to service without a medical opinion. The list leaves out hypertension, peripheral vascular disease and stroke. In decisions that mention Agent Orange or other herbicides, the Board granted 48.5% of coronary artery disease claims (2,263 of 4,670), against 30.8% overall.

Granted

All coronary artery disease claims

30.8%

Agent Orange or other herbicides

48.5%

Vietnam, in country

38.0%

Blue Water Navy (offshore)

35.4%

Korean DMZ

39.4%

Thai air base service

74.6%

Udorn, Thailand

72.9%

Korat, Thailand

74.0%

U-Tapao, Thailand

76.6%

Share of decided claims granted; a remand counts as not granted. One count per veteran. Each row is what the decision mentions; rows overlap, and a mention is not proof of qualifying service.

Where did heart disease claims do best?

In decisions that record service at a Thai air base: 74.6% granted (762 of 1,021). Since the PACT Act took effect in August 2022, VA presumes herbicide exposure for service at any United States or Royal Thai base in Thailand from January 1962 to June 1976, whatever the veteran's job (M21-1 VIII.i.1.A). Decisions that record service in Vietnam itself came out at 38.0%, and Blue Water Navy service at 35.4%.

By base, the Board granted 81.8% at Ubon, 76.6% at U-Tapao (210 of 274), 74.0% at Korat, 72.9% at Udorn and 69.6% at Takhli. Korean DMZ service came out at 39.4%. The decisions do not show why Thai base claims did better than Vietnam claims at the Board.

Two other presumptions reach heart disease. Any former prisoner of war gets atherosclerotic heart disease and its complications, such as a heart attack, presumed once it is disabling to a compensable degree, whatever the length of captivity (38 CFR 3.309(c)). Too few of these claims show up in the decisions to measure. And arteriosclerosis is a chronic disease presumed service connected when it is disabling to a compensable degree within a year of leaving service (38 CFR 3.307(a)(3) and 38 CFR 3.309(a)).

Coronary artery disease claimed secondary to another condition

Can coronary artery disease be secondary to hypertension?

Yes. Hypertension is not ischemic heart disease under the Agent Orange list, but a service-connected condition that causes or worsens heart disease can carry it under 38 CFR 3.310. Hypertension is the condition coronary artery disease is most often claimed secondary to: the Board granted 77 of 219 (35.2%). Claims secondary to PTSD were granted 25.6% and to diabetes 25.0%.

Granted

All coronary artery disease claims

30.8%

Depression (major depressive disorder)

42.9%

Sleep apnea

37.5%

Hypertension

35.2%

PTSD

25.6%

Diabetes

25.0%

Share of decided claims granted; a remand counts as not granted. One count per veteran. Secondary claims are the ones the Board marked as secondary to that condition.

Coronary artery disease claimed secondary to	Granted	Veterans	Share
Hypertension	77	219	35.2%
PTSD	45	176	25.6%
Diabetes	29	116	25.0%
Sleep apnea	18	48	37.5%
Depression (major depressive disorder)	12	28	42.9%

Claims made secondary to hypertension, sleep apnea or depression did better than coronary artery disease claims overall; those made secondary to PTSD or diabetes did a little worse. In the grants below, the Board relied on a medical opinion that explained how the service-connected condition led to the heart disease.

How VA rates coronary artery disease

How does VA rate coronary artery disease?

Under DC 7005 with the General Rating Formula for Diseases of the Heart in 38 CFR 4.104, from 10 percent, when continuous medication is needed or symptoms appear only at a high workload, to 100 percent, when symptoms such as breathlessness, fatigue, angina or dizziness appear at the lightest workload. The workload is measured in METs, usually on an exercise test; when a test cannot be done for medical reasons, the examiner may estimate it (38 CFR 4.100 and 38 CFR 4.104).

What follows from coronary artery disease

What conditions can be claimed secondary to coronary artery disease?

The most common are hypertension (13.6% granted), sleep apnea (19.4%) and erectile dysfunction (43.2%). A fast heart rhythm (supraventricular tachycardia) was granted 50.0% and bleeding in the brain (stroke) 26.2%. The rule also runs the other way: heart disease that develops after a service-connected leg amputation at or above the knee, or both legs at or above the ankles, is held to follow from it (38 CFR 3.310(c)).

Claimed secondary to coronary artery disease	Granted	Veterans	Share
Hypertension	32	235	13.6%
Sleep apnea	42	216	19.4%
Erectile dysfunction	38	88	43.2%
Peripheral artery disease	16	84	19.0%
COPD	7	61	11.5%
Stroke (bleeding in the brain)	11	42	26.2%
Supraventricular tachycardia	20	40	50.0%

Look up your client's group

Every base, exposure, job and medal with at least 15 decided coronary artery disease claims, 146 groups in all; 21 fall under a presumption.

Bases 56Service history 23Exposures 28Military jobs 26Medals 13

Bar: share of this group's coronary artery disease claims the Board granted. Red line: all coronary artery disease claims, 30.8% granted. A bar past the line won more often than usual.

×

More often than usual: how much more often coronary artery disease comes up in this group's decisions than in all Board decisions. It shows how common the condition is here, not how often it wins.

Set aside

For groups VA does not presume, veterans whose decision shows service VA already presumes for coronary artery disease (for example Vietnam or Thailand for Agent Orange) are left out, because for them the presumption is the answer.

Sort byGrant shareMore often than usualClaims decided

• Camp Friendship

  Presumed by law · 38 CFR 3.309(e)
  85.7% granted · 18 of 21

  11.7×more often

• Ubon Royal Thai Air Force Base, Thailand

  Presumed by law · 38 CFR 3.309(e)
  81.8% granted · 90 of 110

  10.6×more often

• U-Tapao Royal Thai Air Force Base, Thailand

  Presumed by law · 38 CFR 3.309(e)
  76.6% granted · 210 of 274

  10.1×more often

• Nakhon Phanom Royal Thai Air Force Base, Thailand

  Presumed by law · 38 CFR 3.309(e)
  76.1% granted · 89 of 117

  9.8×more often

• Royal Thai Air Force Base (RTAFB) in Korat, Thailand

  Presumed by law · 38 CFR 3.309(e)
  74.0% granted · 165 of 223

  9.4×more often

• Udorn Royal Thai Air Force Base, Thailand

  Presumed by law · 38 CFR 3.309(e)
  72.9% granted · 159 of 218

  9.3×more often

• Don Muang Royal Thai Air Force Base

  Presumed by law · 38 CFR 3.309(e)
  72.2% granted · 13 of 18

  9.2×more often

• Takhli Royal Thai Air Force Base, Thailand

  Presumed by law · 38 CFR 3.309(e)
  69.6% granted · 103 of 148

  11.3×more often

• Da Nang AFB

  Presumed by law · 38 CFR 3.309(e)
  57.0% granted · 118 of 207

  7.3×more often

• Vung Tau Air Base

  Presumed by law · 38 CFR 3.309(e)
  56.3% granted · 9 of 16

  9.9×more often

• Tan Son Nhut Air Force Base

  Presumed by law · 38 CFR 3.309(e)
  50.0% granted · 21 of 42

  8.3×more often

• Andersen AFB, Guam

  Presumed by law · 38 CFR 3.309(e)
  43.1% granted · 22 of 51

  7.5×more often

• Cam Ranh Bay Air Base

  Presumed by law · 38 CFR 3.309(e)
  40.0% granted · 20 of 50

  7.9×more often

• Fort McClellan, Alabama
  20.0% granted · 5 of 25 · 58 with presumptive service set aside

  2.2×more often

• Camp Lejeune
  19.4% granted · 28 of 144 · 77 with presumptive service set aside

  1.2×more often

41 more groups: too few claims to judge once veterans with presumptive service are set aside

• Osan Air Force Base: 1 of 28 claims left, 27 set aside
• USS Coral Sea: 2 of 30 claims left, 28 set aside
• Marine Corps Base Camp Pendleton, California: 8 of 20 claims left, 12 set aside
• USS America: 3 of 41 claims left, 38 set aside
• USS Kitty Hawk: 3 of 45 claims left, 42 set aside
• Fort Benning: 4 of 18 claims left, 14 set aside
• Fort Dix, NJ: 9 of 19 claims left, 10 set aside
• Fort Campbell: 5 of 19 claims left, 14 set aside
• Fort Knox: 6 of 22 claims left, 16 set aside
• Fort Ord: 14 of 25 claims left, 11 set aside
• Camp Carroll, South Korea: 0 of 21 claims left, 21 set aside
• Camp Casey: 3 of 124 claims left, 121 set aside
• Camp Howze: 0 of 15 claims left, 15 set aside
• Camp Humphreys: 0 of 21 claims left, 21 set aside
• Camp Page, Korea: 1 of 26 claims left, 25 set aside
• Camp Red Cloud: 0 of 33 claims left, 33 set aside
• Clark Air Force Base, Philippines: 0 of 36 claims left, 36 set aside
• Eglin AFB, Florida: 1 of 26 claims left, 25 set aside
• Fort Bragg: 2 of 15 claims left, 13 set aside
• Fort Chaffee, Arkansas: 1 of 23 claims left, 22 set aside
• Fort Gordon (Eisenhower): 2 of 42 claims left, 40 set aside
• Fort Hood: 7 of 17 claims left, 10 set aside
• Fort Lewis, Washington: 3 of 18 claims left, 15 set aside
• Fort Polk: 3 of 24 claims left, 21 set aside
• Kadena AFB: 2 of 69 claims left, 67 set aside
• Kadena Air Force Base, Okinawa, Japan: 2 of 57 claims left, 55 set aside
• Kunsan Air Force Base: 1 of 17 claims left, 16 set aside
• Subic Bay Naval Station: 0 of 72 claims left, 72 set aside
• Travis AFB: 3 of 20 claims left, 17 set aside
• USS Bennington: 0 of 15 claims left, 15 set aside
• USS Bon Homme Richard: 1 of 18 claims left, 17 set aside
• USS Constellation: 1 of 39 claims left, 38 set aside
• USS Enterprise: 4 of 46 claims left, 42 set aside
• USS Forrestal: 4 of 20 claims left, 16 set aside
• USS Franklin D. Roosevelt: 1 of 18 claims left, 17 set aside
• USS Intrepid: 0 of 25 claims left, 25 set aside
• USS Kearsarge: 0 of 19 claims left, 19 set aside
• USS Midway: 3 of 16 claims left, 13 set aside
• USS Oriskany: 2 of 23 claims left, 21 set aside
• USS Ranger: 2 of 28 claims left, 26 set aside
• USS Ticonderoga: 2 of 27 claims left, 25 set aside

Read the decisions

Recent decisions, with the Board's reasoning as summarized by AI:

• A25095171, November 2025: heart disease, including ischemic heart disease and coronary artery disease, granted on herbicide exposure at Korat air base in Thailand; the Board applied the PACT Act presumption and also found the veteran's duties placed them near the base perimeter.
• A25090573, October 2025: coronary artery disease with congestive heart failure granted; the Board found herbicide exposure at Nakhon Phanom air base in Thailand on the facts, with the evidence in balance.
• A25061733, July 2025: coronary artery disease granted secondary to service-connected hypertension, with the evidence in balance and the benefit of the doubt to the veteran.
• A25045381, May 2025: coronary artery disease granted secondary to service-connected PTSD, on a persuasive private medical opinion.
• A25104826, December 2025: coronary artery disease, hypertension and heart failure granted secondary to service-connected knee conditions, then cardiomyopathy secondary to the coronary artery disease, hypertension and diabetes.
• A25108186, December 2025: coronary artery disease claimed secondary to high cholesterol denied; high cholesterol is a laboratory finding, not a disability VA can service connect, so it cannot carry a secondary claim.

What the data cannot tell you

The counts follow DC 7005, so they include some claims for related heart conditions coded there. The groups come from what each decision mentions; a mention is not proof of service or exposure, and a decision can fall in more than one group. Secondary counts include only claims the Board marked as secondary to a condition. These are historical outcomes, not predictions.

For representatives

• Prove the qualifying service and dates first; for a herbicide-exposed veteran with ischemic heart disease, the presumption carries the link.
• For a Thai air base, show service on the base within the dates; since the PACT Act, no particular job or perimeter duty is needed.
• Check the diagnosis fits ischemic heart disease. Hypertension, peripheral vascular disease and stroke are not on the list as heart disease and need their own route.
• Without presumptive service, look at service-connected hypertension, PTSD, diabetes or sleep apnea, and get an opinion that explains how it caused or worsened the heart disease.
• Ask for METs testing, or the examiner's estimate when testing cannot be done; the rating turns on it.