Vietnam veterans and coronary artery disease: a claim map

The claim map

A claim map follows one veteran's route: where they served, the condition VA presumes for that service, and the conditions that follow from it. Each box shows how the Board ruled at that step.

Where they served

Vietnam

Service in the Republic of Vietnam or its offshore waters, January 1962 to May 1975

59,560 Board decisions that name Vietnam

presumed by law38 CFR 3.309(e)

Step 1 · presumed by law

Coronary artery disease

44.1% granted

911 of 2,067 veterans · all coronary artery disease claims 35.4%

secondary38 CFR 3.310(a)

Step 2 · claimed secondary to coronary artery disease

44.4%granted when the same decision granted the coronary artery disease

0.0%granted when it did not

Step 2 depends on step 1: a secondary claim needs a service-connected condition to attach to.

• Hypertension DC 7101

  7.1% · 6 of 85

  all veterans 10.7%Also presumed on its own (PACT Act)

• Sleep apnea DC 6847

  16.3% · 7 of 43

  all veterans 17.5%

• COPD DC 6604

  10.3% · 3 of 29

  all veterans 13.3%

• Peripheral artery disease DC 7114

  20.8% · 5 of 24

  all veterans 18.6%

• Erectile dysfunction DC 7522

  43.5% · 10 of 23

  all veterans 44.6%→ may open special monthly compensation

Bar: share granted in Board decisions that name Vietnam (one count per veteran; a remand counts as not granted). Red mark: all veterans with the same claim. Step 2 counts claims decided in the same decision; conditions with at least 15 veterans.

Is coronary artery disease presumptive for Vietnam veterans?

Yes. Ischemic heart disease is on the herbicide list in 38 CFR 3.309(e), and it includes coronary artery disease, heart attacks, coronary bypass surgery and stable or unstable angina. In decisions that name Vietnam, the Board granted 44.1% of coronary artery disease claims, against 35.4% for all veterans.

The presumption covers the link between the exposure and the heart disease, at any time after service. 59,560 Board decisions from 2020 to 2025 name Vietnam; this page counts the claims rated under DC 7005, coronary artery disease.

Does ischemic heart disease include hypertension?

No. 38 CFR 3.309(e) says ischemic heart disease does not include hypertension, peripheral artery disease or stroke. Hypertension has its own place on the herbicide list since the PACT Act (38 U.S.C. 1116), so it can be claimed directly instead of as secondary to heart disease.

Medically, high blood pressure usually comes first and is a risk factor for heart disease, not the other way round. That is why secondary claims for hypertension rarely win, and why the PACT Act route is the stronger one.

Why are coronary artery disease claims denied?

For 385 denials, the Board's note named the exposure or the service in 56.4% of them, often because the Board did not find qualifying service, and a medical link in 59.7%. In 72 of 407 denials the decision said there was no current diagnosis of ischemic heart disease.

In the denial below, the records did not show ischemic heart disease at all. A diagnosis from a cardiologist, with the test results behind it, is the first thing to check.

What conditions follow from coronary artery disease?

They are harder to win. In the same decisions, hypertension claimed secondary to coronary artery disease was granted for 6 of 85 veterans (7.1%), sleep apnea for 7 of 43, and erectile dysfunction for 10 of 23.

In the same decisions, 325 veterans had a claim secondary to coronary artery disease. Where the heart disease was not on appeal, usually because it was already service connected, 16.1% of those secondary claims were granted.

Read the decisions

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

• A25109186, December 2025: coronary artery disease granted on the herbicide presumption for service in the Republic of Vietnam, with the evidence of the diagnosis in balance.
• A25108005, December 2025: coronary artery disease granted on the presumption; the Board found the veteran was exposed to herbicides in 1968, resolving doubt in the veteran's favor.
• A25092011, October 2025: ischemic heart disease denied; VA medical records did not show the diagnosis, and earlier reviews were negative for ischemia.

What the data cannot tell you

The Vietnam group comes from the places each decision names; it includes ships off the coast that may not qualify. Service-connection claims only; rating appeals are left out. The count follows DC 7005; heart attacks and other ischemic conditions coded elsewhere are not included. The second step counts only claims decided in the same decision. These are historical outcomes, not predictions.

For representatives

• Settle the service first: land service, or a ship in qualifying waters.
• Make sure the diagnosis is documented as ischemic heart disease, with the tests behind it.
• Claim hypertension under its own PACT Act presumption, not as secondary to heart disease.