Atrioventricular Block (Heart Block)

DC 7015Cardiovascular38 CFR 4.104, DC 7015

A condition where the electrical signals that tell your heart when to beat are delayed or blocked between the upper and lower chambers. The VA rates heart block using the standard heart rating formula based on METs, ejection fraction, and whether you need a pacemaker.

Rating Levels

Your workload capacity is 3 METs or less causing symptoms, or you have ongoing congestive heart failure, or your heart pumps at less than 30 percent of normal, or you are pacemaker-dependent with major limits on what you can do.

What the VA looks for

Chronic congestive heart failure
Workload capacity of 3 METs or less
Left ventricular ejection fraction less than 30%
Complete pacemaker dependence documented
Significant functional limitations from cardiac condition
Severe exercise limitation

Common Pitfalls

⚠Not documenting your pacemaker implantation and dependence — a pacemaker is strong evidence of serious heart block. Keep all surgical records, device cards, and pacemaker interrogation reports.
⚠Not getting an exercise stress test or METs estimation — the rating depends on your measured workload capacity. If you have a pacemaker and cannot do a standard treadmill test, the examiner can estimate METs based on your daily activities.
⚠Not keeping records of pacemaker adjustments and complications — if your device needs frequent reprogramming, battery replacements, or lead revisions, this supports a higher rating by showing ongoing cardiac impairment.
⚠Not connecting heart block to in-service cardiac events, medications, or exposures — heart block can develop from cardiac surgery, infections (like Lyme disease during service), or toxic exposures.
⚠Not reporting all symptoms honestly during the C&P exam — dizziness, fainting (syncope), shortness of breath, and exercise intolerance should all be described. These symptoms determine your METs level and rating.

Related DBQ Forms

DBQ Heart Conditions

View evidence checklist →See secondary conditions →

Condition Rating Guides

Understand what the VA looks for at each rating level — loading conditions…

Atrioventricular Block (Heart Block)

Rating Levels

What the VA looks for

Chronic congestive heart failure
Workload capacity of 3 METs or less
Left ventricular ejection fraction less than 30%
Complete pacemaker dependence documented
Significant functional limitations from cardiac condition
Severe exercise limitation

Common Pitfalls

⚠Not documenting your pacemaker implantation and dependence — a pacemaker is strong evidence of serious heart block. Keep all surgical records, device cards, and pacemaker interrogation reports.

⚠Not getting an exercise stress test or METs estimation — the rating depends on your measured workload capacity. If you have a pacemaker and cannot do a standard treadmill test, the examiner can estimate METs based on your daily activities.

⚠Not keeping records of pacemaker adjustments and complications — if your device needs frequent reprogramming, battery replacements, or lead revisions, this supports a higher rating by showing ongoing cardiac impairment.

⚠Not connecting heart block to in-service cardiac events, medications, or exposures — heart block can develop from cardiac surgery, infections (like Lyme disease during service), or toxic exposures.

⚠Not reporting all symptoms honestly during the C&P exam — dizziness, fainting (syncope), shortness of breath, and exercise intolerance should all be described. These symptoms determine your METs level and rating.