Evidence Checklist: Cardiomyopathy

Echocardiogram with ejection fraction (EF%)Critical

Echocardiography is essential — it documents left ventricular EF, chamber dilation, wall motion, and diastolic function. EF below 30% with CHF symptoms supports 100%; EF 30-50% may support 60%.

Exercise stress test with METs estimationCritical

Cardiopulmonary exercise testing or standard stress test documenting peak exercise capacity in METs. METs are the primary rating driver under the General Heart Formula.

Nexus opinion linking cardiomyopathy to service ("at least as likely as not")Critical

A medical opinion connecting cardiomyopathy to service-related causes: toxic exposure (Agent Orange, burn pits), alcohol use during service, viral illness during service, or service-connected hypertension.

Cardiac MRI (if performed)

Cardiac MRI provides detailed assessment of myocardial tissue, fibrosis, and EF when echocardiography is inconclusive.

Ongoing cardiology records documenting functional class

Serial cardiology records showing NYHA functional class, symptom progression (dyspnea, edema, orthopnea), and treatment changes over time.

Buddy statement from spouse, family, or fellow service member

A written statement from someone who can describe observable symptoms and how your condition affects daily life.

Personal statement describing symptoms and functional impact

Your own written account of how this condition affects your daily activities, work, and relationships. Describe your worst days.

Completed DBQ Heart ConditionsCritical

Standardized form capturing EF, METs, NYHA class, and functional limitations from cardiomyopathy.

Service treatment records (STRs)Critical

Military medical records showing in-service treatment, complaints, or injuries related to this condition.