Evidence Checklist: Heart Valve Disease

Echocardiogram documenting valve pathology and ejection fractionCritical

Echocardiography is the definitive study for valve disease — it quantifies regurgitation severity (trace/mild/moderate/severe), stenosis gradient, valve area, and left ventricular ejection fraction.

Exercise stress test with METs estimationCritical

Stress test documenting functional exercise capacity in METs. The VA Heart rating formula uses METs as the primary rating driver: 3 or less = 100%, 3-5 = 60%, 5-7 = 30%, over 7 = 10%.

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

A medical opinion connecting valve disease to service-connected endocarditis, rheumatic fever during service, or other in-service cause.

Cardiology follow-up records with symptom documentation

Serial cardiology records documenting the progression of valve disease, symptom burden, and functional class (NYHA classification).

Surgical records if valve repair or replacement performed

Operative report and post-operative records for valve repair or replacement surgery. Post-operative rating is typically 100% for 6 months, then re-evaluated by METs.

Anticoagulation records (if mechanical valve)

INR monitoring and anticoagulant prescription records for mechanical valve recipients, documenting ongoing treatment requirements.

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 valve findings, ejection fraction, METs, and functional limitations from heart valve disease.

Service treatment records (STRs)Critical

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