Cardiovascular System§ 4.104Updated
Rating criteria

VA Diagnostic Code 7016Heart valve replacement (prosthesis)

A single 100% rating under § 4.104. Here is what the VA requires for it.

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  1. 100%

    For an indefinite period following date of hospital admission for valve replacement

How it is applied

General rating formula

General Rating Formula for Diseases of the Heart

From the schedule

Notes on this code

These notes are part of the regulation. They change how the levels above are applied.

  • Note: Six months following discharge from inpatient hospitalization, disability evaluation shall be conducted by mandatory VA examination using the General Rating Formula. Apply the provisions of § 3.105(e) of this chapter to any change in evaluation based upon that or any subsequent examination.

Heart Valve Replacement (Prosthesis) — VA Diagnostic Code 7016

Cardiovascular System · 38 CFR § 4.104

What This Rating Covers

Diagnostic Code 7016 applies to a heart valve replacement with a prosthesis — a surgical procedure in which a damaged or diseased heart valve is replaced with an artificial (prosthetic) valve. Because this condition affects the cardiovascular system, the VA evaluates it under the General Rating Formula for Diseases of the Heart.

Available Rating Levels

RatingCriteria
100%For an indefinite period following the date of hospital admission for valve replacement

Under this code, a 100% disability rating is assigned for an indefinite period beginning on the date of hospital admission for the valve replacement.

What the VA Looks For

  • The date of hospital admission for the valve replacement, which marks the start of the 100% evaluation period.
  • A mandatory VA examination conducted six months following discharge from inpatient hospitalization. At that point, the disability is evaluated using the General Rating Formula for Diseases of the Heart.
  • Changes in evaluation: Any change to the rating based on that examination — or any subsequent examination — is handled under the provisions of § 3.105(e).

This information is drawn directly from the VA rating schedule at 38 CFR § 4.104, Diagnostic Code 7016. It is provided for general informational purposes and does not guarantee any specific rating or outcome.

These criteria are a rendering of § 4.104, diagnostic code 7016. The official version is the one that governs your rating.

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What next

How to claim this

Knowing the criteria is the first half. Getting your file to show them is the second.

  1. Find your level in the stack

    Read each rung against what your medical records already say. The level your records document today is the one the VA can support today.

  2. Name the gap

    Look at the rung above yours and write down exactly what it asks for that your file does not show yet — a diagnosis, a measurement, a prescribed brace, a doctor’s opinion linking it to service.

  3. Claim it by code

    File under diagnostic code 7016 and attach the evidence for the level you are asking for. Other Cardiovascular System codes may cover your secondary conditions.

Find out which rating your evidence supports.

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