Citation Nr: 22017501 Decision Date: 03/25/22 Archive Date: 03/25/22 DOCKET NO. 19-06 156 DATE: March 25, 2022 ORDER A 100 percent rating for aortic valve replacement and thoracic aortic aneurysm status post-graft with hypertrophy, diastolic dysfunction, and scar (heart disability) as of August 10, 2015, is granted. FINDING OF FACT The Veteran's heart disability caused a workload of 1-3 METs which resulted in heart failure symptoms. CONCLUSION OF LAW The criteria for 100 percent rating for the Veteran's heart disability as of August 10, 2015, are met. 38 U.S.C. §§ 1155, 5107; 38 C.F.R. §§ 3.655, 4.1, 4.2, 4.3, 4.7, 4.104, Diagnostic Code (DC) 7016. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty from August 1979 to January 2002 and September 2010 to September 2012. In November 2021, the Veteran testified before the undersigned Veterans' Law Judge. A copy of the transcript is associated with the record. Heart Disability Disability evaluations are determined by the application of a schedule of ratings which is based on average impairment of earning capacity. 38 U.S.C. § 1155; 38 C.F.R. § 4.1. Separate diagnostic codes identify the various disabilities. Where there is a question as to which of two evaluations shall be applied, the higher evaluation will be assigned if the disability picture more nearly approximates the criteria required for that rating. Otherwise, the lower rating will be assigned. 38 C.F.R. § 4.7. Any reasonable doubt regarding the degree of disability is resolved in favor of the Veteran. 38 C.F.R. § 4.3. The Veteran sought a higher rating for his heart disability in August 2015. The Veteran's heart disability was assigned a 30 percent rating under Diagnostic Code 7016. The rating criteria for evaluating a heart disability under 38 C.F.R. § 4.104 were revised November 14, 2021. See 38 C.F.R. § 4.104. Essentially, however, under DC 7016 both before and after the revisions, a 100 percent rating is warranted for a workload of 3 METs or less that results in dyspnea, fatigue, angina, dizziness, or syncope i.e., heart failure symptoms. One MET is defined as the energy cost of standing quietly at rest and represents an oxygen uptake of 3.5 milliliters per kilogram of body weight per minute. 38 C.F.R. § 4.104, NOTE (2). When the level of MET's at which dyspnea, fatigue, angina, dizziness, or syncope develops is required for evaluation, and a laboratory determination cannot be done for medical reasons, an estimation by a medical examiner of the level of activity (expressed in MET's and supported by specific examples, such as slow stair climbing or shoveling snow) that results in dyspnea, fatigue, angina, dizziness, or syncope may be used. Along with his request for an increased rating in August 2015, the Veteran submitted a private medical report from his treating physician which showed that his METs level was estimated to be between 1-3 METs which resulted in dyspnea, fatigue, angina, dizziness, and syncope. A March 2020 in-person VA examination also found the Veteran had a METs level between 1-3 METs which resulted in dyspnea, fatigue, and dizziness. Based on these findings, the Board finds that the Veteran's heart disability meets the criteria for a 100 percent rating. The record also contains a 2015 VA interview examination that did not agree with the METs findings above. However, the Board does not find that the 2015 VA examination opinion outweighs the findings of the 2015 private examination from the Veteran's treating provider or the 2020 in-person VA examination. As such, the Board finds that the evidence shows the Veteran's heart disability warrants a 100 percent rating as of the August 2015 date he sought an increased rating. There is no evidence of record prior to the August 2015 increased rating request which indicated the Veteran's heart disability had increased in severity. Thus, a 100 percent rating as of August 10, 2015, for a heart disability is granted. JOHN Z. JONES Veterans Law Judge Board of Veterans' Appeals Attorney for the Board A. Parrish The Board's decision in this case is binding only with respect to the instant matter decided. This decision is not precedential and does not establish VA policies or interpretations of general applicability. 38 C.F.R. § 20.1303.