High cholesterol (hyperlipidemia) is a common condition where the blood contains too many fatty substances, potentially leading to cardiovascular problems. Veterans often seek disability compensation for this condition due to its prevalence. Navigating the Department of Veterans Affairs (VA) process requires understanding that the VA treats high cholesterol differently than many other diseases. Compensation for hyperlipidemia involves proving a connection to military service and focusing on any resulting secondary health conditions.
VA Treatment of High Cholesterol as a Standalone Condition
The VA does not consider high cholesterol a disability for compensation purposes. Instead, the VA classifies hyperlipidemia as a “laboratory finding” or a risk factor, not a diagnosable disease causing functional impairment on its own. Therefore, a veteran cannot receive a disability rating simply for having elevated cholesterol levels documented by a blood test, and claims for hyperlipidemia alone are routinely denied.
Compensation is provided only for conditions resulting in functional impairment. Since high cholesterol typically causes no symptoms until it leads to other diseases, it is not ratable under the Schedule for Rating Disabilities. If hyperlipidemia is managed solely by continuous medication, such as statins, it may warrant a minimal 10% rating if service-connected. The VA’s focus shifts entirely to the downstream complications caused by the elevated lipids.
Establishing Service Connection
A veteran must first establish a link, or nexus, between their military service and the high cholesterol before any resulting condition can be compensated. This connection can be established in two primary ways: directly or secondarily. Direct service connection requires evidence that the hyperlipidemia was diagnosed during active duty, or that medical evidence shows the condition began or was aggravated while the veteran was in service.
Secondary service connection is a more common route for hyperlipidemia claims. This involves proving that the high cholesterol was caused by another condition that is already service-connected. For example, medications prescribed for a service-connected mental health condition like Post-Traumatic Stress Disorder (PTSD) may cause metabolic changes leading to hyperlipidemia. Similarly, service-connected conditions such as diabetes or hypertension can cause or worsen high cholesterol, providing the necessary link.
The most persuasive evidence for establishing this connection is a nexus letter from a medical professional. This letter provides a medical opinion stating that the veteran’s hyperlipidemia is “at least as likely as not” related to their service or an already service-connected condition. The professional must articulate the scientific basis for the connection, such as linking a specific service-connected medication to the development of the high cholesterol. Without this clear, medically supported link, the claim for service connection will likely fail.
Rating Conditions Caused by High Cholesterol
The highest compensation is achieved when hyperlipidemia has progressed and led to a severe cardiovascular disease, such as coronary artery disease (CAD), atherosclerosis, or a heart attack. These resulting conditions are rated under the cardiovascular system portion of the VA Schedule for Rating Disabilities, typically using Diagnostic Code 7005 for ischemic heart disease. The rating is based on the degree of functional impairment, often measured by a test that determines a person’s metabolic equivalents (METs).
METs testing measures the amount of oxygen the heart consumes during physical activity before symptoms like shortness of breath, fatigue, or chest pain occur. A higher disability rating is assigned when the veteran can tolerate fewer METs before experiencing symptoms, indicating greater heart impairment. For example, a 100% rating is assigned if a workload of 3 METs or less results in symptoms, while a 60% rating is given for a workload between 3 and 5 METs.
Conditions resulting from high cholesterol, such as ischemic heart disease, are also rated based on factors including the presence of congestive heart failure or left ventricular dysfunction. If high cholesterol leads to a myocardial infarction (heart attack), a temporary 100% rating is provided during the recovery period. This rating then reverts to one based on the residual functional limitations.