Reviewed by Jonathan Teplitsky · Updated June 2026
How does the VA rate POTS?
POTS (Postural Orthostatic Tachycardia Syndrome) does not have its own VA diagnostic code. Because of that, the VA rates it by analogy under 38 CFR § 4.104 and the analogy rule in 38 CFR § 4.20. In plain terms, the rater finds the closest existing condition and borrows its rating criteria. Most often that is Diagnostic Code 7011 (sustained ventricular arrhythmias), so POTS commonly appears on a rating decision as code 7099-7011. The "7099" part simply signals an unlisted condition rated by analogy.
This matters more than it sounds. Since there is no fixed POTS schedule, the percentage you receive depends on which analogous code the rater chooses. If your symptoms are mostly cardiac (racing heart, fainting, exercise intolerance), the cardiac code usually fits. If your symptoms are mostly neurological, a rater may use an 8299-series code instead - and the criteria are different.
The analogous DC 7011 rating table
When POTS is rated by analogy to DC 7011, these are the levels and the criteria the rater applies. Read every row as "rated by analogy" - these are the cardiac criteria being borrowed, not a POTS-specific schedule.
| Rating (by analogy) | General criteria under DC 7011 |
|---|---|
| 10% | Documented episodes requiring continuous medication, or a workload of greater than 7 METs (but not more than 10) that brings on symptoms such as dizziness or near-syncope. |
| 30% | More frequent documented episodes, or a workload of greater than 5 METs (but not more than 7) producing symptoms; may include evidence of cardiac involvement on testing. |
| 60% | A workload of greater than 3 METs (but not more than 5) producing symptoms, or left ventricular dysfunction with an ejection fraction of 30 to 50 percent. |
| 100% | Chronic congestive heart failure, a workload of 3 METs or less producing symptoms, or a left ventricular ejection fraction of less than 30 percent. |
You can estimate how a POTS rating combines with your other conditions using our VA disability rating calculator. Remember that ratings are combined, not simply added.
The tilt-table test: the diagnostic linchpin
The single most important piece of medical evidence in a POTS claim is the tilt-table test, the recognized gold standard. A positive result shows a sustained heart-rate increase of at least 30 beats per minute within 10 minutes of standing, without a drop in blood pressure (that absence of a blood-pressure drop is what separates POTS from ordinary orthostatic hypotension).
Supporting evidence strengthens the picture: a Holter monitor that captures your heart rhythm over a day or more, formal autonomic testing, and cardiology or neurology treatment records. Without a clear, documented diagnosis, raters often cannot connect your symptoms to a ratable condition at all - which is why the diagnosis step comes before everything else.
Gulf War, dysautonomia, and the CFS / fibromyalgia overlap
POTS is claimed by many Gulf War veterans and frequently travels alongside other hard-to-pin-down conditions. It is a form of dysautonomia (a problem with the automatic nervous system) and its symptoms overlap heavily with chronic fatigue syndrome and fibromyalgia. If you served in the Gulf War theater, review our Gulf War illness page, because some of these chronic, multi-symptom conditions can be claimed through undiagnosed-illness and presumptive pathways that do not always require a textbook nexus.
Secondary connections
POTS can also be granted as secondary to another service-connected condition. If medical evidence shows that a condition the VA already recognizes caused or worsened your POTS, you can claim it on that basis. The link must be supported by a medical opinion - it is not enough to simply list the two conditions together.
Evidence and how to file
A strong POTS claim usually includes:
- A confirmed diagnosis, ideally backed by a positive tilt-table test.
- Cardiology or neurology records documenting episodes, frequency, and any medication you take.
- METs or exercise-tolerance findings, since the analogous cardiac criteria lean on workload.
- A nexus letter linking POTS to your service or to a service-connected condition.
To file, submit a claim listing POTS (or its symptoms), attach your medical evidence, and attend the Compensation & Pension (C&P) exam. Bring your test results to the exam so the examiner is working from the full record. Because POTS is still an emerging and sometimes misunderstood condition, a clear diagnosis paired with a solid nexus is what most often makes the difference.
Common questions
Will the VA always use the cardiac code for POTS?
No. The cardiac DC 7011 analogy is the most common, but a rater may use a neurological 8299-series code when symptoms are dominantly neurological. The choice can change your percentage, so it helps to understand which criteria fit your symptoms.
Can my POTS rating be increased later?
Yes. If your condition worsens - more frequent episodes, lower exercise tolerance, or new cardiac findings - you can file for an increase with updated medical evidence.
Is a tilt-table test required to win?
It is not strictly required, but it is the strongest single piece of evidence. Without it, raters rely on other records, which can make a clean diagnosis harder to establish.
What if I also have CFS or fibromyalgia?
These conditions are rated separately under their own criteria. Overlapping symptoms can complicate a claim, so clear documentation of which condition causes which symptom helps the rater assign accurate ratings.
Does POTS qualify for a Gulf War presumptive?
It may, depending on your service and how the condition is characterized. Gulf War undiagnosed-illness and chronic multi-symptom illness pathways can apply to dysautonomia-type conditions.