VA Disability Ratings for Heat Stroke

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If you suffered a serious heat injury in the military—heat stroke, heat exhaustion, or chronic heat intolerance—you’re probably wondering how the Heat Stroke VA Ratings works, why the VA doesn’t seem to “get it,” and what to do if they already denied or lowballed you.

Heat injuries are common in training, PT, and deployments—especially in hot climates and high-intensity environments. But many veterans never file, or they get denied, because:

• The original heat stroke “resolved” in service
• The rater doesn’t understand the long-term residuals
• The condition gets coded and rated incorrectly—or not at all

In this expert-level guide from Brian Reese, we’ll break down how VA looks at heat injuries, how Heat Injuries VA Ratings actually work, and how to use the VA Claims Insider Golden Circle so you can go after the Heat Stroke VA Rating you deserve.

Summary of Key Points

• You’re not rated for the heat stroke event itself—you’re rated for the ongoing residuals (heat intolerance, headaches, fatigue, sweating, mental health, heart/neuro issues) and how they impact your work and daily life.

• Because there is no stand-alone “heat stroke” code, VA uses analogous ratings under 38 C.F.R. § 4.20, most often pulling from migraine (DC 8100), CFS (DC 6354), hyperhidrosis (DC 7832), mental health (38 C.F.R. § 4.130), and heart/neurologic codes (38 C.F.R. §§ 4.104, 4.124a).

• To prove service connection, you must complete the VA Claims Insider Golden Circle: (1) current diagnosis, (2) in-service heat injury, (3) a medical nexus opinion (“at least as likely as not”), and (4) clear evidence of symptom severity and functional loss.

• If VA denies or underrates your Heat Stroke VA Rating, you can keep fighting through Higher-Level Review, Supplemental Claim, or a Board Appeal, especially if you add new medical evidence, stronger nexus support, and better documentation of how heat limits your ability to work.

What Is Heat Stroke (Medically and for VA Purposes)?

Medically, heat stroke is the most severe form of heat injury. In simple terms it usually involves:

• Markedly elevated core body temperature
• Central nervous system problems (confusion, seizures, coma)
• Organ and tissue damage from extreme heat stress

VA Public Health and medical research recognize that severe heat injuries, including heat stroke, are life-threatening events and can sometimes lead to long-term problems such as chronic heat intolerance, organ damage, cognitive changes, and other lingering symptoms if the body doesn’t fully recover.

From a VA disability standpoint, there’s an important twist:

You’re not rated for the one-time heat stroke event—you’re rated for the current, chronic residuals that event left behind.

The VA Schedule for Rating Disabilities in 38 C.F.R. Part 4 does not list “heat stroke” as its own diagnostic code. Instead, VA almost always rates history of heat stroke and residuals under other diagnostic codes by analogy, based on:

• Which body systems are affected, and
• How severe the ongoing symptoms are

Common residuals of heat stroke that show up in VA decisions include:

• Chronic heat intolerance
• Excessive sweating (hyperhidrosis)
• Dizziness, fainting spells, or syncope
• Chronic headaches or migraines
• Cognitive issues (memory, focus, “brain fog”)
• Seizures or other neurological deficits
• Cardiovascular problems (e.g., arrhythmias, hypertension)
• Psychological symptoms (panic or anxiety triggered by heat)

Those residuals are what ultimately drive your Heat Stroke VA Rating.

The VA Claims Insider Golden Circle for Heat Stroke Claims

At VA Claims Insider, we use what I call the VA Claims Insider Golden Circle to organize every claim.

For heat stroke claims, it has 4 parts:

1. Current Diagnosis – What conditions do you have today (heat intolerance, headaches, neurological issues, etc.)?
2. In-Service Event, Injury, Illness, or Aggravation – What happened in service (heat stroke, heat injury, repeated hot-weather training)?
3. Medical Nexus – Is there a medical opinion connecting your current diagnosis to that in-service event?
4. Severity of Symptoms – How bad is it now, and how does it affect your work, life, and daily functioning?

If any piece of the Golden Circle is weak or missing, your claim is at risk of being denied or underrated.

1. Diagnosis: What Are Your Current Residuals?

VA disability is always about current disability.

It’s not enough to have “a history of heat stroke” in your service treatment records. You need one or more current medical diagnoses that exist today and can be linked to that event.

Examples of diagnoses that might be tied to prior heat stroke:

• “History of heat stroke with residual dizziness and hyperhidrosis”
• “Heat intolerance with chronic fatigue and weakness”
• “Headaches due to heat stroke”
• “Seizure disorder or cognitive disorder secondary to heat stroke”

Pro Tip: Ask your VA or private provider to clearly document specific diagnoses and explicitly mention that they are residuals of prior heat stroke or heat injury, not just “history of heat stroke.”

2. In-Service Event: Proving the Heat Injury Happened

The second part of the Golden Circle is the in-service event.

This is what VA calls direct service connection under 38 C.F.R. § 3.303—you’re showing that a disease or injury resulting in disability was incurred in, or aggravated by, your military service.

Evidence might include:

• Service treatment records showing:
  • ER or clinic visits for heat exhaustion or heat stroke
  • Hospitalization or IV treatment for “heat casualty”
  • Notes documenting collapse during PT, ruck marches, or field training
• Line of Duty reports related to heat injuries
• Deployment or duty records showing work in extreme heat (desert environments, flight line, motor pool, etc.)
• Buddy statements describing you collapsing, being evacuated, or repeatedly experiencing heat problems

If you can show a documented in-service heat injury and you now have residuals, you’ve satisfied the event part of the Golden Circle.

3. Nexus: Connecting Today’s Disability to the Heat Stroke

The third piece is the nexus—the medical link between your current diagnosis and your in-service heat stroke.

Your nexus is often the deciding factor.

A strong nexus letter or medical opinion will:

• Review your service records and post-service medical history
• Identify your current diagnoses (e.g., heat intolerance, headaches, seizures)
• Explain how severe heat stroke can lead to those types of long-term residuals
• Use the VA standard: “at least as likely as not (50% or greater probability)” that your current condition is due to the in-service heat injury

For a deeper dive into nexus and the different types of service connection, check out our guide on VA service connection explained.

4. Severity: How Bad Is It Now?

Finally, VA has to figure out how disabling your residuals are.

This is where:

• C&P exams
• Treatment notes
• Your personal statement and buddy letters all matter.

The more clearly you document how heat affects your work, daily activities, and quality of life, the more accurate your Heat Stroke VA Rating will be.

Direct vs. Secondary Service Connection for Heat Stroke Residuals

When we talk about service connection for heat injuries, you’ve got two main paths:

1. Direct service connection – heat stroke happened in service, residuals continue today (38 C.F.R. § 3.303).
2. Secondary service connection – a current condition is caused or aggravated by a service-connected disability, or vice-versa (38 C.F.R. § 3.310).

Important: Heat stroke is not on any specific VA “presumptive” list, so most veterans will rely on direct or secondary service connection, not presumptives.

Direct Service Connection (Primary Path for Most Vets)

Direct service connection applies when:

1. You have a current disability (heat stroke residuals),
2. You had an in-service heat injury, and
3. You have a nexus opinion linking the two.

This tracks both 38 C.F.R. § 3.303 and the development guidance in M21-1, Part V, Subpart ii, Chapter 2, Section A on direct service connection.

Secondary Service Connection (When One Condition Leads to Another)

Secondary service connection is governed by 38 C.F.R. § 3.310 and M21-1, Part V, Subpart ii, Chapter 2, Section D. It applies when a service-connected disability causes or aggravates another medical condition.

With heat stroke, this can work both directions:

1. Residuals secondary to heat stroke
   • Migraines secondary to brain injury from heat stroke
   • Anxiety or panic disorder triggered by heat exposure due to the traumatic event
   • Kidney disease or other organ damage that traces back to the original heat injury
2. Heat stroke secondary to another service-connected disability
   • Psych medications or other meds impair thermoregulation, contributing to your heat stroke in service
   • Orthopedic or cardiac limitations prevent proper cooling, leading to a heat injury during duty

In each scenario, you need:

• A current diagnosis of the secondary condition, and
• A medical opinion that it was caused or aggravated by the service-connected condition.

Learn more about direct, secondary, and other types of service connection in our article VA Service Connection Explained: How to Prove Your VA Disability Claim.

How Does VA Actually Rate Heat Stroke?

Because “heat stroke” itself doesn’t have a dedicated diagnostic code, VA rates the residuals under other parts of the rating schedule. Under 38 C.F.R. § 4.20 (analogous ratings), when a condition is unlisted, raters must choose a closely related diagnostic code based on:

• The functions affected
• The anatomical location
• The overall symptom pattern

Board of Veterans’ Appeals decisions confirm this approach for “history of heat stroke” and “residuals of heat injury,” where VA rates under other codes such as DC 8100 (migraine), DC 7900 (hyperthyroidism), DC 9326 (dementia due to general medical condition), and more.

In real life, your Heat Stroke VA Rating is usually built from several different diagnostic codes, depending on which body systems were damaged and how severe your symptoms are.

1. Headache / Migraine Residuals – DC 8100

If your main residual is heat-triggered headaches or migraines, VA often uses Diagnostic Code 8100 (Migraine) in 38 C.F.R. § 4.124a. The rating levels are:

• 50% – Very frequent, completely prostrating and prolonged attacks productive of severe economic inadaptability
• 30% – Characteristic prostrating attacks occurring on average once a month over the last several months
• 10% – Characteristic prostrating attacks averaging one in 2 months over the last several months
• 0% – Less frequent attacks

In at least one BVA case, a veteran’s history of heat stroke manifested by heat intolerance and headaches was granted a higher 50% rating under DC 8100 using these migraine criteria.

2. Fatigue and Heat Intolerance – DC 6354 (Chronic Fatigue Syndrome Model)

If your residual picture is dominated by severe, long-lasting fatigue, post-exertional crashes, and heat intolerance, VA can rate those by analogy to Chronic Fatigue Syndrome (CFS) under DC 6354 in 38 C.F.R. § 4.88b. The CFS criteria are:

• 100% – Nearly constant fatigue and/or cognitive issues so severe they almost completely restrict routine daily activities and may occasionally preclude self-care
• 60% – Nearly constant symptoms restricting routine daily activities to < 50% of pre-illness level, or symptoms that wax and wane with incapacitating episodes totaling ≥ 6 weeks/year
• 40% – Nearly constant symptoms restricting activities to 50–75% of pre-illness level, or incapacitating episodes totaling 4–6 weeks/year
• 20% – Nearly constant symptoms restricting activities by < 25% of pre-illness level, or incapacitating episodes totaling 2–4 weeks/year
• 10% – Symptoms that wax and wane but cause incapacitation of at least 1–2 weeks/year, or symptoms controlled by continuous medication

If heat or exertion drops you for days, cuts your activity level in half, and you’re wiped out most of the time, this is the kind of scale VA can look to when rating your heat stroke residuals.

3. Excessive Sweating / Autonomic Issues – DC 7832 (Hyperhidrosis)

When heat stroke damages your ability to regulate sweat, VA may use DC 7832 – Hyperhidrosis in 38 C.F.R. § 4.118. The ratings are simple:

• 30% – Unable to handle paper or tools because of moisture, and unresponsive to therapy
• 0% – Able to handle paper or tools after therapy

If heat-triggered sweating is so bad that your hands or body are constantly soaked and you can’t safely handle tools, weapons, equipment, or paperwork, that lines up with a 30% rating under DC 7832.

4. Mental Health Residuals – General Rating Formula (38 C.F.R. § 4.130)

Some veterans develop panic, anxiety, or trauma responses to heat or collapsing, and VA rates those symptoms under the General Rating Formula for Mental Disorders in 38 C.F.R. § 4.130 (for example, DC 9411 for PTSD or DC 9400 for anxiety). In short:

• 10% – Mild/transient symptoms; decrease work efficiency only during significant stress, or symptoms controlled by continuous medication
• 30% – Occupational and social impairment with occasional decrease in work efficiency and intermittent inability to perform tasks, but generally functioning satisfactorily
• 50% – Occupational and social impairment with reduced reliability and productivity (e.g., more frequent panic, memory problems, mood disturbance)
• 70% – Occupational and social impairment with deficiencies in most areas (work, school, family, judgment, thinking, mood)
• 100% – Total occupational and social impairment

If you avoid heat at all costs, have panic attacks in hot environments, and it’s wrecking your ability to work or be around people, your “heat stroke VA rating” on the mental health side comes from this 0–100% scale.

5. Heart and Neurological Damage – 38 C.F.R. §§ 4.104 and 4.124a

Severe heat stroke can also injure the heart or nervous system:

• Heart / cardiovascular residuals are rated under 38 C.F.R. § 4.104 (DC 7000–7099) based on metrics like METs, ejection fraction, dyspnea, fatigue, angina, dizziness, syncope, and need for medication or hospitalization, with ratings typically from 0% to 100%.
• Neurological residuals (seizures, cognitive deficits, cranial nerve issues, etc.) are rated under 38 C.F.R. § 4.124a using the specific code for migraines, epilepsy, or other neurologic conditions, again with ranges up to 100% for severe impairment.

For example, a veteran whose heat stroke led to a seizure disorder could be rated under the epilepsy codes, while heat-triggered migraines use DC 8100, and cognitive issues might fall under a dementia-type code such as DC 9304 or 9326.

6. TDIU: When the Combinations Add Up to “Can’t Work”

Finally, if the combined impact of your service-connected heat stroke residuals—headaches, fatigue, sweating, mental health symptoms, heart problems, neurological issues, and more—keeps you from maintaining substantially gainful employment, you may qualify for Total Disability based on Individual Unemployability (TDIU) under 38 C.F.R. § 4.16.

TDIU pays at the 100% rate even if your combined schedular ratings are lower, as long as your service-connected conditions alone prevent you from securing and following substantially gainful work.

Bottom line: The diagnostic code label matters less than the severity of your residual symptoms and how they affect your ability to work and function day-to-day. That’s what ultimately drives your Heat Stroke VA Rating.

Evidence You Need to Prove Your Heat Stroke VA Rating

VA decisions live and die on evidence.

For heat stroke residuals, the strongest claims usually have:

1. Clear Medical Documentation

• Service treatment records documenting the original heat injury
• ER, hospitalization, or clinic records describing symptoms like collapse, confusion, IV fluids, etc.
• Current treatment records showing ongoing symptoms: heat intolerance, dizziness, headaches, neurologic or cardiac findings, etc.

2. A Strong Nexus Opinion

A quality nexus letter should:

• Review your military and medical history
• Identify your current diagnoses
• Explain how severe heat injury can cause those specific residuals
• Use the language “at least as likely as not” connecting your current disabilities to your in-service heat stroke or to an already service-connected condition

3. Powerful Lay Evidence (Your Story + Buddies)

Your Statement in Support of Claim and buddy letters can fill in the gaps:

• What happened when you went down from the heat
• How often you were treated or excused from duty afterward
• How your tolerance for heat changed over time
• How heat affects you today—work, chores, hobbies, family life

4. Smart C&P Exam Education

At your Compensation & Pension exam:

• Describe your worst days, not just your best
• Explain specific limitations (“I can’t work outside more than 10–15 minutes without getting dizzy”)
• Tie symptoms to functional impact (missed work, safety issues, needing accommodations)

What to Do After a Denial: HLR vs. Supplemental vs. Board

If VA denies service connection or underrates your Heat Stroke VA Rating, you move into the modern decision review system under the Appeals Modernization Act.

VA.gov explains that you generally have three decision review options if you disagree with a decision:

1. Supplemental Claim
2. Higher-Level Review (HLR)
3. Board Appeal

You usually have 1 year from the date on your decision letter to request an HLR or Board Appeal. You can file a Supplemental Claim later if you obtain new and relevant evidence.

Higher-Level Review (HLR)

Use HLR when:

• You believe VA made an error with the evidence it already had
• You don’t have new evidence to add

Key points:

• File VA Form 20-0996 (Higher-Level Review).
• A more senior reviewer looks at the same evidence and checks for duty-to-assist errors or misinterpretation.
• You can request a one-time informal conference by phone to point out specific errors.
• You cannot submit new evidence in HLR.

After an HLR decision, you can still file:

• A Supplemental Claim, or
• A Board Appeal

For more help choosing between these options, read our guide Higher-Level Review vs. Supplemental Claim: What Veterans Really Need to Know.

Supplemental Claim

Use a Supplemental Claim when:

• You have new and relevant evidence that VA didn’t previously consider (new medical opinions, testing, etc.).

Key points:

• File VA Form 20-0995 (Supplemental Claim).
• “New and relevant” means:
  • Not previously part of your file, and
  • Tends to prove or disprove your claim
• VA re-decides the claim considering the new evidence.

After a Supplemental Claim decision, you can request:

• Another Supplemental Claim (with more new evidence),
• A Higher-Level Review, or
• A Board Appeal

Board Appeal

Use a Board Appeal when:

• You want a Veterans Law Judge at the Board of Veterans’ Appeals to review your case.

Key points:

• File VA Form 10182 (Decision Review Request: Board Appeal).
• Choose one of three dockets:
  • Direct Review – no new evidence, no hearing
  • Evidence Submission – send in new evidence without a hearing
  • Hearing – speak directly with a Judge (plus optional new evidence)

Board appeals usually take longer but can be powerful in complex cases where RO decisions keep missing the mark.

Frequently Asked Questions (FAQs)

1. Can I get a VA rating for heat stroke if it only happened once in service?

Yes—if that single heat stroke left you with ongoing residuals, you can still get rated. VA does not pay you just because “I had heat stroke in 2010.” They pay you for current disabilities that exist today (heat intolerance, migraines, dizziness, fatigue, anxiety, heart or neurologic issues, etc.) that are linked to that in-service event. If your records show a documented heat injury and your current doctor ties today’s symptoms to that event with a “at least as likely as not” nexus, you can absolutely pursue a Heat Stroke VA Rating even if it was “one time.”

2. Is there a specific VA diagnostic code and percentage table for heat stroke?

No. There is no stand-alone “heat stroke” diagnostic code in the VA Schedule for Rating Disabilities. Instead, VA uses analogous ratings under 38 C.F.R. § 4.20 and rates your residuals under other codes—like migraines (DC 8100), chronic fatigue syndrome (DC 6354), hyperhidrosis (DC 7832), mental health (38 C.F.R. § 4.130), heart codes (38 C.F.R. § 4.104), and neurologic codes (38 C.F.R. § 4.124a). Your final “heat stroke rating” is essentially the combined impact of all those residual conditions.

3. What kind of symptoms count as “heat stroke residuals” for VA purposes?

Anything that can be medically linked to your heat injury and still shows up today can count. Common residuals include: chronic heat intolerance, heat-triggered headaches or migraines, dizziness or fainting, overwhelming fatigue, excessive sweating, memory or concentration problems, seizures or neurologic issues, heart problems, and even panic or anxiety tied to heat. VA doesn’t care what you call it—they care that a provider diagnoses it and connects it to your in-service heat stroke.

4. How does VA decide what percentage to give for heat stroke residuals?

VA doesn’t look up “heat stroke = 30%.” They look at the specific body system and apply that system’s rating criteria:

• Headaches/migraines → DC 8100 (0–50%)
• Fatigue/heat intolerance → DC 6354 (10–100%)
• Excessive sweating → DC 7832 (0 or 30%)
• Mental health → 38 C.F.R. § 4.130 (0–100%)
• Heart and neurologic damage → 38 C.F.R. §§ 4.104 & 4.124a (0–100%)

They then combine those ratings using VA math. The higher your frequency, severity, and impact on work and daily life, the higher your percentages under those codes.

5. What evidence do I need to prove my heat stroke VA claim?

Think in terms of the Golden Circle:

1. Current diagnosis – VA or private doctor documenting your residuals now (e.g., “heat intolerance with migraines and fatigue”).
2. In-service event – Service treatment records, ER notes, Line of Duty reports, or buddy statements showing you had a heat injury on active duty.
3. Medical nexus – A provider opinion stating it is “at least as likely as not” that your current condition is due to that in-service heat stroke or is secondary to a service-connected condition.
4. Severity – C&P exam, treatment notes, and your lay statements describing how often your symptoms hit and how they affect work, family, and daily activities.

The more complete that circle is, the better your chances.

6. What if my heat stroke isn’t well documented in my service treatment records?

You still have options. VA can consider:

• Buddy statements from people who saw you collapse or be evacuated
• Duty records showing you served in extreme heat environments
• Post-service medical records where you’ve consistently reported a history of heat stroke
• A strong nexus letter where a doctor explains that your current residuals fit the pattern of a prior severe heat injury

Is it harder without STR documentation? Yes. Is it impossible? No. In many cases, credible lay evidence plus a well-supported medical opinion can bridge the gap.

7. Is heat stroke considered a presumptive VA condition?

No. Heat stroke is not on any presumptive list. That means you don’t get automatic service connection just for serving in a certain location or timeframe. Most veterans must prove direct service connection (heat stroke in service → residuals now) or secondary service connection (e.g., seizures, migraines, kidney disease, or anxiety secondary to heat stroke). You get rated properly by building the right evidence, not by relying on a presumptive shortcut.

8. Can I get TDIU (paid at 100%) because of my heat stroke residuals?

Yes, if your service-connected residuals (from heat stroke and anything else) prevent you from maintaining substantially gainful employment, you can go after Total Disability based on Individual Unemployability (TDIU). This is common when:

• Heat-triggered migraines knock you out several days a month
• Fatigue and heat intolerance severely limit your activity and stamina
• Heart or neurologic issues make many jobs unsafe
• Panic/anxiety around heat environments blocks you from most work settings

If your service-connected conditions make you unemployable, TDIU under 38 C.F.R. § 4.16 can pay at the 100% rate even if your combined ratings don’t add up to 100%.

9. What happens at a C&P exam for heat stroke residuals?

At a C&P exam, the examiner is trying to answer three big questions:

1. What do you have now? (Diagnoses and symptoms)
2. Is it related to service? (Nexus)
3. How severe is it? (Impact on work and daily life)

Your job is to be brutally honest about your worst days, not your best ones. Explain:

• How heat affects you (how fast you get dizzy, sick, weak, panicky)
• How often you have episodes (migraines, near-syncope, exhaustion crashes)
• How it affects your job (missed days, productivity, safety concerns, having to avoid certain environments)

Don’t minimize it and don’t guess. “I don’t know” is better than making something up. Stick to the truth, but make sure the full truth gets on the record.

10. What can I do if VA denies or lowballs my Heat Stroke VA Rating?

You’ve got options, not just a dead end. Under the modern VA decision review system, you can:

• Request a Higher-Level Review if you think VA made a mistake and you don’t have new evidence.
• File a Supplemental Claim if you have new and relevant evidence like a nexus letter, new specialist records, or updated work limitations.
• File a Board Appeal to get your case in front of a Veterans Law Judge.

The key is to fix the weaknesses in your original claim—usually missing diagnoses, weak or no nexus, or not enough detail on severity—and then choose the lane that fits your strategy. This is exactly where having a coach and a plan can change everything.

Conclusion & Wrap-Up

If you’ve made it this far, here’s the big takeaway:

You are not rated for the one-time heat stroke you had in basic, on deployment, or during PT.
You are rated for the residual damage that heat stroke left behind—headaches, dizziness, fatigue, panic, heart issues, sweating, cognitive problems, and how all of that affects your ability to work and live your life.

Because there’s no stand-alone code for “heat stroke” in the VA system, your Heat Stroke VA Rating is built from multiple pieces of the rating schedule—migraines, chronic fatigue, hyperhidrosis, mental health, heart, neurological, and even TDIU if you can’t work. That’s why the Golden Circle matters so much:

1. Current diagnosis (what you’re dealing with today)
2. In-service heat injury (what happened on active duty)
3. Medical nexus (linking #1 and #2)
4. Severity of symptoms (how bad it is now and how it limits you)

If any one of those is missing or weak, VA has an easy excuse to deny you or lowball you.

You don’t have to let that happen.

If you’re dealing with heat intolerance, crashing fatigue, heat-triggered headaches, anxiety, or other problems that trace back to a heat injury in service, it’s time to get serious about your claim. That might mean:

• Getting a real, current diagnosis (not just “history of heat stroke”)
• Asking your doctor for a strong nexus opinion
• Tightening up your personal statement and buddy letters
• Using the right review lane if VA already denied or underrated you

At VA Claims Insider, this is exactly what we help veterans do every single day—take a confusing, frustrating claim and turn it into a clear, evidence-backed story that fits the VA’s own rules.

If you’re ready for help with your Heat Stroke VA Rating or any other VA disability issue, reach out to VA Claims Insider and let us walk this journey with you so you’re not fighting the VA alone!

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