Securing VA Disability Ratings for Atrial Fibrillation (AFIB)
A veteran who has atrial fibrillation may have no symptoms at all, or may experience symptoms such as:
- Racing or irregular heart rate
- Fluttering sensation in the chest
- Fatigue
- Shortness of breath
- Dizziness
- Anxiety
- Feeling faint
- Confusion
- Sweating
- Chest pain
Depending on the type of atrial fibrillation, the condition may be intermittent or may require intervention to correct the heart rhythm. Atrial fibrillation may also be permanent, meaning the heart rate cannot be restored to normal.
Service Connection for Atrial Fibrillation
Service connection for atrial fibrillation may be direct or secondary. For example, atrial fibrillation can be caused by a physical injury. If you sustained an injury during your military service that can be connected to atrial fibrillation, you may be able to establish a direct service connection.
Atrial fibrillation may also be caused by a wide range of conditions that may themselves be service-connected. For example:
- Sleep apnea
- High blood pressure
- Heart attack
- Lung disease
- Viral infections
- Thyroid disease
There is also some evidence of a link between posttraumatic stress disorder (PTSD) and atrial fibrillation.
Whether you are pursuing a primary or secondary service connection, it will be up to you to provide evidence demonstrating that connection. An experienced VA disability benefits advocate can help you determine what type of medical and other evidence will be required to establish that connection.
Your VA Disability Rating for AFIB
Atrial fibrillation is usually rated based on the schedule for supraventricular tachycardia. Under that listing, there are just two possible VA disability ratings: 10% and 30%. All disability ratings for atrial fibrillation require confirmation by ECG.
A 10% disability rating is assigned if the veteran requires one to four treatment interventions per year, or requires continuous medication or regular use of vagal maneuvers to control the condition.
A 30% disability rating is assigned if the veteran requires five or more treatment interventions per year.
Can You Get a Higher Disability Rating for Atrial Fibrillation?
In some circumstances, a veteran with atrial fibrillation may be able to secure a higher disability rating.
Ratings for Bradycardia
While most cases of atrial fibrillation are rated as supraventricular tachycardia, there is an exception. AFIB with slow ventricular response requiring permanent implantation of a pacemaker may be rated under diagnostic code 7009. That rating system is more complex.
For the first month following hospitalization for implantation or reimplantation, the veteran is assigned a 100% VA disability rating. After that time passes, the condition is evaluated using the General Rating Formula to Evaluate Diseases of the Heart. That rating formula relies on the workload required to trigger heart failure symptoms, as follows:
- 10% disability rating: Workload of 7.1-10 METs triggers heart failure symptoms, or continuous medication is required
- 30% disability rating: Workload of 5.1-7 METs triggers heart failure symptoms, or evidence of cardiac hypertrophy or dilatation is confirmed by echocardiogram or similar testing
- 60% disability rating: Workload of 3.1-5 METs triggers heart failure symptoms
- 100% disability rating: Workload of 3 METs or less triggers heart failure symptoms
For purposes of this evaluation, heart failure symptoms include (but are not limited to):
- Breathlessness
- Fatigue
- Angina
- Dizziness
- Arrhythmia
- Palpitations
- Syncope
Combined Disability Ratings for AFIB
The VA disability rating assigned may also be higher if there are other service-connected or secondary conditions involved. For example, atrial fibrillation may be found to be secondary to service-connected PTSD. In that situation, the VA will already have assigned a disability rating for the PTSD.
PTSD is evaluated under the General Rating Formula for Mental Disorders and may be assigned a disability rating of 0%, 10%, 30%, 50%, 70% or 100%. To illustrate how the combined disability rating might work, assume the veteran was assigned a 30% disability rating for PTSD. Later, the veteran filed a claim for atrial fibrillation secondary to PTSD and was assigned a separate 30% disability rating for the AFIB.
The VA will combine those ratings by first deducting the 30% for the first rating, leaving 70% “non-disabled.” The VA will then apply the 30% rating for atrial fibrillation to that remaining 70% (.70 x .30 = .21) to arrive at an effective 21% rating for the AFIB. Next, the VA adds the original disability rating of 30% to the newly calculated 21% and adds them together. That’s a total of 51%, which will be rounded to the nearest multiple of 10. That means the veteran with a 30% rating for PTSD and a 30% rating for atrial fibrillation will have a combined VA disability rating of 50%.
Not only will the veteran see an increase in monthly monetary benefits, but reaching the 50% mark will also entitle them to more extensive healthcare services.
Next Steps in Pursuing VA Disability Benefits for AFIB
Demonstrating that atrial fibrillation is service-connected or secondarily connected can be complicated. At this time, there are no circumstances under which atrial fibrillation is presumed service-connected. Getting the right disability rating can be difficult, too. For example, if you fit the criteria for both supraventricular tachycardia and bradycardia with permanent implantation of a pacemaker, the ratings formula instructs the VA to use the code that “reflects the predominant disability picture.” It will be up to you to provide the right documentation to paint the predominant disability picture, and which condition you’re rated under can make a significant difference in the available disability ratings.
At Veterans Help Group, our experienced advocates understand the type of evidence that is required to establish a service connection or secondary service connection, and what medical documentation is required to support a diagnosis and help the VA arrive at the appropriate disability rating. Whether you are filing an initial VA disability claim, filing a claim for a secondary condition, or embarking on one of the multiple possible paths to appeal a denial of VA disability benefits or a disability rating you think is too low, we can help. To learn more about how we can help you put together the strongest possible claim or appeal, call us at 855-855-8992 right away or contact us here now.
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