Atrial fibrillation (AFib) is a condition where the heart’s upper chambers beat chaotically and irregularly, often resulting in a rapid heart rhythm. This erratic electrical activity causes the atria to quiver, preventing them from efficiently moving blood into the ventricles. AFib is a common heart arrhythmia that can lead to complications such as blood clots, stroke, and heart failure. Veterans diagnosed with AFib may be eligible for disability compensation from the Department of Veterans Affairs (VA) if they establish a direct link between the condition and their military service.
Establishing Service Connection for Atrial Fibrillation
Establishing service connection is required to receive VA disability compensation, meaning the veteran must prove their AFib is related to military service. The most direct pathway, known as direct service connection, applies if the condition was diagnosed while the veteran was on active duty. This requires a current AFib diagnosis, evidence of an in-service event or illness, and a medical nexus linking the two.
AFib can also be service-connected on a secondary basis, which is a common pathway for veterans. This occurs when AFib develops as a result of a condition that is already service-connected. AFib is frequently linked to other health issues like obstructive sleep apnea, hypertension, coronary artery disease, and Post-Traumatic Stress Disorder (PTSD). The association between obstructive sleep apnea and AFib is particularly strong.
While AFib is not a presumptive condition, a veteran may qualify for presumptive benefits if their AFib is secondary to a condition the VA recognizes as presumptive. For example, ischemic heart disease is presumptive for veterans exposed to Agent Orange in certain regions and timeframes. If a veteran’s AFib is medically linked to their service-connected ischemic heart disease, they may receive secondary service connection.
Understanding the VA Disability Rating Schedule
The VA assigns disability ratings for AFib using Diagnostic Code 7010, which covers supraventricular arrhythmias. The rating is based on the frequency and severity of AFib episodes and the required medical interventions. The VA assesses severity based on the impact of residual symptoms on the veteran’s daily life, not solely on the diagnosis.
The maximum rating under Diagnostic Code 7010 is 30 percent. This rating is awarded for paroxysmal AFib or other supraventricular tachycardia with more than four documented episodes per year. Documentation must be provided by an electrocardiogram (ECG) or Holter monitor. An episode is defined by the need for a treatment intervention, such as intravenous medication adjustment, electrical cardioversion, or ablation for symptom relief.
A 10 percent rating is assigned for permanent AFib (often called lone atrial fibrillation). The 10 percent rating also applies to veterans with paroxysmal AFib who experience between one and four documented episodes per year. Additionally, a 10 percent rating may apply if the condition is confirmed by ECG and requires the continuous use of oral medications to control the heart rate or rhythm.
If AFib is severe and persistent, it may be rated by analogy under a different diagnostic code, such as 7011 for sustained ventricular arrhythmias, if it meets the criteria of a more severe heart disease. For instance, if AFib leads to severe symptoms like congestive heart failure, the rating may use the general formula for heart diseases, which utilizes Metabolic Equivalent of Task (METs) testing and can result in ratings up to 100 percent. Treatment procedures like ablation or pacemaker implantation do not automatically change the rating, as the VA focuses on the remaining residual symptoms and functional limitations.
Required Documentation and the Claims Process
To successfully file a claim for AFib, a veteran must gather specific documentation, typically submitted using VA Form 21-526EZ. Required evidence includes:
- The veteran’s DD214 or other separation documents.
- Service treatment records.
- All private medical records related to the AFib.
- Diagnostic test results, such as ECGs or Holter monitor reports, documenting the frequency and nature of the episodes.
Establishing the medical nexus is a key part of the process, often supported by a private medical opinion or a nexus letter. The VA will also arrange for a Compensation and Pension (C&P) exam. This exam evaluates the current severity of the condition and provides a medical opinion on the link between AFib and military service. During the C&P exam, the veteran should clearly articulate the frequency of symptoms, the treatment interventions received, and how AFib affects their daily functioning.
Veterans can seek assistance from an accredited Veterans Service Officer (VSO) to help file the claim and navigate the complex process. A VSO can ensure all necessary forms and evidence are included, which helps expedite the claim’s processing time. Submitting a complete package of evidence, including “buddy statements” from family or friends detailing the impact of the condition, helps the VA make an informed decision.