Atrial fibrillation (AFib) is a heart rhythm disorder that causes the upper chambers of the heart to beat irregularly and often rapidly. This uncoordinated beating can lead to poor blood flow and symptoms such as palpitations, shortness of breath, and fatigue. For veterans who have been diagnosed with this condition, the Department of Veterans Affairs (VA) does recognize Atrial Fibrillation as a compensable disability. The possibility of receiving benefits depends entirely on establishing a service connection, which links the heart condition to the veteran’s time in uniform.
Establishing Service Connection for AFib
Securing service connection for AFib involves demonstrating a link between the diagnosis and military service through one of three primary pathways. The most direct method requires showing that AFib was diagnosed or clearly manifested during active duty or shortly after separation. This direct connection relies on medical evidence of a current diagnosis, a specific in-service event, injury, or illness, along with a medical opinion establishing the relationship, known as a nexus statement.
A more frequent method for veterans is secondary service connection, where AFib is shown to be caused or worsened by an existing, service-connected disability. This often occurs because other conditions common among veterans, such as hypertension, sleep apnea, post-traumatic stress disorder (PTSD), or ischemic heart disease, are known risk factors for developing AFib. For example, if a veteran is service-connected for hypertension, and medical evidence indicates the high blood pressure led to the onset of AFib, a secondary connection can be established.
A third route involves presumptive service connection, though AFib is not presumptive on its own. However, AFib may develop secondary to another condition that is presumptive, such as Ischemic Heart Disease (IHD) linked to Agent Orange exposure. In these cases, the VA presumes IHD is service-connected, reducing the burden of proof for the veteran. AFib can then be connected secondarily to the IHD. The key to any claim is providing a current diagnosis and medical evidence that clearly ties the condition back to service.
How the VA Rates Atrial Fibrillation
The VA rates AFib under the cardiovascular system section of the Schedule for Rating Disabilities, specifically using Diagnostic Code 7010 for supraventricular tachycardia. The percentage rating reflects the severity, frequency, and duration of the episodes, not the underlying cause. The maximum rating under this code is 30 percent, which is assigned for paroxysmal AFib or other supraventricular tachycardia with more than four documented episodes per year.
A lower rating of 10 percent is given for permanent Atrial Fibrillation, or for paroxysmal AFib with documented episodes occurring one to four times per year. Documentation of the episodes, typically via an electrocardiogram (ECG) or Holter monitor, is necessary to confirm the frequency and type of the arrhythmia. If a veteran’s AFib is non-compensable, a zero percent rating may be assigned.
The VA’s rating for AFib focuses on the arrhythmia, not the resulting physical limitations. Ratings for many other heart conditions are determined by the functional impairment measured by a Metabolic Equivalent of Task (METs) test. While AFib is not rated using METs, if the condition progresses and causes a separate, debilitating service-connected condition like heart failure, the veteran may receive a higher rating based on METs under a different diagnostic code. The evaluation under Diagnostic Code 7010 focuses on the frequency of episodes and the type of AFib—paroxysmal or permanent.
Filing and Managing the VA Disability Claim
Veterans begin seeking disability compensation by submitting VA Form 21-526EZ, the Application for Disability Compensation and Related Compensation Benefits. This form is used for new claims, claims for a secondary condition, or requests for an increase in a current rating. The form can be completed online through the VA website, or submitted by mail or in person at a regional office.
Successful claims require comprehensive evidence to support the link between AFib and military service. This evidence package should include a current medical diagnosis, all relevant private medical records, and the veteran’s service treatment records (STRs). Lay statements, also known as buddy statements, from family, friends, or former service members who witnessed the onset or progression of symptoms, can also be helpful.
After the application is submitted, the VA will often require the veteran to attend a Compensation and Pension (C&P) examination. A VA or VA-contracted healthcare provider conducts this exam to gather medical evidence and provide an independent medical opinion on the nexus between the AFib and service. If the initial claim is denied or the assigned rating is considered too low, veterans have several options for appeal, including filing a Supplemental Claim with new evidence, requesting a Higher-Level Review, or appealing directly to the Board of Veterans’ Appeals.