Can You Get Disability Benefits for Arrhythmia or Fibrillation?

An arrhythmia is an abnormal heartbeat. Arrhythmias are caused by disturbances in the heart's electrical system. Some arrhythmias cause the heart to beat too quickly (tachycardia) and some cause the heart to beat too slowly (bradycardia).

The symptoms of arrhythmia vary widely. Some arrhythmias are dangerous while others are harmless. Some can be felt in the chest as a fluttering. Your arrhythmia may cause you to faint or feel like fainting, become dizzy, have shortness of breath after minor exercise, experience chest pain, or you might have no symptoms at all.

Types of Abnormal Heartbeats

Healthy hearts beat in a sinus rhythm. In a normal sinus rhythm, a part of your heart called the sinus node generates an electrical impulse that tells the rest of your heart to contract. When the impulse is interrupted or generated incorrectly, an arrhythmia occurs. Doctors classify abnormal heartbeats according to what part of the heart is causing the arrhythmia.

Atrial Fibrillation

Atrial fibrillation (often called AF, or "AFib") is a common type of arrhythmia that causes the upper chambers of the heart—the atria—to squeeze too fast and irregularly. Most people who have AFib are asymptomatic, but in serious cases, AFib can cause strokes and heart failure.

Ventricular Fibrillation

Ventricular fibrillation occurs when the two lower chambers of the heart (the ventricles) flutter, preventing blood from being delivered to the body. Ventricular fibrillation is typically more severe than atrial fibrillation, and is considered a life-threatening emergency requiring emergency treatment. Untreated, ventricular fibrillation can lead to cardiac arrest or sudden cardiac death.

Heart Block

Heart block occurs when the electrical impulse originating in your sinus node slows down as it passes from your atria to your ventricles. Heart block can be mild (first-degree) moderate (second-degree) or severe (third-degree) based on whether the impulse is slightly slowed, slowed enough to skip a heartbeat, or blocked entirely.

Can I Get Disability for My Arrhythmia?

To be eligible for disability based on your arrhythmia or fibrillation, the Social Security Administration (SSA) will first look to see if you are eligible under the non-medical disability criteria and if you aren't working at the level of substantial gainful activity. You also need to show that your arrhythmia is a severe impairment—meaning that the condition is expected to last at least 12 months and that it causes a more than minimal effect on your ability to work.

Once the SSA has determined that your arrhythmia is severe, the agency will then see if your arrhythmia meets or equals one of the qualifying conditions established in the Listing of Impairments ("Blue Book"). If your medical records contain certain specific evidence of your arrhythmia, the SSA will automatically approve your disability application.

Listing 4.05 for Recurrent Arrhythmias

Social Security discusses the qualifying criteria for recurrent arrhythmias in listing 4.05. Under the requirements for this listing, you can get disability benefits if you have medical documentation of all of the following:

• your arrhythmia must cause syncope (fainting or loss of consciousness) or near-syncope (altered consciousness) on at least three different occasions in 12 consecutive months
• you must have an electrocardiogram (ECG or EKG) that shows a connection between your arrhythmia and your episodes of syncope or near-syncope
• the episodes must occur even though you've been following your doctor's treatment, and
• your arrhythmia cannot be due to a reversible condition (such as an adverse reaction to medication).

If your abnormal heart rhythm doesn't cause you to faint or almost faint, or medication can control your fainting, you won't likely be eligible for disability benefits. But if you're regularly fainting despite medication, you might be able to meet the requirements of the listing.

Let Social Security know the names of all the doctors, clinics, and hospitals you visited for treatment of your arrhythmia. If you aren't sure whether you meet the criteria of Listing 4.05, you should review the listing with your regular physician. Your doctor may help you by writing a medical source statement that can help Social Security better understand how your arrhythmia affects your health.

What if My Arrhythmia Doesn't Meet the Listing 4.05 Requirements?

You can still be approved for disability even though your arrhythmia doesn't meet the requirements of listing 4.05 if you can show that your symptoms prevent you from doing your past jobs or any other work. Social Security determines whether you can work by first looking at your medical records and your daily activities in order to assess your residual functional capacity (RFC).

What's In Your RFC?

Your RFC is a set of restrictions reflecting the most you're capable of doing safely in a work environment. Any symptoms from your arrhythmia that limit your job performance will be included in your RFC. Here are some examples:

• If your arrhythmia causes chest pain and dizziness, your RFC may state that you need extra breaks to rest throughout the day.
• If your arrhythmia makes it difficult for you to focus, your RFC may state that you have limitations in concentration, persistence, and pace that rule out job tasks.
• If your arrhythmia causes weakness or shortness of breath, your RFC may contain restrictions on how much weight you can lift or how long you can stand or walk.

You can provide your doctor with a form to complete that helps Social Security assess your RFC. As with the listing requirements, having your doctor write a letter that describes what activities you should avoid because of your arrhythmia can be very persuasive to the agency—especially if they're a cardiologist who's treated you regularly for a long time. A doctor's note isn't a substitute for a complete medical history, however, so don't forget to give the SSA information about hospitalizations, lab tests, and any other treatment you've received for your arrhythmia.

Your RFC should include any limitations you have from other physical ailments in addition to your arrhythmia or fibrillation. Poor kidney function and hemodialysis, for example, are risk factors for AFib. Social Security is required to consider the combined effect of all your medical conditions when assessing your RFC, so having multiple impairments can increase the chances that you'll be approved for disability benefits.

How Social Security Uses Your RFC

Once the SSA has assessed your RFC, the agency will look at your work history and compare the duties of your past jobs with the restrictions in your current RFC to see whether you could do those jobs now. If you can return to your past work, Social Security can't find that you're disabled, and you'll receive a denial of benefits.

If you can't do any of your past jobs, then—depending on your age, education, and work experience—the agency will look to see whether any other jobs exist that you can do, despite the limitations in your RFC. If Social Security doesn't think that you can perform any work given the combination of your impairments, your claim will be approved.

More Information About Disability Benefits and Heart Conditions

Cardiovascular impairments are one of the most common disorders listed on applications for disability benefits. If your doctor has told you that you have arrhythmia or fibrillation, you might also have been diagnosed with one or more of the following heart conditions:

• bradycardia or tachycardia
• coronary heart disease
• congestive heart failure
• aneurysm, or
• mitral valve prolapse.

You can find more information on getting Social Security disability for heart conditions in our section on cardiovascular and blood problems.