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). Arrhythmias can be harmless, with zero symptoms, or they can manifest as a fluttering in your chest, dizzy spells, experiencing chest pain, or having shortness of breath after minor exertion.

Symptomatic arrhythmia or fibrillation can be disabling if they prevent you from working full-time for at least one year. Very intense, frequent arrhythmia may meet the requirements of listing 4.05 and qualify for benefits automatically, but even if your arrhythmia is milder, you can still be eligible for SSDI or SSI if you can show that your symptoms cause functional limitations that rule out all types of jobs. Before you apply for benefits, it's a good idea to become familiar with some basic medical and legal terms involved in getting disability benefits for arrhythmia and fibrillation. 

How Can I Get Disability for Arrhythmia or Fibrillation?

You can get disability based on your arrhythmia or fibrillation if it keeps you from earning at or above the level of substantial gainful activity for at least 12 months. That means you'll need medical records establishing that your condition meets the requirements of a listed impairment or that you can't do any kind of job in the national economy. 

Listed impairments are medical conditions that Social Security considers serious enough to be automatically disabling. Not all conditions are included in the "Blue Book" of listed impairments, and the ones that are have pretty strict documentation requirements in order to get approved under a listing. But even if you don't meet (or equal) a listed impairment, you can still qualify for benefits under a medical-vocational allowance if you're unable to work due to your health. 

Getting Disability for Recurrent Arrhythmias by Meeting Listing 4.05

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.

Getting Disability With a Reduced Functional Capacity to Work

You can still be approved for disability even though your arrhythmia doesn’t meet 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). Your RFC is a set of restrictions reflecting the most you’re capable of doing safely in a work environment.

What's In Your RFC?

Any symptoms from your arrhythmia that limit your job performance will be included in your RFC. For example, if your arrhythmia causes chest pain and dizziness, your RFC may state that you need extra breaks to rest throughout the day. Weakness or shortness of breath can result in restrictions on how much weight you can lift or how long you can be on your feet, while feeling lightheaded can cause difficulties in concentration that limit the kind of work tasks you can do.

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 Does Social Security Use Your RFC?

Once Social Security 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.

But 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. Most people younger than 50 will need to show that they have an RFC that rules out even the simplest, sedentary jobs in order to qualify for benefits.

Medical Evidence You'll Need to Get Disability Based on Arrhythmia or Fibrillation

Whether you're trying to establish disability based on listing 4.05 or by showing that you can't work with your RFC, you’ll need to include your doctor’s notes, physical exams, lab reports, and ECG/EKG results. Your doctor’s notes should describe what your treatment is (for example, what medication you’re taking or whether you have a pacemaker) and how well you’re responding to treatment. If you need to show a certain amount of syncope episodes within a year, make sure that Social Security has records from all medical sources you’ve seen within that time frame.

Keep Social Security updated with the names of all the doctors, clinics, and hospitals you visited for treatment of your arrhythmia. You can provide your doctors with a form to complete that helps Social Security assess your RFC, or you can have your regular doctor write a medical source statement that can help the agency better understand what limitations you have as a result of your heart arrhythmia or fibrillation. 

How Much Can I Get in Disability Benefits?

Social Security doesn’t pay benefits based on the type of disability you have, so there’s no specific award amount for individual medical conditions. Rather, the amount of money you’ll receive depends on whether you’re eligible for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI).

SSDI eligibility is based on your earnings history and how many work credits you’ve acquired before you became disabled. Employment doesn’t matter for SSI eligibility, but it is a needs-based benefit subject to low income and asset limits. You can learn more (and calculate your estimated benefit amount) in our article on SSDI and SSI monthly check amounts.

How Do I File for SSDI or SSI?

Starting an application for SSDI or SSI is a fairly straightforward process. You can choose from one of the methods below to begin your claim.

• One easy way is to file online. You don’t have to complete the application in one sitting, and you’ll get a tracking number so you can check the status of your claim.
• You can also apply over the phone by calling Social Security at 800-772-1213 (TTY 800-325-0778) 8 a.m. to 7 p.m., Monday through Friday.
• If you prefer to file in person, you can schedule an appointment with a representative at your local Social Security field office.

When completing the application, you’ll need the contact information and treatment dates for all of your medical providers and the names, addresses, and dates of employment for all of your employers in the last five years. For more information, check out our step-by-step guide on applying for SSDI or SSI.

What if My Disability Claim Is Denied?

If a disability adjudicator reviewed your application and thought that you were able to return to your past work or that other jobs exist that you could do, you’ll receive a denial letter. (You’ll also receive a denial letter if you didn’t meet the non-medical eligibility requirements for SSDI or SSI, although those types of denials are harder to challenge.)

Don’t get too discouraged if your initial application for disability benefits was denied. You always have the option to appeal the denial, and can eventually request a hearing in front of an administrative law judge. (Most disability applicants who are ultimately granted benefits don’t get approved until after they’ve been in front of a judge.) You may also want to consider contacting a disability attorney to help increase your chances of a successful appeal. Disability attorneys work on contingency—meaning they get paid only if you win—and many offer free consultations, so it doesn’t hurt to ask around to find a lawyer you like.