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 and some cause the heart to beat too slowly or irregularly. Some arrhythmias are dangerous while others are harmless. The symptoms of arrhythmia vary widely. Some arrhythmias can be felt in the chest as fluttering, or as a slower or faster than normal heartbeat. Your arrhythmia may cause fainting or near fainting, dizziness, shortness of breath or chest pain. Some arrhythmias cause no symptoms at all.
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. AFib increases the chance of stroke. Most individuals who have atrial fibrillation are asymptomatic, but some individuals experience palpitations, fainting, dizziness, chest pain, exercise intolerance, and fatigue. In serious cases, AFib can cause strokes and heart failure. Women often suffer a poorer quality of life due to AFib than men, and a significant portion of AFib patients suffer from depression and anxiety. Treatment options for individuals who suffer from atrial fibrillation usually involve medication. If medication fails to control AF, physicians will usually use a pacemaker to regulate heart rhythm.
Ventricular fibrillation occurs when the ventricles flutter, preventing blood from being delivered to the body, and can lead to cardiac arrest or sudden cardiac death (SCD).
Heart block is a type of arrhythmia where the heart beat is slowed; it can be mild (first-degree) or severe (third-degree).
To be eligible for disability based on your arrhythmia, the Social Security Administration (SSA) will first look to see if you are eligible under the non-medical disability criteria and if you are not working (or working less than the gainful activity amount). You must also show that your arrhythmia is expected to last at least 12 months and that it is “severe”—that is, it causes a more than minimal effect on your ability to work.
Once the SSA has determined that your arrhythmia is severe, the SSA must then look to see if your arrhythmia meets or equals one of the qualifying conditions established in the SSA’s Listing of Impairments; if your arrhythmia meets a listing you will be automatically approved.
The SSA discusses the qualifying criteria for recurrent arrhythmias in Listing 4.05. In order to be automatically approved for disability based on your arrhythmia, you must meet ALL of the following criteria:
If your abnormal heart rhythm doesn't cause fainting or near fainting, or medication can control your fainting or near fainting, you won't likely be eligible for disability benefits. If your syncope or presyncope can't be controlled, you might be able to meet the requirements of the listing. For example, patients with persistent or chronic AFib who experience fainting despite being under a doctor's treatment may qualify for disability under this listing. If you are unsure whether you meet the criteria of Listing 4.05, you should review the listing with your treating physician.
In order to prove that your arrhythmia meets the requirements of the arrhythmia listing, you must provide the SSA with your detailed medical record, physical exams, lab reports, and EKG results, as well as descriptions of your treatment and evidence of how you responded to treatment. You should also provide the SSA with the names of all the hospitals and clinics you visited for treatment of your arrhythmia or any procedures you had in an attempt to correct the arrhythmia. Because of the time and treatment requirements of Listing 4.05, you must provide the SSA with medical evidence that documents at least 12 consecutive months of treatment.
Even though your arrhythmia doesn’t meet the official listing requirements for an automatic approval, you may still be approved for disability. The SSA will look at how your arrhythmia affects your life and whether it prevents you from doing your prior job, or any other work.
To win a claim at this stage, you should provide the SSA with a Residual Functional Capacity (RFC) assessment from your doctor that proves your arrhythmia prevents you from doing work-related activities. For instance, the form should address whether your arrhythmia causes you to frequently experience chest pain or dizziness. If it does, your cardiologist should also report how this affects your ability to work. For example, if your arrhythmia causes chest pain and dizziness, you will likely need to rest throughout the day. If your arrhythmia makes it difficult to focus, concentrate or keep up with your work as expected, your doctor should note this as well, as these limitations would make it difficult for you to work. Also, because your arrhythmia may cause weakness or shortness of breath, your physician should note any limitations on how long you can walk and whether you can stoop, climb, or crawl. The SSA will often approve claims based on the complete inability to stoop; therefore, if your arrhythmia prevents this activity, be sure to report it to your doctor.
The SSA will consider an RFC form submitted by your doctor only if your doctor provides objective medical evidence to support the work limitations that result from your arrhythmia. Therefore, it is important to provide the SSA with copies of the reports from doctors’ visits, hospitalizations, medication lists with side effects, lab tests, EKGs, catheterizations and any other treatments or tests.
Because chronic illnesses often cause depression and anxiety, it is important to let the SSA know if you see a doctor or psychologist for treatment of these illnesses. Mental illness can cause significant interruptions in your ability to focus, complete tasks, get along with others, follow directions, and be reliable. Your psychiatrist or psychologist can prepare a mental RFC assessment that discusses any mental limitations as a result of your depression and anxiety. The SSA will consider the effect of your anxiety or depression along with your arrhythmia on your ability to engage in full-time work. For more information, see our article on having the effect of moderate anxiety or depression on a disability claim.
Patients with arrhythmias often have other physical ailments. For instance, poor kidney function and hemodialysis are risk factors for AFib. Having more than one medical condition can help you qualify for disability benefits. For more information, see our article on having multiple medical conditions.
The SSA will use your doctor's RFC form, as well as its own assessment of what your residual functional capacity (RFC) is, and compare is to the requirements of your prior work and other jobs to see if there is work you can be expected to do. If the SSA believes that there is no work you can perform given the combination of your impairments, your claim will be approved.
Learn more about how the SSA uses your RFC to decide if you can work.