Disability for Atrial Fibrillation

What is Atrial Fibrillation (Afib)

Atrial fibrillation (AFib or AF) is a heart condition that is characterized by irregular heartbeats or an arrhythmia. At least 2.7 million Americans are estimated to be living with AFib that can range in severity and may or may not produce symptoms. Severe forms can cause blood clots, strokes, heart failure and other heart-related complications. If chronic atrial fibrillation significantly interferes with your ability to work, you may qualify for disability benefits administered by the Social Security Administration (SSA), which has strict rules governing eligibility for benefits due to AFib.

AFib occurs when the heart’s two upper chambers, called the atria, beat rapidly and become out of sync with the lower heart chambers, known as ventricles. This erratic heartbeat, or arrhythmia, can be an occasional occurrence or an ongoing, chronic condition that negatively affects blood flow. It can result in heart palpitations, weakness, shortness of breath, chest pain, or fainting, leading to heart failure or stroke. General treatment for AFib usually involves medication or possibly a pacemaker.

Many people are unaware that AFib may qualify for disability benefits. Hence, they never think about applying for SSDI or SSI benefits and instead face financial and other challenges related to the condition without support. If you have been diagnosed with a disabling condition that has lasted or is anticipated to last for at least 12 months, you may qualify for benefits.

Atrial Fibrillation Symptoms

An erratic heartbeat, or arrhythmia, is the main symptom of atrial fibrillation. However, additional symptoms may be present in conjunction with an arrhythmia. These may include:

1. Fatigue
2. Confusion
3. Fainting
4. Dizziness
5. Palpitations
6. Shortness of breath
7. Chest pain
8. Anxiousness

Though Some people may experience no symptoms at all, and may not even be aware of the condition, most will be aware that something is awry when the heart begins beating rapidly or irregularly.

Types of Atrial Fibrillation

There are several types of atrial fibrillation. Not all types of atrial fibrillation symptoms will qualify for disability benefits. It is important to know what to look for before applying for benefits. In 2014, the Journal of the American College of Cardiology determined that medical experts can assess the kind of AFib a patient has by ascertaining which of four types of arrhythmia the patient presents with.

• Paroxysmal Atrial Fibrillation: This type of AFib is the least severe. While experiencing any of the symptoms associated with this condition warrants a visit to the doctor’s office, the paroxysmal arrhythmia typically lasts less than a week. The arrhythmia often comes and goes, but can be brought on again by stress and other lifestyle choices.
• Persistent Atrial Fibrillation: This type lasts longer than paroxysmal AFib. It may need to be treated with medicine to keep it under control. Sometimes a more severe treatment is necessary, such as electrical cardioversion. Here, low-voltage electricity is used to re-establish the heart’s rhythm into a normal beating pattern.
• Long-standing Atrial Fibrillation: Afib is long-standing if the arrhythmia lasts for more than a year without stopping. Treatments that may be successful with persistent AFib will probably not work with this type. If a person is diagnosed with long-standing AFib, there may also be structural damage to the heart.
• Permanent Atrial Fibrillation: If the arrhythmia is determined to be chronic, the AFib is likely to be classified as permanent. With this type of AFib, treatment is usually ineffective. There’s a much higher risk of stroke or another cardiac event when the condition is chronic. A long-term plan with medication is typically the course of action recommended by medical professionals. Treatment will attempt to stabilize the heart rate to minimize major cardiac risks.

A long-term plan with medication is typically the best course of action. We are saying this because it stabilizes the heart rate and minimizes the major cardiac risks.

• Valvular Atrial Fibrillation: When a problem with the heart valve is what is causing the arrhythmia, it results in valvular AFib. While a pre-existing heart valve disorder may cause this type of AFib, it is also possible to develop this type of condition if there has been a prosthetic or artificial valve installed. Stabilizing the heart rate and minimizing blood clots are the common courses of treatment for this type of atrial fibrillation.
• Nonvalvular Atrial Fibrillation: Nonvalvular AFib may be caused by high blood pressure or other lifestyle choices. Treatment can either come in the form of medication or procedures like cardioversion.

Atrial fibrillation With Rapid Ventricular Response (AFib with RVR): This is when an arrhythmia in the atria, or top two chambers of the heart, occurs at the same time as arrhythmia in the ventricles, or bottom two chambers of the heart. Medical professionals refer to this as AFib with rapid ventricular response. This type can have minor symptoms like shortness of breath, but can also lead to stroke. Stabilizing the heart rate is the main course of treatment for this condition, as well.

Regardless of the type, if you feel your heart beating irregularly, you should see a doctor. While AFib can start as a paroxysmal arrhythmia, it can escalate to a more severe type of atrial fibrillation.

Disability benefits for AFib are determined through a strict eligibility process. The Social Security Administration follows the same rules for all the applicants to verify their disability and the extent that symptoms affect their lives and ability to work. They do this to ensure that only those eligible to receive benefits are provided support.

Atrial Flutter vs. Atrial Fibrillation

While both conditions involve arrhythmias, a person with an atrial flutter does not necessarily have an irregular heartbeat. With AFib, the atria beats out of sync with the ventricles, which causes an erratic heartbeat. With atrial flutter, the atria and the ventricles are in sync, but the atria beats faster than the ventricles. An example of atrial flutter is when the atria beats two times for every ventricles’ beat. The atria’s rapid beat could happen multiple times, always beating more than that of the ventricles. Your doctor may assess your condition using an EKG to tell whether you are experiencing an atrial flutter or atrial fibrillation.

Atrial Fibrillation vs. Ventricular Fibrillation

Once again, both conditions have arrhythmia in common. Ventricular fibrillation, or VFib, is opposite to AFib in the way it presents arrhythmia. The irregularity of VFib occurs in the ventricles, while the abnormality of AFib occurs in the atria.

Ventricular fibrillation, however, is more severe than atrial fibrillation. VFib presents an immediate threat to a patient’s life, while AFib is a gradual threat to one’s life. This is because the erratic heartbeats involved in VFib do not allow enough blood to be pumped to the arteries.

Atrial Fibrillation Diagnosis

When patients tell their doctor that they are experiencing irregular heartbeats, it is a good indication that some type of fibrillation is happening. Physical examinations and diagnostic testing are necessary to diagnose the exact type you may be experiencing.

Some Tests That a Doctor May Suggest

• EKG: An electrocardiogram (EKG) is a test that allows doctors to monitor the heart’s activity. This should allow doctors to know if there is a pattern indicative of AFib. To be able to diagnose AFib, the arrhythmia has to happen at the time the EKG is being administered. If it does not, the doctor may ask the patient to wear a Holter monitor.
• Holter Monitor: A Holter monitor is a portable machine that records the heart’s activity on the go. It is a small device that will allow a doctor to detect any arrhythmia that might be present. Doctors may ask patients to wear it for a full 24-hours or more to detect any irregularity. If this still does not work, doctors may try to simulate an AFib episode by having the patient undergo a stress test.
• Stress Test: This test requires the patient to exercise to an elevated heart rate, forcing it to work hard. Since stress can sometimes trigger AFib, this can be a way for doctors to diagnose the condition.

Other tests doctors may perform to diagnose this condition are chest x-rays or blood tests. These tests may help diagnose the exact type of AFib the patient has and its severity.

Atrial Fibrillation Causes.

The connection between the upper and lower heart chambers are sometimes overloaded with electrical signals that create abnormal rhythms. The many possible causes of atrial fibrillation include:

• Abnormal heart valves.
• High blood pressure.
• Congenital heart defects
• Overactive thyroid.
• Heart attack.
• Viral infections.
• Stress from surgery or illness.
• Lung diseases.
• Sleep apnea.
• Exposure to tobacco, caffeine, alcohol, or stimulant medications.

The cause of atrial fibrillation may differ depending on the type of AFib the patient presents.

For example, paroxysmal atrial fibrillation can be caused by lifestyle choices or stress, whereas valvular AFib can be caused by heart valve problems.

Atrial Fibrillation Treatment

Treatment for atrial fibrillation is going to depend on the type a patient was diagnosed with. Some of the more common forms of treatment for AFib attempt to stabilize the heart rate and decrease the chance of a stroke or heart attack from occurring. These objectives can typically be accomplished with medication, but medical procedures may also be necessary if medication is not successful.

Some of these medical procedures may include:

• Ablation: In this procedure, the patient is first sedated carefully. Then the surgeon guides a flexible, thin tube to the area of the heart that is causing the irregularity to occur. Once the tube has reached the trouble spot, the surgeon will either burn or freeze the tissue in that area. This is done to help prevent the arrhythmia from happening again.
• Electrical Cardioversion: This procedure attempts to reset the heart’s regular rhythm by sending an electrical shock to the heart through patches. These patches are attached to the patient’s chest while the patient is sedated. Once the rhythm has been stabilized, doctors can continue treating the AFib with long-term use of medication. This procedure is not meant to be a permanent fix.
• Pacemakers: A permanent pacemaker can be surgically placed. This is done to consistently send electrical signals to the heart that regulate its rate. To seek disability benefits for AFib, you must provide all necessary medical documents that show the extent of your condition. These documents should include diagnostic testing and ongoing treatment notes. The SSA will require this documentation when determining eligibility for benefits. Having all supporting documentation up front can make your claim stronger, and you can get approved faster.

Atrial Fibrillation Natural Treatment-

Many cases of AFib will require medical intervention such as the use of medication or some of the procedures previously described. Those types of AFib that are caused by lifestyle and habits may alternatively be treated naturally by changing those habits.

Treatment in this regard often includes exercising, smoking cessation, eating healthy foods, performing mindfulness or de-stressing activities such as meditating, and drinking little to no alcohol or caffeine. If natural treatment does not stop the arrhythmia, further treatment will be necessary. You should always consult a medical professional whenever you have questions regarding treatment of a serious medical condition like AFib or VFib.

Can You Get Disability for Atrial Fibrillation?

Yes, if you are able to provide supporting evidence of your long-term disability due to AFib. Atrial fibrillation is classified with other arrhythmias, and there are several conditions to meet before receiving approval for disability payments. You should know at the outset that fibrillations that are able to be controlled by medication or other treatments will not qualify you.

If medication does not relieve the condition, the SSA will first review your current work status and income. If your income exceeds certain limits, you will not qualify for atrial fibrillation disability.

Next, your condition must be expected to last 12 months or more and it must have a significant effect on your capacity to work. If this is the case, the SSA may classify your condition as severe. The SSA will first look to evaluate your diagnosis of AFib under its listing of impairments, section 4.05 for Recurrent Arrhythmias. If you meet all of the qualifying conditions the SSA will likely be able to approve your application.

The qualifying criteria, paraphrased is:

1. Episodes that occur even while following a doctor’s treatment, and
2. An arrhythmia that causes fainting or near fainting (syncope) at least three separate times in 12 successive months, and
3. An EKG that proves the condition is related to fainting or near fainting, and
4. An arrhythmia that is not caused by a reversible medical condition.

To prove your disability, you will need to provide detailed medical records for 12 successive months. You will also have to show the lab results, EKG tests, treatment and response records. You will need the names of places you have been treated, and any procedures you have had.

Suppose you do not meet the conditions for approval of an AFib disability under section 4.05. In that case, a doctor can still verify that atrial fibrillation interferes significantly with your ability to work. The SSA will work with the doctor to determine your residual functional capacity (RFC). The SSA defines your RFC as the most you can still do despite limitations caused by your ailments.

Frequent dizziness, chest pain, weakness, or shortness of breath may be considered when determining eligibility for disability benefits. Your ability to perform certain vocationally-related functions will also be taken into account, such as the ability to crawl, climb, or stoop. How your arrhythmia impacts your vocational functionality will weigh heavily in the decision for eligibility.

Chronic mental illness, including anxiety or depression, and multiple physical medical conditions, may also contribute to your overall disability. Proof of all medical diagnoses and treatments will be required as part of the application process.

If you do not qualify for approval based on listing criteria, the SSA will carefully review all the records and forms you submit. A clear and complete medical history of your treatment and your response to treatment will help the SSA to determine your eligibility for Social Security payments. Contact a qualified attorney who is available to help you through the complex and lengthy SSA disability application process. 

Client Review

About the author 

Mr. Chermol is a Founding and Lead Partner at the disability law firm of Chermol & Fishman, LLC. He represents Social Security disability and SSI claimants across the United States both at the administrative level and in federal court

From 1997 until 2007, Mr. Chermol was as an Assistant Regional Counsel for the Social Security Administration’s Office of the General Counsel in Philadelphia.