Individuals with Atrial Fibrillation (AFIB) may be eligible for disability benefits if the condition significantly impairs their ability to engage in substantial gainful activity (SGA) for at least 12 months. 

To support a disability claim for AFIB, thorough and compelling medical evidence is crucial. It includes comprehensive documentation from medical professionals detailing the diagnosis, treatment history, severity of symptoms, functional limitations, and the impact of AFIB on daily activities and work capacity. 

What is AFIB?

Atrial Fibrillation (AFIB) is a common heart rhythm disorder where the heart’s upper chambers (atria) experience irregular electrical signals, causing them to quiver instead of contracting effectively. This irregular heartbeat can lead to symptoms like palpitations, shortness of breath, fatigue, and dizziness. 

Is AFIB a Disability?

Whether AFIB qualifies as a disability depends on the severity of the condition and its impact on an individual’s ability to perform work. In some cases, AFIB may be considered a disability if it significantly limits an individual’s physical or cognitive abilities, making it impossible to perform their job or engage in other daily activities.

To determine if AFIB qualifies as a disability, factors such as the severity of symptoms, the effectiveness of treatment, the individual’s age, and ability to perform work-related tasks are considered. If AFIB severely impairs an individual’s ability to work and meet the criteria established by the Social Security Administration (SSA) in the Blue Book, they may be eligible to apply for SSDI or SSI benefits.

Types Of AFIB

Atrial Fibrillation (AFIB) can be categorized into several types based on its duration and underlying causes:

  • Paroxysmal AFIB: This type involves episodes of irregular heartbeats that start suddenly and usually stop on their own within 7 days. The heart returns to its normal rhythm without medical intervention.
  • Persistent AFIB: In this type, the irregular heart rhythm lasts more than 7 days and doesn’t revert to normal. Medical treatment or procedures may be needed to restore a regular heartbeat.
  • Long-standing persistent AFIB refers to AFIB that has persisted for over a year and requires ongoing management to control the heart rhythm.
  • Permanent AFIB: In permanent AFIB, efforts to restore a normal heart rhythm have been unsuccessful, and the condition is considered permanent. Treatment focuses on managing symptoms and reducing the risk of complications.
  • Nonvalvular AFIB: This type occurs without an underlying heart valve issue. It’s the most common form of AFIB and is often associated with other risk factors like age, high blood pressure, and heart disease.
  • Valvular AFIB: Valvular AFIB is related to heart valve disorders, such as mitral valve stenosis. It’s less common and may require specialized treatment.

Symptoms Of AFIB

Atrial Fibrillation (AFIB) can manifest with various symptoms, which may vary in intensity and duration. Common symptoms of AFIB include:

  • Palpitations: Irregular, rapid, or fluttering heartbeat sensations, often described as a “racing” or “pounding” heart.
  • Fatigue: Feeling exhausted, even with mild exertion.
  • Shortness of Breath: Difficulty breathing or catching your breath, especially during physical activity or lying down.
  • Dizziness or Lightheadedness: Feeling faint, dizzy, or lightheaded, which may be accompanied by a spinning sensation (vertigo).
  • Chest Discomfort: Chest pain, pressure, or discomfort, which may be mistaken for a heart attack. This symptom may occur, especially in people with underlying heart conditions.
  • Weakness: Generalized weakness or a sense of reduced physical strength.
  • Confusion or Mental Fog: Difficulty concentrating, confusion, or a feeling of mental cloudiness.
  • Anxiety: Increased feelings of anxiety or unease.

AFIB can increase the risk of blood clots, stroke, and other heart-related complications. It can also lead to other disorders such as depression.

Eligibility Criteria For AFIB

Atrial Fibrillation (AFIB) is covered under Section 4.05 of the Social Security Administration’s (SSA) “Blue Book,” which is the manual used to evaluate disability claims. Section 4.05 explicitly addresses various types of heart arrhythmias, including AFIB.

To qualify for disability benefits under Section 4.05, the medical documentation must show that your AFIB meets specific criteria, such as:

  • Chronic Heart Failure: The presence of chronic heart failure that meets certain specifications.
  • Symptomatic Atrial Fibrillation: Documented episodes of AFIB that cause syncope (fainting) or near-syncope, congestive heart failure, or a reduced ability to perform daily activities.
  • Recurrent Atrial Fibrillation: Frequent episodes of AFIB that are resistant to treatment and result in severe symptoms.

How To Apply For AFIB Disability Benefits

To apply for disability benefits due to Atrial Fibrillation (AFIB), follow these general steps. 

  • Gather Medical Documentation: Collect comprehensive medical records, test results, and documentation from healthcare providers that detail your AFIB diagnosis.
  • Review Eligibility Criteria: Understand the eligibility criteria for the disability benefits program you’re applying for. 
  • Complete Application: Apply for disability benefits through the appropriate channels. For Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI), you can apply online through the SSA’s website, in person at a local Social Security office, or by phone.
  • Provide Detailed Information: Complete the application forms with accurate and detailed information about your medical condition, work history, earnings, and other relevant details. 
  • Appeals Process: You can appeal the decision if your initial application is denied. The appeals process may involve reconsideration, a hearing, and further legal steps.

Can You Get Disability For AFIB Without A Lawyer?

Applying for AFIB disability benefits is a complex procedure that requires extensive paperwork that includes medical documentation and other necessary information. Getting approval for the Social Security Disability Benefits may even take years if the SSA rejects your initial application. The complete disability claim process requires multiple denials and appeals before your disability benefits receive approval. 

Sometimes, even if your paperwork and application form are completed without any document missing, your claim may get rejected. Therefore, hiring a lawyer may help to not only speed up your case but will also guide you to apply for the right disability benefits. They will ensure that you submit the medical records and other documents before applying for the benefits. 

An experienced disability attorney will also represent you in the hearings thereby improving your chances of getting approved for the benefits.  

Importance Of Medical Documentation Required For AFIB Disability Benefits

An applicant is required to submit their clinical testing of their medical condition at least 3 times a year. Along with these, they need to submit their medical records to support their AFIB disability claim. The medical documents submitted must have a connection between your fainting spells and your AFIB.

Furthermore, your doctor must certify that AFIB may cause the following:

  • Uncontrolled arrhythmia
  • Fainting episodes
  • Persisting symptoms apart from medical intervention

Along with these, the doctor must give a detailed form that contains impairments related to AFIB, physical and mental abilities, limitations caused by AFIB, and the number of hospitalizations. 

What Happens When You Are Approved With Atrial Fibrillation?

Once your disability claim for atrial fibrillation gets approved, you will get disability benefits for 6th month from the date when you have become disabled. Applicants may experience different symptoms of atrial fibrillation and these play a significant role in the approval of disability benefits. 

However, the medical records must be detailed, and how your AFib is affecting your condition thereby making you unable to work. These will confirm your diagnosis, your treatment plan, medications, symptoms, restrictions, and side effects from treatment. 

Retroactive Payments For Atrial Fibrillation

Applicants may qualify for retroactive payments for Atrial fibrillation. These payments may go as far as 12 months before an applicant files a claim. However, you need to show that you were disabled due to atrial fibrillation. 

Retroactive payments are applicable only according to the SSA guidelines and they cannot exceed 12 months. To receive retroactive benefits for an AFIB claim, an applicant must provide all the documentation that indicates that you are struggling with the disability at least 5 months before you filed for disability.

How To Calculate How Much You Could Receive With Atrial Fibrillation?

The amount that an applicant is paying in Social Security taxes plays a significant role in the amount of the benefit. The SSA has strict criteria and will review all the work history, earnings history, and taxes paid by the applicant. Then, SSA will determine the average indexed monthly earnings (AIME) and primary insurance amount (PIA). This will help them to calculate monthly benefits for atrial fibrillation. 

Disability Benefits denied? Contact A Disability Lawyer

If you receive a denial of Atrial Fibrillation (AFIB) disability benefits, a Social Security disability lawyer can assist in appealing the decision and increasing your chances of a successful outcome. They will carefully review the denial letter to understand the specific reasons for the denial and identify any areas that must be addressed in the appeal.