Atrial Fibrillation (AF) is the most common type of heart arrhythmia. The two upper chambers (atria) contract irregularly, which causes blood to pool there instead of being pumped into the lower chambers (ventricles). Between 3 and 6 million people in the United States have AF, according to the Centers for Disease Control (CDC).
If AF is a burden in your life or the life of a loved one, there may be help available. The Social Security Administration (SSA) offers benefit programs to help those with a disability that makes them unable to support themselves financially.
The Financial Costs of Atrial Fibrillation
AF costs the nation about 26 billion dollars annually for direct and indirect costs, WebMD reported. The CDC added individuals with AF will pay an extra $8,705 each year, as opposed to those who don't have AF.
According to a study done by Beth Israel Deaconesses Medical Center and Harvard Clinical Research Institute, about 75 percent of these costs are due being in the hospital. The condition accounts for over 750,000 hospitalizations per year in total, according to the CDC.
Additionally, though many patients with AF don't believe the disease is serious, it can lead to stroke, heart failure and other conditions that could end up costing tens of thousands more in medical expenses. For example, a study in Clinical Cardiology found that each episode of heart failure can cost up to $25,000 and the CDC reported that strokes can cost up to $40,000.
Medically Qualifying for Benefits with the Blue Book
The Blue Book is the SSA's official list of disabilities that quality for benefits. All applications are first evaluated using the Blue Book to determine if the applicant meets or equals any of the medical requirements in a listing.
Atrial Fibrillation can be found in section 4.05—Cardiovascular under Recurrent Arrhythmias.
You can qualify for disability benefits if your Atrial Fibrillation meets the following criteria:
- Your arrhythmia is uncontrolled, and
- you experience syncope (fainting).
- you are able to show that you still experience symptoms from AF despite taking treatment.
When qualifying for uncontrolled AF, our AF must show in clinical testings at least three times in a 12-month period resulting in multiple fainting episodes or periods of altered consciousness (cardiac syncope or near syncope respectively), despite standard prescribed treatment. Standard prescribed treatment means that you are taking medication doctors would expect the typical patient to use and see improvements with.
Additionally, you must have medical records that show the connection between your fainting episodes and AF. You cannot qualify for disability benefits for a temporary condition like an electrolyte imbalance.
If your AF is severe and keeping you out of work, talk to your doctor about applying for disability benefits.
Qualifying Without Meeting a Medical Listing
Because AF occurs in older adults, it's often brought on by other medical issues, like high blood pressure, heart disease, diabetes, hyperthyroidism, chronic kidney disease, and an abnormal heart size. These disorders already have costs of their own.
If your AF doesn't meet or equal the Blue Book listing, but you feel it's severe enough to make you unable to work, you may be approved for benefits with a medical-vocational allowance instead of medical requirements. As with all applications, your AF must be expected last for a year or longer and it must keep you from earning the SSA's 2016 minimum monthly wage of $1,130.
In order to be considered with a medical-vocational allowance, your doctor must fill out a long form detailing your impairment(s) and related symptoms as well as physical and mental abilities and limitations. Separately, you must provide an education and work history to the SSA. With these the SSA will look for jobs you can do with your work ability.
AF causes some symptoms that may make working full time hard, such as extreme fatigue, lightheadedness, shortness of breath, chest pain, and the amount of sick days needed for hospitalizations. However, many more debilitating symptoms are caused by co-occurring conditions like stroke or heart failure. The study done by Beth Israel Deaconesses Medical Center and Harvard Clinical Research Institute showed that 75 percent of patients 80 and over were highly dependent on another person for daily living activities.
The disease most commonly affects an older population, so approval with an RFC is likely, especially if patients have a work history of non-sedentary jobs, such as trucking, landscaping, or construction. Individuals with a college degree who worked in an office may have a smaller chance of approval.
How to Apply for Social Security Disability Benefits
The requirements for AF are very specific, so talk to your doctor before you begin the SSA's application. If your doctor doesn't think approval is likely, it may not be worth the trouble to apply. Many disability claims take up to two years to be approved, if approved at all, after multiple denials and appeals.
If you meet the Blue Book listing for AF, you will be automatically be approved for disability benefits. However, if you leave out important medical evidence, you may be denied anyway. Important medical evidence for AF may include:
- Medical imaging tests, like a chest X-ray, MRI, ultrasound, or CT scan.
- An electrocardiogram (EKG/ECG) at rest to test the electrical activity of your heart.
- Holter monitoring, also known as an EKG, while performing normal activities.
- Blood tests.
- Documented connection between the fainting episodes (cardiac syncope) and AF.
- Tilt table test, which measures how your blood pressure and heart rate respond to gravity.
- Exercise tolerance test (ETT), also known as an exercise EKG or stress test.
- Echocardiogram, which uses sound waves to create images of the heart.
- Electrophysiological testing and mapping with catheters throughout blood vessels to map the spread of the heart's electrical impulses.
- A detailed report from your doctor and/or your cardiologist describing the severity of your AF and the limitations it causes.
- Operative reports and summaries of other hospitalizations caused by AF.
- List of all prescribed treatments and outcomes.
When applying for Social Security Disability Insurance, you can apply online or by appointment as an SSA office. If you want to apply for Supplementary Security Income, you must apply in person at an SSA office. If you have questions about your application or what you need to submit with it, contact an SSA representative or use the application checklist on the SSA's website, which has a list of all required documentation.
Make sure your check over your application carefully before you submit it. Any missed questions, typos, or spelling errors could hurt your application, because the SSA may not be able to find the information they need to approve your claim. Small mistakes can cause a delay in your answer, or a denial, even if you are eligible for benefits.
If your AF worsens after you apply for disability benefits, make sure to report any changes in symptoms, treatment, or test results to the SSA as soon as possible. The additional information will help show the SSA you're in need of assistance because of the limitations AF causes you.
If you’re approved for benefits, your spouse and children may also be eligible for benefits. To learn more about the different forms about disability benefits, visit our pages on Social Security Disability Insurance.