The VA rates cardiac arrhythmias under 38 CFR 4.104, the schedule of ratings for the cardiovascular system, using three main diagnostic codes: DC 7009 for symptomatic bradycardia requiring a pacemaker, DC 7010 for supraventricular arrhythmias (including atrial fibrillation), and DC 7011 for sustained ventricular arrhythmias. Ratings under these codes run from 10 percent for occasional, medication-controlled episodes to 100 percent for arrhythmias requiring an implanted cardioverter-defibrillator or ongoing treatment for a life-threatening rhythm. This guide covers how each code works, how the VA measures severity after the acute phase, and how to build a claim that gets the rating your heart condition actually warrants.
How the VA classifies arrhythmias
An arrhythmia is any abnormal heart rhythm, whether the heart beats too fast, too slow, or irregularly. The VA schedule splits arrhythmias into three categories based on where in the heart the abnormal signal originates and how dangerous it is:
- Supraventricular arrhythmias (DC 7010): Abnormal rhythms starting above the ventricles, in the atria or the AV node. This category includes atrial fibrillation, atrial flutter, paroxysmal supraventricular tachycardia (PSVT), and Wolff-Parkinson-White syndrome. Atrial fibrillation is the most commonly claimed condition under this code, but it is one example within a broader category, not a separate diagnostic code of its own.
- Ventricular arrhythmias (DC 7011): Sustained abnormal rhythms originating in the ventricles, such as ventricular tachycardia or ventricular fibrillation. These are considered medically serious and are rated accordingly.
- Bradycardia (DC 7009): A symptomatic slow heart rate, typically from a conduction abnormality like sick sinus syndrome or heart block, severe enough to require a permanent pacemaker.
The VA rates each veteran under whichever single code best reflects the predominant disability picture. DC 7009, 7010, 7011, and 7015 (arteriosclerotic heart disease) are not combined for the same underlying heart condition. If a veteran has more than one qualifying cardiac diagnosis, the VA assigns one evaluation under the code that fits the dominant presentation, not a stacked rating.
DC 7010: Supraventricular arrhythmias
Diagnostic Code 7010 covers supraventricular tachycardia and other supraventricular arrhythmias, including atrial fibrillation. Since a rule change effective November 2021, the VA rates this code based on the number of documented treatment interventions per year rather than simply counting episodes.
| Rating | Criteria |
|---|
| 30% | Confirmed by ECG, with five or more treatment interventions per year (intravenous pharmacologic adjustment, cardioversion, and/or ablation) |
| 10% | Confirmed by ECG, with one to four treatment interventions per year; or confirmed by ECG with either continuous use of oral medication to control the rhythm, or reliance on vagal maneuvers to control it |
"Treatment interventions" is a specific term in the regulation. It means active medical procedures such as electrical cardioversion, catheter ablation, or IV medication administered to correct the rhythm, not routine outpatient visits or refills of a standing prescription. A veteran on daily beta-blockers with stable, well-controlled paroxysmal AFib and no cardioversions in a given year typically falls into the 10 percent tier under the "continuous medication" clause, even without five interventions.
Because atrial fibrillation is the most frequently claimed condition under DC 7010, a dedicated guide covering AFib-specific evidence and claim strategy in more depth is available separately on this site. This page covers the diagnostic code as a category.
DC 7011: Ventricular arrhythmias (sustained)
Sustained ventricular arrhythmias, such as sustained ventricular tachycardia or a history of ventricular fibrillation, are rated at 100 percent for as long as the veteran requires active treatment for the arrhythmia, or for as long as an implantable cardioverter-defibrillator (ICD) remains in place. The 100 percent rating also applies for an indefinite period following:
- Hospital admission for initial treatment of the arrhythmia
- Aneurysmectomy for a ventricular aneurysm associated with the arrhythmia
Because ventricular arrhythmias carry a real risk of sudden cardiac death, the VA does not step this rating down automatically once symptoms are controlled. A mandatory VA examination is scheduled roughly six months after hospital discharge (or after the last treatment episode) to reassess the condition. At that point, if the ICD is still in place or active treatment is ongoing, the 100 percent rating continues. If the veteran no longer requires an ICD or active treatment, the VA re-evaluates residual symptoms under the General Rating Formula for the heart, described below.
DC 7009: Symptomatic bradycardia requiring a pacemaker
DC 7009 applies to symptomatic bradycardia (a heart rate persistently below 60 beats per minute caused by a conduction disorder) that is severe enough to require implantation of a permanent pacemaker.
| Rating | Criteria |
|---|
| 100% | For one month following hospital discharge for pacemaker implantation or re-implantation |
| Reassessed under the General Rating Formula | After the first month post-implant |
Asymptomatic bradycardia found only on an EKG or Holter monitor, with no functional symptoms and no pacemaker, is considered a medical finding and is not compensable on its own. It may still support a claim if it is a documented symptom of a separately ratable heart condition.
General Rating Formula for the heart: how ratings are set after the acute phase
Once a veteran with DC 7009, 7011, or a downgraded DC 7010 claim moves past the acute or 100 percent period, the VA applies the General Rating Formula for the cardiovascular system. Unlike the standard 0 to 100 percent VA rating scale, this formula uses only four levels, based on the workload (measured in METs, or metabolic equivalents) at which the veteran first develops symptoms such as dyspnea, fatigue, angina, dizziness, or syncope, or based on objective findings like cardiac hypertrophy or dilatation on imaging, or evidence of congestive heart failure.
| Workload at symptom onset | Rating |
|---|
| 3.0 METs or less, or acute congestive heart failure, or left ventricular dysfunction with an ejection fraction below 30% | 100% |
| 3.1 to 5.0 METs, or one or more episodes of congestive heart failure in the past year, or ejection fraction 30 to 50% | 60% |
| 5.1 to 7.0 METs, or evidence of cardiac hypertrophy or dilatation on echocardiogram, ECG, or X-ray | 30% |
| 7.1 to 10.0 METs | 10% |
A MET level of 5 to 6, for example, corresponds to activities like brisk walking or light yard work. If a veteran develops chest pain, dizziness, or shortness of breath at that workload, a C&P examiner uses that threshold to assign the rating rather than requiring a formal treadmill stress test in every case, though a stress test is the most objective way to document the METs level supporting a claim.
2026 VA compensation rates for arrhythmia ratings
VA disability compensation rates increased 2.8 percent effective December 1, 2025, for the 2026 payment year. Monthly payments for a veteran with no dependents at the ratings most relevant to arrhythmia claims are:
| Rating | Monthly Payment (Veteran, no dependents) |
|---|
| 10% | $180.42 |
| 30% | $552.47 |
| 60% | $1,435.02 |
| 100% | $3,938.58 |
Veterans rated 30 percent or higher can receive additional compensation for a dependent spouse, children, or dependent parents. Ratings of 10 percent or 20 percent pay the same amount regardless of dependents. A 100 percent rating under DC 7011 or DC 7009 during the acute period is paid at the full 100 percent rate even if the underlying diagnosis is later downgraded at the six-month or one-month re-examination.
How to file a claim for arrhythmia
Step 1: Confirm a current diagnosis. You need a documented arrhythmia diagnosis from a medical provider, ideally supported by an ECG, Holter monitor recording, or event monitor showing the specific rhythm abnormality.
Step 2: Establish service connection. This can be direct (the arrhythmia began or was diagnosed during active duty), or secondary. Arrhythmia itself is not on the VA's presumptive conditions list, but it is frequently connected as secondary to conditions that are well established in the medical literature as cardiac risk factors, including:
- PTSD (chronic stress and elevated catecholamines are linked to increased arrhythmia and broader cardiovascular disease risk)
- Obstructive sleep apnea (intermittent hypoxia during sleep is a recognized trigger for atrial fibrillation)
- Hypertension
- Diabetes mellitus
- Ischemic heart disease connected to Agent Orange or other toxic exposure presumptions
A secondary connection claim needs a medical nexus opinion stating it is "at least as likely as not" that the service-connected condition caused or aggravated the arrhythmia.
Step 3: Gather treatment records. Collect cardiology notes, ECG and Holter reports, records of any cardioversions or ablations, pharmacy records showing continuous antiarrhythmic medication, and hospital discharge summaries if you've had a pacemaker or ICD implanted.
Step 4: File the claim. Submit VA Form 21-526EZ through VA.gov, by mail, or with help from an accredited Veterans Service Officer (VSO).
Step 5: Attend the Compensation and Pension (C&P) exam. The examiner will review your records, may order a stress test to establish your METs level, and will document current symptoms, medication, and any devices such as a pacemaker or ICD.
Step 6: Track the decision and file an appeal if needed. If the rating doesn't reflect the severity of your treatment or symptoms, you can file a Higher-Level Review, a Supplemental Claim with new evidence, or a Notice of Disagreement to the Board of Veterans' Appeals.
Increasing an existing arrhythmia rating
If your arrhythmia has worsened since your last rating decision, such as needing more frequent cardioversions, starting a new antiarrhythmic medication, or requiring a device implant, you can file a claim for an increased rating. Submit updated cardiology records and a current C&P exam request. The same DC 7009, 7010, and 7011 criteria above apply to increase claims exactly as they do to initial claims.
Frequently Asked Questions
What is the VA disability rating for arrhythmia?
Ratings depend on the type and severity. Supraventricular arrhythmias (DC 7010) are rated 10% or 30% based on the number of treatment interventions per year. Sustained ventricular arrhythmias (DC 7011) are rated 100% for as long as active treatment continues or an ICD is in place. Symptomatic bradycardia requiring a pacemaker (DC 7009) is rated 100% for one month post-implant, then reassessed.
Is atrial fibrillation the same as arrhythmia for VA rating purposes?
Atrial fibrillation is one specific type of supraventricular arrhythmia and is rated under DC 7010 alongside other supraventricular tachycardias. It is not a separate diagnostic code. Veterans researching AFib specifically should look for coverage dedicated to that condition, since it has its own evidence patterns around Holter monitor documentation and cardioversion history.
Can arrhythmia be rated at 100 percent?
Yes. Sustained ventricular arrhythmias (DC 7011) are rated 100 percent for as long as treatment continues or an ICD remains implanted. Symptomatic bradycardia requiring a pacemaker (DC 7009) is rated 100 percent for the first month after implantation. Severe cases under the General Rating Formula, such as a workload capacity of 3.0 METs or less, can also reach 100 percent.
Does the VA consider arrhythmia a presumptive condition?
No. Arrhythmia is not on the VA's list of presumptive conditions on its own. However, it is commonly granted service connection on a secondary basis when linked to conditions like PTSD, sleep apnea, hypertension, or ischemic heart disease tied to toxic exposure presumptions.
What evidence helps the most in an arrhythmia claim?
ECG or Holter monitor documentation of the specific rhythm abnormality, records of any cardioversions, ablations, or IV medication interventions, pharmacy records showing continuous antiarrhythmic medication use, and a nexus letter connecting the arrhythmia to service or to another service-connected condition.
Can I get a separate rating for arrhythmia and a related heart condition?
Generally no. DC 7009, 7010, 7011, and 7015 are not combined for the same underlying heart disability. The VA assigns a single evaluation under whichever code reflects the predominant disability picture. A separate, medically distinct condition, like hypertension, can be rated and combined separately under VA math.
How often does the VA re-examine an arrhythmia rating?
For DC 7011, a mandatory exam is typically scheduled around six months after hospital discharge or the last treatment episode. For DC 7009, re-examination occurs after the first month following pacemaker implantation. Ratings under DC 7010 can be reviewed whenever the VA schedules a routine future exam or when a veteran files a claim for increase.
