Ventricular arrhythmias (irregular lower heart rhythm)

For the 100% rating, records showing inpatient hospital admission for initial medical therapy for a sustained ventricular arrhythmia, or for ventricular aneurysmectomy, directly establish the starting date. Documentation confirming an AICD is in place — such as implant procedure notes or device clinic records — supports that basis for 100% as well.

For ratings under the General Rating Formula, the most direct evidence is an exercise stress test that measures the MET level at which you develop breathlessness, fatigue, angina, dizziness, arrhythmia, palpitations, or syncope. If exercise testing cannot be done for medical reasons, a medical examiner can estimate your MET level based on specific activities you can and cannot perform, such as slow stair climbing. For the 30% level, an echocardiogram, multigated acquisition scan, or MRI confirming cardiac hypertrophy or dilatation also meets the criteria. For the 10% level, prescription records or treatment notes showing continuous medication is required for control are relevant. Statements from you or people who know you describing how symptoms limit your physical activity at work or at home can help connect those records to the MET-level criteria.