Body system: Cardiovascular SystemRegulation: 38 CFR § 4.104
Sustained ventricular arrhythmias are life-threatening rhythm disturbances arising from the ventricles (sustained ventricular tachycardia, ventricular fibrillation). The VA rates this at 100% on one of three pathways: (1) indefinite 100% from the date of inpatient hospital admission for INITIAL MEDICAL THERAPY for a sustained ventricular arrhythmia; (2) indefinite 100% from the date of inpatient hospital admission for VENTRICULAR ANEURYSMECTOMY; or (3) indefinite 100% with an AUTOMATIC IMPLANTABLE CARDIOVERTER-DEFIBRILLATOR (AICD) in place. For pathways (1) and (2), a MANDATORY VA exam is required SIX MONTHS after hospital discharge. At that exam, the rating may continue at 100% or transition to a lower rating (60%, 30%, or 10%) based on post-surgical residuals under the General Rating Formula for Diseases of the Heart. Any reduction is subject to the due-process rules of 38 CFR § 3.105(e). Note: when DC 7011 ratings overlap with DC 7009, 7010, or 7015, only ONE evaluation is assigned under whichever code best captures the predominant disability picture.
Rating levels
- 100% — You qualify for this rating if you were hospitalized for initial treatment of sustained ventricular arrhythmias (dangerous irregular heartbeats from the heart's lower chambers that don't stop on their own), or if you had surgery to remove a ventricular aneurysm (weakened, bulging area of the heart wall), or if you have an AICD device implanted (a small device that monitors your heart rhythm and delivers electrical shocks to correct life-threatening irregular heartbeats). This rating continues indefinitely from the date you were hospitalized for treatment or surgery, or for as long as you have the AICD device.
- -1% — The indefinite 100% rating applies cleanly when an AICD is in place. For the OTHER two qualifying pathways (initial inpatient medical therapy for sustained ventricular arrhythmia, OR inpatient hospitalization for ventricular aneurysmectomy), there's a specific timing rule: the 100% begins on the date of HOSPITAL ADMISSION, then the VA conducts a MANDATORY examination SIX MONTHS after hospital discharge. At that exam, the VA decides whether the 100% continues or transitions to a lower rating based on post-surgical residuals under the General Rating Formula for Diseases of the Heart (the MET-based ladder below). Any reduction from that exam (or any later exam) is subject to the due-process protections of 38 CFR § 3.105(e), the veteran gets advance notice and an opportunity to submit evidence before the reduction takes effect.
- 60% — At the mandatory 6-month-post-discharge exam (if you took the inpatient-therapy or aneurysmectomy pathway), if your residuals show a workload of 3.1 to 5.0 METs brings on heart failure symptoms, the rating shifts from 100% to 60%.
- 30% — At the mandatory 6-month-post-discharge exam, if your residuals show a workload of 5.1 to 7.0 METs brings on heart failure symptoms, OR cardiac hypertrophy or dilatation on imaging, the rating shifts from 100% to 30%.
- 10% — At the mandatory 6-month-post-discharge exam, if your residuals show a workload of 7.1 to 10.0 METs brings on heart failure symptoms, OR you require continuous cardiac medication (such as antiarrhythmics) for control, the rating shifts from 100% to 10%.
- -1% — If you qualify for ratings under multiple codes in this group (DC 7009 Bradycardia/pacemaker, DC 7010 Supraventricular tachycardia, DC 7011 Sustained ventricular arrhythmia, or DC 7015 AV block), the VA does NOT stack the percentages or combine them under § 4.25. Instead, the VA assigns a SINGLE evaluation under the code that best reflects your predominant disability picture, the one that captures the bulk of your functional impairment. This avoids pyramiding across overlapping cardiac-rhythm disability codes.