Body system: Cardiovascular SystemRegulation: 38 CFR § 4.104
Implantable cardiac pacemakers covers veterans who have had a permanent pacemaker surgically placed (or replaced) to regulate the heartbeat, typically for symptomatic bradycardia, AV block (Mobitz Type II or third-degree), or other rhythm disorders. The VA rates this condition at 100% for ONE MONTH following hospital discharge for the implantation or re-implantation. After that 1-month window, the VA evaluates the UNDERLYING arrhythmia that required the pacemaker under whichever code matches: DC 7010 (supraventricular tachycardia), DC 7011 (sustained ventricular arrhythmias), or DC 7015 (atrioventricular block). Regardless of the underlying-arrhythmia rating, a 10% MINIMUM floor applies under DC 7018 as long as the pacemaker is in place. Per the shared note on DC 7009/7010/7011/7015, only ONE evaluation is assigned under whichever code best captures the predominant disability picture (no combining).
Rating levels
- 100% — You qualify for 100% for ONE MONTH following hospital discharge for permanent pacemaker implantation (or re-implantation). The 100% rating recognizes the immediate post-procedure recovery period. After that 1-month window, the rating transitions to whichever underlying arrhythmia code applies (DC 7010 SVT, DC 7011 ventricular arrhythmia, or DC 7015 AV block), with a 10% MINIMUM floor under DC 7018 regardless of how the underlying arrhythmia rates.
- -1% — After the 1-month post-implant window, DC 7018 itself does not assign the ongoing rating beyond the 10% floor. The VA evaluates the UNDERLYING arrhythmia that necessitated the pacemaker, under whichever code best matches: DC 7010 (Supraventricular tachycardia) if the indication was atrial fibrillation, atrial flutter, or another SVT requiring pacing; DC 7011 (Ventricular arrhythmias, sustained) if the indication was sustained ventricular tachycardia or ventricular fibrillation; or DC 7015 (Atrioventricular block) if the indication was Mobitz Type II or third-degree complete heart block. If the underlying-arrhythmia rating is less than 10%, the 10% DC 7018 minimum applies instead. Note: per the shared note on these codes, only ONE evaluation is assigned under whichever code best captures the predominant disability picture.
- 10% — The 10% minimum rating under DC 7018 is a FLOOR that applies as long as the pacemaker is in place, regardless of how the underlying arrhythmia would rate under DC 7010, DC 7011, or DC 7015. If the underlying-arrhythmia rating yields a higher percentage, the higher value applies instead; if it would yield 0%, the 10% floor still applies because of the pacemaker.