Evidence Checklist: Cardiac Pacemaker Implant
DC 7018
Significant gaps — claim likely to be denied or underrated
Specialist Opinion (Highest Value)
Nexus opinion linking pacemaker-requiring condition to serviceCritical
A medical opinion connecting the underlying cardiac condition that required pacemaker implantation to military service.
Post-implant exercise stress test with METs estimationCritical
Stress test documenting functional exercise capacity after pacemaker implantation. METs level drives the cardiac rating assigned after the mandatory 100% evaluation period.
Echocardiogram with ejection fraction
Echocardiography documenting EF and any structural changes. Pacemaker-induced cardiomyopathy (pacing-induced LV dysfunction) is documented here.
Treatment Records
Pacemaker implant records and device interrogation reportsCritical
Implant operative report documenting device type, indication, and lead placement. Follow-up device interrogation (remote or in-clinic) records showing pacing percentage and dependency.
Documentation of primary condition requiring pacemakerCritical
Medical records establishing the underlying condition that necessitated pacemaker implantation (complete heart block, sick sinus syndrome, bradyarrhythmia). The underlying condition may be separately ratable.
Pacemaker generator replacement records (if applicable)
Records of pulse generator replacements, demonstrating ongoing device dependency and continued treatment burden.
Lay Statements & Personal Documentation
Buddy statement from spouse, family, or fellow service member
A written statement from someone who can describe observable symptoms and how your condition affects daily life.
Personal statement describing symptoms and functional impact
Your own written account of how this condition affects your daily activities, work, and relationships. Describe your worst days.
Disability Benefits Questionnaire (DBQ)
Completed DBQ Heart ConditionsCritical
Standardized form capturing device records, METs, ejection fraction, and functional limitations in pacemaker-dependent veterans.
Service Records
Service treatment records (STRs)Critical
Military medical records showing in-service treatment, complaints, or injuries related to this condition.