What Counts as “Heart Disease” for First Responders? It’s Not as Simple as You Think. My Conversation with Dr. David Perloff.
We just dropped a new episode of Shielded, and this one tackles a question that sounds simple but has become one of the most hotly contested issues in first responder claims.
What is “heart disease”?
In our latest episode, we sit down with Dr. David Perloff, a board-certified cardiologist with decades of experience treating cardiac conditions and working within the workers’ compensation system. His perspective is critical because what doctors consider “heart disease” and what the law recognizes are not always the same. And that disconnect is where problems start.
From a medical standpoint, heart disease is broad. It includes:
- “Plumbing” issues like coronary artery disease (blockages, heart attacks, stents, bypass surgery)
- “Electrical” issues like arrhythmias (atrial fibrillation, tachycardia, pacemakers)
- Structural problems involving the heart muscle or valves
In medicine, if something is wrong with the heart it’s heart disease. Simple.
But legally? Not always.
Recent case law has tried to narrow that definition, creating confusion around whether certain conditions, especially arrhythmias actually qualify under Florida’s presumption laws. That means first responders can be diagnosed with a real cardiac condition, treated for it, and still face a fight over whether it even “counts.”
We also dig into two other critical issues:
- Disability — The Real Battleground
It’s no longer enough to have a diagnosis. Now, claims often turn on whether a condition rises to the level of “disability.”
Dr. Perloff explains that he relies on objective standards like NFPA 1582 for firefighters to determine whether someone should be restricted from duty. But in practice, many cases fall into gray areas, especially with conditions like hypertension or intermittent arrhythmias.
- Causation vs. Presumption
Here’s the reality: doctors often can’t pinpoint the exact cause of heart disease. And that’s normal.
That’s why presumption laws exist, to protect first responders without requiring impossible proof. But in litigation, these cases still get pushed into debates over causation, forcing doctors to answer questions medicine isn’t designed to answer.
Finally, we talk about something that doesn’t get enough attention: prevention. Dr. Perloff’s advice is simple but critical:
- Get regular checkups
- Control your risk factors (blood pressure, cholesterol, etc.)
- Stay physically fit
- Take your prescribed medications
Too many cases we see could have been mitigated, or even avoided, with consistent treatment.
Bottom line: The law is evolving, and not always in a way that benefits first responders. Understanding how these claims are evaluated, medically and legally, can make all the difference.
👉 If you’re a first responder dealing with a heart condition, denied claim, or questions about your benefits, don’t wait. Contact our team today. We’ll help you understand your rights and protect your claim.
Stay safe,
Paolo Longo
Bichler & Longo, PLLC