Social Security Disability Benefits for Heart Disease
By Wally Mountz / April 19, 2017 / Applying for Social Security Disability & SSI Benefits / No Comments
We explain how you may be eligible for disability benefits for heart disease, what to do to qualify and prove your inability to work, and how Social Security reviews your medical history and tests your job function ability.
To collect disability benefits for heart disease, the two most important factors the SSA considers are how serious your disease is and the type of heart disease you have been diagnosed with. There are a number of different heart problems, but the final assessment is if your condition is so bad, you are completely unable to work, as well as, the specific type of heart problem you have.
In addition, the SSA will review your employment history to determine your previous job experience. They will match those with your physical limitations concerning your heart disease to see if it is possible you could return to work or do the same type of work but in a lesser capacity. The Disability Examiner will determine what kind of related jobs you could be retrained for considering your experience, skills, and education. However, once a person reaches about age 50 – 55, retraining might not be a feasible option.
SSA’s Criteria for Disability Benefits for Heart Disease
Many types of heart disease qualify for Social Security disability benefits. This is a serious disease with a wide range of conditions. Although many people respond favorably to effective treatment and go on living and working, others may not. In years past, chronic heart disease meant the patient might never return to work, however, with today’s advancements in treatments, along with new medications, more and more heart patients are returning to the workplace.
The Social Security Administration (SSA) has set up guidelines for its disability examiners to evaluate claim applications. They use a manual called a Blue Book which lists a number of disease limitations which would qualify someone with automatic approval. However, many times there will not be an exact match.
Disability from heart disease can qualify for benefits from the SSA, however, the requirements are strict. The disease must completely disable you from your work and from any reasonable similar work you could be trained to perform.
Examples of Heart Diseases that Could Meet SSA’s Standards
A number of heart diseases meet the criteria for Social Security Disability, but this would be highly dependent on your exact symptoms and treatments, and how they affect you. This is just a partial list:
- Aorta Aneurism or in a major branch
An aneurism is a bulge or a weakening in the aorta, the largest blood vessel in the body. In some cases, a graft of a man-made material can be put in place to correct this problem. If imaging from a medical test confirms this, you would receive disability.
- Chronic Venous Insufficiency
A person’s heart is not able to pump blood to the legs and back to the heart. The symptoms of this disease are ulcers, swelling, and problems with standing. The SSA could grant disability if the painful ulcers do not heal within 3 months or if you suffer from brawny edema in at least two-thirds of the leg from the ankle to the knee or one-third from the ankle to the hip.
- Congestive Heart Failure (chronic heart failure)
To meet the benefit standard, you need to show you have pain, even without any exertion and your heart is pumping at a 30% capacity or less.
- Heart Transplant
You will be judged to be disabled for the first year after this operation.
- Hypertensive Heart Disease
This disease by itself is not sufficient to qualify for disability benefits. If it is serious enough to fall under Congestive Heart Failure or Ischemic Heart Disease you may meet the threshold for benefits.
- Ischemic Heart Disease
Usually this heart problem is found after an angiography or a stress test. The arteries are narrowed and thus unable to carry enough oxygen rich blood throughout the body and are a pre-heart attack condition.
- Peripheral Artery Disease
This is a narrowing of the peripheral arteries, most often to the legs although arms, head and organs can also be affected. Usually causes difficulty in walking. Your symptoms must be confirmed with image testing and fall within the SSA criteria.
- Symptomatic Congenital Heart Disease
This would need to be confirmed with a catheter to the heart or a medical imaging test. Your oxygen and hematocrit levels need to fall within the SSA’s guidelines in order to receive SSD. An elevated systolic blood pressure or insertion of stents or shunts could also qualify for a disabled status.
- Recurrent Arrhythmias
This category of a heart condition covers the state where your heart does not beat at a regular rate – it is beating very slowly or very fast. Coupled with this diagnosis, you must show it causes you to occasionally almost or completely lose consciousness.
These examples are just general guidelines and your specific condition may not fall neatly into one of the categories. What is important is the Disability Examiner understands why you are unable to do your previous work, or why you may not be able to perform a new job if you were to receive training.
To make disability judgments, the Disability Examiner will study the medical history that you provide during your initial interview. Because this is a key component of your disability application, it is vitally important your medical records are complete. Make certain the results of all your tests, examinations, treatments and medications are included.
In addition, your complaints of symptoms, such as pain, shortness of breath, inability to think or focus because of the pain should also be noted in the record. If you are on medication, there may be side effects such as nausea, headaches, fatigue, depression, vomiting, vision problems, or problems with your memory. If these sorts of entries have been left out, contact your doctor to have your record updated with all the information available.
Hopefully, your doctor is familiar with Social Security Disability applications so your medical record includes detailed observations of your condition and what your limitations are. For example, your doctor could note you are unable to walk more than one block without becoming out of breath, you are unable to stand more than 15 minutes, or you are unable to lift a certain amount of weight.
Reduced Functional Capacity Test
A different method of meeting the benefit requirements of the SSA is a Reduced Functional Capacity Test (RFC). This test measures your ability to perform actions common to a job during a regular eight hour shift for five days a week.
The RFC will measure your ability to sit, walk, stand, carry objects, lift objects, push, and to pull. The results of this test will show your capacity for work and will fall into one of the following categories, Heavy, Medium, Light, Sedentary, or less than Sedentary level.
Here are the different categories results of a RFC test:
- Sedentary – Sitting with no lifting or carrying, just filing and dealing with paperwork.
- Light – Lift 20-pounds often during the day and can carry ten pound objects. Expected to walk or stand for most of the day.
- Medium – Lift 50-pound objects and carry 25-pound objects throughout the day.
- Heavy – Lifting 100-pound items and lifting and carrying 50-pound objects.
With this rating in hand, the SSA will determine which category you belong in and if you are able to perform the daily and weekly tasks in your old job. If not, they will seek to find a job which is less taxing in your past work record. If neither of those is possible, they will evaluate the chances of retraining you to work at a different job while still in your RFC category.
If your doctor says that due to shortness of breath you should not stand and walk for more than three hours a day and you can only lift ten pounds, the SSA will give you a rating of Sedentary.
The SSA will apply these to your previous jobs and see if you are able to perform those tasks. If not, they will then determine if you were trained for another job would you be able to function with your limitations there.
Will you get approved for SSD benefits?
Even though heart disease is a very serious medical condition, it does not mean an automatic approval for Social Security Disability benefits. Your exact condition must be evaluated to determine if it falls within the criteria of the SSA.
Presenting a heart disease benefit application to the SSA can be a complicated chore. There will likely be a very technical, medical diagnosis with an evaluation by an SSA Disability Examiner. Due to the complexities of such a situation, if your application is denied but you surely cannot work, it is advisable for you to contact an attorney who specializes in Social Security Disability cases to help file an appeal. With their training and experience, you should be able to determine the likelihood of success with your claim.