If you’ve been diagnosed with congestive heart failure, you’re not alone. Nearly 5 million people with congestive heart failure (CHF) live in the United States, and some 500,000 people are diagnosed with it each year. CHF is a serious condition that occurs when the heart fails to pump blood efficiently. The sufferer can experience a range of symptoms, from feeling weak and fatigued to persistent chest pain or a wheezing cough. The condition can also lead to severe kidney or liver damage.

How to Meet the SSA Criteria for Congestive Heart Failure

If congestive heart failure has made it impossible for you to work, receiving Social Security Disability Insurance (SSDI) benefits can help provide financial relief. The Social Heart Failure Puzzle Piece With a StethoscopeSecurity Administration (SSA) will consider you eligible for SSDI if your conditions meet the criteria for CHF listed in the “Blue Book,” a book listing specific criteria for meeting certain disabilities. 

According to Section 4.02 of the Blue Book, you can qualify for Social Security disability benefits for CHF if you can prove that:

  • A medical doctor has diagnosed you with CHF while undergoing prescribed treatment.
  • You have medically documented evidence of systolic failure that meets specific conditions.
  • You have persistent symptoms of heart failure that prevent you from independently initiating, sustaining, or completing activities of daily living.
  • You have had three or more separate documented episodes of acute congestive heart failure within a 12-month period.
  • You suffer an inability to perform an exercise tolerance test at a workload equivalent to 5 METs or less.

Why You Might Be Denied SSDI in New Hampshire for Congestive Heart Failure

If the SSA has denied your application for SSDI for CHF, don’t panic. Most applicants are denied the first time around. The most common reasons for denial include:

  • You didn’t provide sufficient medical evidence proving that your CHF is a disability. You must prove that you meet the Blue Book criteria for CHF.
  • You didn’t provide sufficient medical evidence proving that you cannot work. Your doctor must provide an assessment showing that the condition makes it too risky or impossible for you to work in any employment related to your experience.

What to Do When Appealing the SSDI Denial Decision in New Hampshire for Congestive Heart Failure

If your application for SSDI has been denied, you are entitled to appeal the decision. Although your appeal will be seen by someone new at the SSA, you will need to provide more information than you did the first time. You must show clear-cut evidence of your heart failure and how it prevents you from working.

To increase your chances of being approved, you must provide medical evidence documenting one of the following symptoms in your appeal:

  • Your heart’s ejection fraction, or the percentage of blood coming out each time your heart beats, is 30 percent or less during a typical day.
  • The diastolic dimensions in your left ventricular end are bigger than 6 centimeters.
  • The thickness of the left ventricular wall is larger than 2.5 centimeters.
  • The left atrium is larger than 4.5 centimeters.

Each of these symptoms is characteristic of either systolic failure or diastolic failure. You can prove these conditions by submitting the proper imaging tests, doctor evaluation reports, and any other medical evidence. You should also describe how these symptoms impact your ability to work both in a high-exertion position and in a sedentary role at your job. It’s also a good idea to keep an SSI disability journal to show the SSA adjudicators how CHF affects your daily life and limits normal activity.

How a New Hampshire SSDI Lawyer Can Help

Have you gone, or are you going through the appeal process for Congestive Heart Failure? If so, you need an experienced lawyer to help ensure that you have all the proper medical documentation and have built a strong case that you’re entitled to SSDI benefits. Your chance of receiving benefits increases if you work with a lawyer during the appeal process. If you would like to speak with an experienced Social Security disability lawyer, please contact us online or call directly at 508.283.5500 to schedule your free consultation as soon as possible.


John L. Keefe
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Founding Attorney, Massachusetts Social Security Disability Lawyer