According to the Centers for Disease Control and Prevention, each year approximately 600,000 people die of heart disease in the United States. Heart disease is the leading cause of death among adults and accounts for an estimated one out of every four deaths in this country.
When the Social Security Administration (SSA) evaluates a claim of cardiovascular impairment, the agency takes into consideration the severity of the heart condition and the impact the disease has on the claimant’s ability to work. Reviewers use a simple checklist to determine if a person with a heart condition qualifies for disability benefits.
To receive Social Security disability benefits for heart disease, the disease must fit into one of the following categories:
- Chronic (or congestive) heart failure: To qualify for disability benefits, the individual must either show symptoms such as shortness of breath, persistent fatigue, chest discomfort, palpitations, or tachycardia while taking an exercise tolerance test or be deemed medically unable to take an exercise test without significant risk to his or her well-being. A person may also qualify for disability if he suffers three or more separate episodes of acute congestive heart failure within a one-year period with evidence of fluid retention. Congestive heart failure occurs when the heart is unable to pump enough oxygenated blood to meet the body’s needs, causing blood to back up into the lungs or into the legs and liver, depending on which chambers of the heart are failing.
- A history of ischemic heart disease: This occurs when there is reduced blood supply to the heart muscle. The SSA has established criteria that must be met for a person with ischemic heart disease to qualify for disability; these criteria describe specific treatment, imaging/testing, and surgical procedure requirements.
- A history of recurrent arrhythmias: The arrhythmias must be caused by a condition that is irreversible, and they must be uncontrollable, even with treatment.
- Symptomatic congenital heart disease: This involves a problem with the structure of the heart that is present at birth. In addition to meeting certain other criteria set forth by the SSA, the heart defect must be documented with medical imaging and must affect the individual’s ability to function in daily life.
- Heart transplant: After undergoing heart transplantation, a person qualifies for disability for one year after the procedure. After that, he or she must be reevaluated under the condition that caused the need for the transplant.
- Aneurysm: An aneurysm of the aorta or any major branch of the heart may be a qualifying condition if it is documented by imaging and is not controlled with treatment.
- Chronic venous insufficiency: This is a condition in which the veins are not able to pump a sufficient amount of oxygenated blood back to the heart. To qualify for disability, the condition must affect the deep venous system of a lower extremity and must cause extensive edema (swelling) or superficial varicosities, stasis dermatitis, or recurrent/persistent ulceration.
- Peripheral artery disease: PAD, which is caused by a buildup of plaque that reduces the flow of blood to the extremities and other parts of the body, is a qualifying condition when the severity of the disease has been property documented with imaging test results, when it causes muscle pain that comes and goes with activity, and when it has been shown to have a significant effect on resting blood pressure.
If you have heart disease and are no longer able to work, you probably have questions about filing for Social Security disability benefits. Boston Social Security disability attorney John Keefe has written a book to help answer your questions. Request your free copy of Unlocking the Mystery – The Essential Guide for Navigating the Social Security Disability Claims Process by following the link at the top of the page.
To discuss your case with a Massachusetts disability lawyer, contact Keefe Disability Law toll free at 888-904-6847.