Yes, you may be able to get Social Security disability for heart disease and cardiovascular impairment.

If your heart disease or cardiovascular impairment prevents you from being able to make a living, you may be eligible for Social Security disability benefits. The Social Security Administration (SSA) reviews conditions, whether congenital or acquired, under Section 4.00: Cardiovascular System.

How Long Must My Heart Disease Affect Me?

To be eligible for benefits, your heart disease must have lasted at least 12 months, or a doctor must expect it to last 12 months or result in death.

Having one abnormal cardiac test by itself will not qualify you for disability benefits.

A Doctor Diagnosed Me With Heart Disease. Will I Automatically Qualify for Benefits?

No. If your cardiovascular condition does not prevent you from working, the SSA will determine that you are not disabled.

If you have heart disease, but you are still able to provide for yourself and your family, you will likely not qualify.

What Evidence Must I Provide to Get Disability for Heart Disease?

The SSA uses lists of detailed medical benchmarks to determine if a person meets the medical requirements to receive disability benefits. To qualify, you must meet the listing’s severity criteria. There are quite a few heart diseases in the Listing of Impairments. For example:

4.11 or 4.12: Peripheral Vascular Disease

Peripheral vascular disease (PVD) primarily impacts the legs. This can affect veins or arteries and impair mobility and function.

The SSA will evaluate you under either 4.11 Chronic Venous Insufficiency or 4.12 Peripheral Arterial Disease.

To qualify under 4.11, we must prove:

  • “Extensive brawny edema involving at least two-thirds of the leg between the ankle and knee or the distal one-third of the lower extremity between the ankle and hip; or
  • Superficial varicosities, stasis dermatitis, and either recurrent ulceration or persistent ulceration that has not healed following at least three months of prescribed treatment.”

To qualify under 4.12, we must provide medical evidence that proves intermittent claudication and at least one of the following:

  • “Resting ankle/brachial systolic blood pressure ratio of less than 0.50; or
  • Decrease in systolic blood pressure at the ankle on exercise of 50 percent or more of pre-exercise level and requiring 10 minutes or more to return to pre-exercise level; or
  • Resting toe systolic pressure of less than 30 mm Hg; or
  • Resting toe/brachial systolic blood pressure ratio of less than 0.40.”

4.05: Cardiac Arrhythmias

Cardiac arrhythmias are irregular heartbeats, such as when your heart beats too fast or too slow, or when it skips a beat.

The SSA will evaluate you under 4.05 if you are not able to fully control your arrhythmia will medication. To qualify, your arrhythmia must be recurrent (i.e., must repeat or occur regularly) and result in episodes of cardiac syncope (i.e., loss of consciousness) or near-syncope.

We must provide documentation through a resting or ambulatory (Holter) electrocardiography or other medically acceptable testing.

4.09: Heart Transplant

If your heart disease requires a heart transplant, the SSA will deem you disabled for one year after surgery.

If you are still disabled after that year, you can request the SSA reevaluates you.

Am I Automatically Disqualified if I My Condition Is Not on the List?

No. The SSA’s Listing of Impairments contains many, but not all medical conditions that could cause a person to be unable to work.

If your condition is not on the list, you may qualify for a medical vocational allowance.  

The medical vocational allowance focuses on how your condition keeps you from working. Your doctor will need to fill out a residual functional capacity (RFC) form that gives the SSA an idea of the job duties you can do, despite your condition.

If the RFC assessment determines you cannot adjust to any work, the SSA might grant you benefits under the medical vocational allowance.

Is having a severe medical condition enough to get benefits?

No. There are different qualifications depending on the type of benefits you are applying for. If you are applying for Social Security Disability Insurance (SSDI), you must:

  • Earn less than $1,170 per month. This is the 2017 earning limit. If you earn more than this threshold, your condition is not preventing you from working.
  • Have accumulated sufficient work credits. You obtain work credits by working and paying into the Social Security system. The amount of work credits you need depends on your age (e.g., a 50-year-old needs 28 work credits).

If you do not have enough work credits, you might be eligible for Supplemental Security Income (SSI). To qualify, you must:

  • Be disabled
  • Have low income
  • Have limited assets

Can I Have a Lawyer Help Me With My Claim?

Yes, and we strongly recommend it. Many deserving people with serious medical issues receive denials the first time they apply for disability benefits. This process can be daunting and difficult and it is easy to make mistakes. We will ensure you fill your forms out correctly the first time.

If you have just received a denial, we can help you through the process of asking the SSA to reconsider its decision. (Do this quickly; you only have 60 days to file for an appeal.)

The claims and appeals processes are difficult, but do not give up. The disability lawyers at Disability Advantage Group will help you navigate through the process and fight to get you the benefits you deserve.

Call us today at 865-566-0800 to schedule your free, no-obligation consultation.

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