How to Get Disability for Chronic Heart Failure

Chronic heart failure happens when structural or functional abnormalities in the heart prevent it from generating enough cardiac output to meet your body’s demands. In a patient with chronic heart failure, the heart cannot pump enough blood to power other organs, muscles, and extremities without increasing diastolic pressure to a dangerous level. Diastolic pressure refers to the pressure between beats of the heart. Systolic pressure is the level of pressure when the heart contracts.

Symptoms of chronic heart failure include breathlessness, sodium and water retention, and edema—or excess fluid trapped in bodily tissues. It renders many patients physically incapable of working.

If you are unable to work due to your condition, you may be eligible for disability for chronic heart failure. An attorney at the Disability Advantage Group, can help you get benefits.

We offer free consultations to meet with a lawyer, receive free advice on your disability claim, and have all your questions answered. Call our office at 865-566-0800 to set up an appointment today.

Can I Get Disability for Chronic Heart Failure?

The short answer is yes. There are two ways to qualify for Social Security Disability (SSD) for a medical condition.

The first, and easiest, is to meet the criteria of a listing in the Social Security Administration’s (SSA) “Blue Book” of approved conditions. The medical conditions listed in the book are ones the SSA has singled out as disabling.

If your condition does not meet a Blue Book listing, we can take an alternative route and prove to the SSA that it reduces your functional capacity to a level that makes sustaining gainful employment impossible.

The Blue Book Listing for Chronic Heart Failure

The SSA’s Blue Book has a specific entry for chronic heart failure. However, the listing is very particular about the criteria your condition must meet for you to receive benefits.

First, you must demonstrate a medically documented presence of either systolic or diastolic failure.

If you are suffering from systolic failure, we need to be able to show the SSA proof that:

  • Your left ventricular end diastolic dimensions are above 6.0 cm; or
  • Your ejection fraction is under 30 percent during a stable period—meaning not during an episode of acute heart failure.

If you are suffering from diastolic failure, we need evidence such as:

  • A medical image showing your left ventricular posterior wall and septal thickness is above 2.5 cm; and
  • You have an enlarged left atrium of at least 4.5 cm during a stable period—again, not an episode of acute heart failure.

We also have to show proof that your medically documented systolic or diastolic failure causes at least one of the three following outcomes.

Heart Failure Symptoms

To qualify, your symptoms must severely limit your ability to carry out regular activities of daily living, such as cooking, bathing, and grocery shopping. Moreover, we need a doctor’s opinion that even the process of subjecting you to an exercise test—designed to measure the strength of your heart—poses too big a health risk to consider.

Multiple Episodes of Acute Congestive Heart Failure

To qualify under this heading, you must have suffered three or more episodes of acute congestive heart failure within a 12-month period. These occurrences must also have caused severe fluid retention that required medical intervention in the form of a hospital or emergency room stay lasting 12 hours or longer.

An Inability to Exercise

The SSA will look for proof that you are unable to complete a special exercise test due to any of the following symptoms:

  • Fatigue, chest discomfort, or heart palpitations;
  • Three or more consecutive premature ventricular contractions or six more premature contractions within any 60-second interval;
  • A decrease in systolic blood pressure of more than 10mm Hg below your established baseline during exercise; or
  • Mental confusion or uncoordinated movements.

If we determine that your condition has a solid chance of meeting the SSA’s Blue Book entry, we work with your treating physicians to ensure that the evidence we put together is thorough and convincing so that you can receive approval for benefits on the first try.

What If I Do Not Meet the Blue Book Listing?

Some applicants have chronic heart failure, but for one reason or another cannot meet the SSA’s Blue Book listing for approval. If this is the case for you, we have another avenue to win benefits, known as the residual functional capacity (RFC) test.

The RFC test provides an alternative measure of the functional limitations your condition causes. Ultimately, when the SSA judges your application, they are less concerned with the strict definition of your condition and more concerned with the measurable ways that it affects your ability to sustain gainful employment and carry out activities of daily living.

We work with your doctor to fill out the RFC test. The result offers the SSA a vivid picture of your condition and how it affects you. Our attorneys have helped many clients who failed to meet Blue Book listings secure benefits through the RFC process. We can put our experience to work for you.

Are There Work or Income Requirements to Receive Disability?

The SSA offers benefits via two programs: Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI).

SSDI is an insurance program that draws its funding from workers’ payroll taxes. Only those who have paid into the program—in other words, who have a sufficient work history and have earned enough work credits—can file a claim and receive benefits.

SSI is for low-income people. Accordingly, this program does not offer benefits to those with incomes or assets above SSA-mandated amounts.

After evaluating your financial situation, we can determine which disability program you have the best chance of qualifying for.

Ready to Start Your Application? Call 865-566-0800 for a Free Attorney Consultation.

Whether it is your first time applying or you wish to appeal a denial of benefits, the expert legal team at the Disability Advantage Group, can help. We have won disability benefits for many clients and we can put our expertise to work for you.

Are you ready to get started? Call 865-566-0800 to set up a free consultation with one of our attorneys.