Can I Get Social Security Disability Benefits for Chronic Heart Failure?
Yes! The Social Security Administration (SSA) uses a Five Step Sequential Evaluation in determining an applicant’s entitlement to Social Security Disability benefits. At Step 3 of the Five Step Sequential Evaluation, the SSA will review your medical records to determine if you have a Listing level impairment for chronic heart failure.
The SSA has specific evidentiary requirements that must be met to establish that you’ve met a Listing level impairment. Your medical records must document an abnormal cardiac imagining that shows “objective measures of left ventricular function and structural abnormality in the heart.” §4.00(D)(2)
You must also demonstrate that your heart condition is chronic. You can establish chronicity by documenting symptoms and signs such as easy fatigue, weakness, shortness of breath, cough, or chest discomfort at rest or with activity, and more. 20 C.F.R. §404, subpt. P, app. 1 §4.00(D)(2)(b)(i)(ii).
What Other Criteria Do I Have to Meet?
You must meet one of the criteria in subsection A and one of subsection B of the Listing.
Criteria of Subsection A:
1. Systolic failure, with left ventricular end diastolic dimensions greater than 6.0 cm or ejection fraction of 30 percent or less during a period of stability (not during an episode of acute heart failure); or
2. Diastolic failure, with left ventricular posterior wall plus septal thickness totaling 2.5 cm or greater on imaging, with an enlarged left atrium greater than or equal to 4.5 cm, with normal or elevated ejection fraction during a period of stability (not during an episode of acute heart failure).
These findings must be established during periods of stability.
You must also meet one of subsection B.
Criteria of Subsection B:
“Resulting in one of the following:
1 – Persistent symptoms of heart failure which very seriously limit the ability to independently initiate, sustain, or complete activities of daily living in an individual for whom an MS, preferably one experienced in the care of patients with cardiovascular disease, has concluded that the performance of an exercise test would present a significant risk to the individual; or
2 – Three or more separate episodes of acute congestive heart failure within a consecutive 12-month period, with evidence of fluid retention from clinical and imaging assessments at the time of the episodes, requiring acute extended physician intervention such as hospitalization or emergency room treatment for 12 hours or more, separated by periods of stabilization; or
3 – Inability to perform on an exercise tolerance test at a workload equivalent to 5 METs or less due to:
Dyspnea, fatigue, palpitations, or chest discomfort; or
4 – Three or more consecutive premature ventricular contractions, or increasing frequency of ventricular ectopy with at least 6 premature ventricular contractions per minute; or
5 – Decrease of 10 mm Hg or more in systolic pressure below the baseline systolic blood pressure or the preceding systolic pressure measured during exercise due to left ventricular dysfunction, despite an increase in workload; or
6 – Signs attributable to inadequate cerebral perfusion, such as ataxic gait or mental confusion.”
As you can see, objective findings are only half of the equation and exercise tolerance can be vital in evaluating and establishing the criteria.
What Happens If I Don’t Meet the Elements of a Listing?
All is not lost! You may be entitled to SSD benefits by meeting the criteria at Step 4 establishing that you are unable to perform the lightest job you have held the last fifteen years before you became disabled because of your cardiological impairments.
The burden of proof will then switch to the Social Security Administration at Step 5 to show that there is other work that you can perform in the national economy in view of your age education and transferable skills as a result of your restrictions and limitations.
Do I need help?
You need help in applying for SSD benefits or appeal any denial of your claim. Call today at 727-894-3188 to get the Social Security disability help you need.
Don’t let the Social Security Administration rob you of your peace of mind and your entitlement to your Social Security Disability benefits. Call today for your complimentary consultation at 727-894-3188.