Congestive Heart Failure Social Security Disability Claims Lawyer

Do I Qualify For Social Security Disability Benefits If I Have Congestive Heart Failure?

The Social Security Administration (SSA) doesn’t always make it easy for those with congestive heart failure to get the Social Security Disability Insurance (SSDI) or Supplemental Security Income benefits they deserve. Many claims are denied because SSA says:

(1) Your congestive heart failure doesn’t meet the requirements of or is the equivalent of a Medical Listing,

(2) You can return to the lightest job you held in the 15 years before you became disabled, or

(3) There is other work you can do in the mythical national economy based on your age, education, transferable skills and your residual functional capacity.

Not all cases of congestive heart failure are severe enough to make you eligible for Social Security Disability benefits, but Nancy Cavey has successfully represented many SSA applicants with congestive heart failure. She works to overcome the claims denial by working closely with you and your physician to show that you:

Meet the requirements for a disability listing, or that
Your limitations are too great for you to work at your old job or any other job in the national economy in view of your age, education and transferable work skills.

She offers a free initial consultation and welcomes the opportunity to speak with you about your Social Security disability claim.

What Is Congestive Heart Failure?

When your heart’s pumping power is weak, blood moves through your heart and body at a rate slower than normal. Your heart just can’t pump enough oxygen. The chambers of the heart stretch to hold more blood to pump throughout the body or become stiff and thickened.

As your heart muscles weaken and become less efficient, your kidneys can respond by retaining water and salt. As the fluid builds up in your arms, legs, feet and lungs, the body becomes congested.

There are two types of heart failure, called systolic or diastolic dysfunction. An echocardiogram is used to measure how well your heart pumps with each beat and will determine what type of heart failure you have.

What Are The Symptoms Of Congestive Heart Failure?

The symptoms can be mild to severe and can come and go. Common symptoms include:

Congested lungs that cause shortness of breath at rest or with exercise, wheezing or a hacking cough,
Fluid and water retention that can result in swelling, weight gain, bloating, nausea and increased need to urinate,
Dizziness, fatigue, weakness and confusion, and
Rapid or irregular heartbeat.

Blood tests, B-type natriuretic peptide (BNP), chest x-rays, echocardiograms, EKG or ECG, cardiac cauterization and stress tests are used to make a diagnosis and determine the severity of your congestive heart failure.

Your physician rates the stages of heart failure using the New York Heart Association classification, which rates your symptoms and functional limitations.

When Your Congestive Heart Failure Meets A Listing

Congestive heart failure is included in the SSA’s “Listing of Impairments.” If your congestive heart failure meets or equals a Listing, your Social Security disability benefits will be awarded at Step 3 of the Five-Step Sequential Evaluation.

Your medical records must establish that you meet every element of the Listing for your congestive heart failure to be considered disabling. SSA will review your medical records and look for a diagnosis of severe continuing heart failure despite being on medication with fluid retention at some point.

SSA requires objective symptoms of either systolic or diastolic heart failure.

A showing of systolic heart failure occurs when the heart has weakened pumping strength, which can be shown by one of the following:

Your heart’s ejection fraction, which is the percentage of blood pumped out of the heart with each heartbeat, is 30% or less during a period of stability, or your heart’s left ventricular end diastolic dimensions are larger than 6.0 cm.

A showing of diastolic failure occurs when the heart is unable to fill properly, and must be shown by all of the following:

Thickness of left ventricular wall and interventricular septum 2.5 cm or longer on imaging,
An enlarged left atrium 4.5 cm or larger, and,
Normal or elevated ejection fraction during a period of stability.

Once you have shown objective evidence of either systolic or diastolic dysfunction, you must have one of the following functional limitations:

An inability to perform an exercise tolerance test at a workload equivalent to 5 METS or less during certain difficulties,
If an exercise tolerance test would be too risky, persistent symptoms of heart failure that seriously limits activities of daily living are required, or
At least three episodes of heart failure and fluid retention within the past 12 months, requiring emergency room treatment or hospitalization for at least 12 hours.

If you don’t meet or equal a listing, SSA then will determine your entitlement to benefits based on medical and vocational criteria at Steps 4 and 5.

When Your Congestive Heart Failure Makes It Impossible To Work

If your congestive heart failure doesn’t meet a listing, you will have to prove that you:

Can’t return to the lightest job you held in the 15 years before you became disabled (PRW), and
There isn’t any other work you can do in the mythical national economy based on your age, education, transferable skills and your residual functional capacity (RFC).

SSA or, ultimately an Administrative Law Judge, will answer those questions by determining your residual functional capacity. Your RFC is what you can do despite your congestive heart failure.

Determining your RFC involves a comprehensive evaluation of your physical limitations and how your medical condition affects your ability to perform work-related activities. This includes assessing your endurance, strength, ability to sit, stand, walk, lift, carry, and perform other tasks necessary for employment. The evaluation also considers symptoms such as shortness of breath, chest pain, fatigue, and any cognitive or psychological impairments caused by your heart disease.

In cases of congestive heart failure, your RFC will take into account how your cardiovascular impairment impacts your stamina and capacity to sustain work over a typical workday and workweek. This assessment is critical when you do not meet the strict medical criteria of a listing but still experience significant functional limitations that prevent you from maintaining gainful employment.

Medical evidence plays a vital role in establishing your RFC. Detailed records from your treating doctors, including cardiologists, documenting your medical history, ongoing treatment, physical examinations, and response to prescribed treatment, provide the foundation for this evaluation. A longitudinal clinical record covering your condition over time helps demonstrate the expected duration and severity of your heart disease.

If your congestive heart failure causes episodes of acute heart failure or fluid retention requiring hospitalization or emergency room visits, these events further support the severity of your condition and its impact on your ability to work.

Additionally, exercise tests, such as exercise tolerance tests or drug induced stress tests, may be used to objectively measure your cardiovascular system’s response to physical activity and help determine your functional limitations.

Ultimately, the Social Security Administration considers your RFC alongside your age, education, and prior work experience to decide if you qualify for long term disability benefits.

If you cannot return to your past relevant work or adjust to other work in the national economy due to your physical limitations caused by congestive heart failure, you may be entitled to Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) benefits.

Understanding how your congestive heart failure affects your residual functional capacity is essential to building a strong long term disability benefits claim. Working closely with your treating doctors to document your symptoms and limitations accurately increases your chances of obtaining the SSDI benefits you deserve.

Residual Functional Capacity For Congestive Heart Failure

The SSA will review your medical records at the Initial Application and Reconsideration stage of the claims process and determine your functional capacity to perform sedentary, light, medium and heavy work.

SSA medical consultants often opine that a Social Security Disability applicant can do light and sedentary work, and that will result in a claims denial. The lower your RFC the more likely that you can’t return to the lightest job you held in the last 15 years or perform other work.

SSA doesn’t tell applicants or physicians about the existence and importance of properly completed RFC forms that will explain that because of shortness of breath, chest discomfort, and heart palpitations:

How far you can walk,
How long you can stand and sit at one time and for an eight-hour day,
How much and how often you can lift, stoop, squat, bend during an eight- hour day,
Whether you have to alternate sitting and standing,
Whether you have good days and bad days and how many days per month you would miss from work, and
Whether you have psychological problems that would interfere with your ability to work.

Short Term Disability for Congestive Heart Failure

This is not an exhaustive list of all of the questions on a congestive heart failure RFC form. But you can see that having an explanation of what you can do physically, cognitively and emotionally is key to winning your case.

Many SSA cases are lost because the applicant did not obtain an RFC or the right RFC form, or because their treating physician didn’t properly complete the RFC form. That is one of the many reasons you should have an experienced Florida social security disability attorney like Nancy L. Cavey represent you in your claim.

How Your Residual Functional Capacity Is Used At A Social Security Hearing

Many claims are denied both at the Initial Application and Request For Reconsideration stages of the claims process.

At the hearing stage, the Administrative Law Judge will determine your RFC and give hypotheticals to the vocational evaluator (VE) who will testify at your hearing. The judge will ask the VE to take into consideration your RFC, as determined by the judge, your age, education and prior work experience in determining:

Whether you can return to the lightest job you held in the last 15 years,
Whether there is other work you can do or could learn to do.

It is crucial that you are represented at a hearing to make sure the right questions are asked of the VE.

How Do I Get The Social Security Disability Benefits I Deserve?

If you no longer can work because of congestive heart failure or your doctor has told you to apply for Social Security disability, you should hire Nancy Cavey to help you:

File your initial Social Security Disability application. The application process is confusing and designed so you make mistakes that can result in a delay or even a denial of your benefits.
Appeal a wrongful denial of your Social Security disability application or Request for Reconsideration.
File an Application for Hearing and represent you at the hearing with the Administrative Law Judge who will decide if you get benefits. She will have your physician, if possible, complete the right RFC(s), prepare you for the hearing, prepare a hearing brief, and be prepared to cross-examine the VE.

The SSA is in the business of denying claims and will use any reason to deny your benefits. The odds of getting your Social Security benefits are greater when you are represented by an experienced Social Security Disability attorney like Ms. Cavey.

Contact Social Security Disability Attorney Nancy L. Cavey, Who Can Help You Regardless Of Where You Live In Florida

Congestive heart failure can make it difficult, if not impossible, to work. You owe it to yourself and your family to get help today! Ms. Cavey can explain the Five-Step Sequential Evaluation process used in every claim, the claims process and how to get your disability benefits. Call today for a free consultation at 727-477-3263.