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A diagnosis of heart failure can be terrifying. It is a condition that can limit your life expectancy. Many people live for many years after their diagnosis. That makes it critical to determine if you can return to work after your diagnosis.
Social Security Disability may be available to you if you cannot go back to work. Heart failure disability benefits are dependent on numerous factors.
A diagnosis does not automatically qualify you to receive benefits. Many people will qualify if they meet specific requirements set by the Social Security Administration (SSA). Our disability attorneys can help you find out if you are eligible.
What Is Heart Failure?
Heart failure is a condition impacting the heart muscle. The muscle is not strong enough to squeeze the blood throughout the body as it should. The heart cannot pump enough oxygen-rich blood to meet the body’s needs. This leads to a limited amount of oxygen getting to your brain, lungs, and other organs. Over time, this can cause organ failure.
There are various types of heart failure. This depends on the amount of squeezing the heart can do. It also depends on which portion of the heart is impacted.
Qualifications for Social Security Disability with Heart Failure
You can qualify for Social Security Disability Insurance (SSDI) with heart failure. Qualifying depends on the type of heart failure you have. SSA assesses the severity of your condition by considering various tests and laboratory results.
Systolic Failure
In systolic failure, the heart pumps too little blood. Qualifications for SSDI require one of two factors to be true:
- You must have an enlarged left ventricle. On an echocardiogram, a left ventricle that measures 6.0 CM or higher may meet this threshold.
- Having an ejection fraction (EF) of 30% or less during a period of stability may also qualify.
An ejection fraction is a measurement of how much blood leaves the heart after each squeeze. A healthy heart pumps 50 to 60% of its blood with each squeeze.
Diastolic Failure
A diagnosis of diastolic failure means the heart is not relaxing enough for blood to enter before it squeezes again. To qualify for SSDI, you must demonstrate the following to be true.
- The left ventricular posterior wall and septal thickness is 2.5 cm or higher on imaging.
- There is enlargement of the left atrium. It measures 4.5 cm or more. AND
- You have a normal or elevated ejection fraction during a period of stability.
These are two of the most common causes of heart failure. However, some individuals experience these symptoms and still maintain a good overall quality of life. This is why SSA also requires evidence of limitations. Talk with an SSA attorney today about your case.
A diagnosis of either form of heart failure allows for consideration of SSDI. This is if you have at least one of the following symptoms that accompany it:
- Heart failure symptoms that remain. These symptoms may include limitations on your ability to start daily activities. It may also include continuing or completing activities of daily living. This may include becoming out of breath or being unable to bathe yourself.
- Three or more serious heart failure episodes have occurred within 12 months. Many people will suffer a heart failure episode and then see improvement. The development of fluid retention or the need for physical intervention indicates destabilization.
Exercise Tests
You fail an exercise tolerance test. This test evaluates the workload capacity of your heart. If it is equivalent to 5 METs or less, you may qualify. This must be due to dyspnea, fatigue, palpitations, or chest discomfort.
It may also apply if you have three irregular, consistent heartbeats. This is a condition called ventricular tachycardia.
You may also have frequent abnormal heart rhythms with at least six extra beats per minute.
You may also fail if your systolic pressure drops 10 mm HG or more. This applies in situations even where the workload is reduced.
You may also file an expertise test if you experience confusion or ataxic gait. This could indicate the brain is not receiving enough oxygen.
When Will SSA Provide Disability for Heart Failure
Ultimately, you must meet the symptoms and signs described under the SSA’s 4.00 listing. This includes medical evidence provided by an approved medical provider. Tests such as EF, exercise tolerance tests, and blood work will offer some indication. The frequency of symptoms may also play a role. Most people with heart failure suffer numerous hospitalizations during periods of destabilization.
Some people do not meet the exact listing criteria. A residual capacity assessment could also be used to show the limitations you have. This looks at factors such as the type of work you do. It considers what limitations are expected with the type of work you do.
Numerous factors play a role in qualifying for disability with heart failure. A diagnosis alone is not enough. You must demonstrate the impact on your ability to work. Your doctor can provide some insight to SSA about this. A Medical Expert hired by SSA will also consider your case and limitations.
Work with an Experienced Social Security Disability Attorney for Guidance
You can obtain SSDI for heart failure if you can show the impact the condition has on your daily life. Our SSA Disability attorney will help you understand your medical evaluations and symptoms. The goal of working with an attorney is to ensure that the SSA receives all the necessary information. This helps you make the best decision.
Reach out to Pond Lehocky Disability to discuss your claim. Our experienced legal team has helped many patients with heart failure. Contact us for a consultation to discuss your rights to support. We work with both first-time applicants and those who have been previously denied.
