According to the Heart Failure Society of America, over 6.5 million Americans over age 20 have heart failure. Heart failure contributes to 8.5% of fatalities associated with heart-related diseases nationwide. It’s also the number one cause of hospitalizations in the Medicare population.
Congestive heart failure, recognized widely as CHF, is a form of heart disease that limits the heart’s ability to pump blood. This leads to high blood pressure and potential fluid accumulation in the lungs, abdomen, and other body areas. As a critical health issue, it can easily affect an individual’s ability to work and even perform simple daily tasks.
If your life has been impacted by CHF, you might be wondering, “Can you get Social Security Disability for congestive heart failure?” or “Are heart conditions that qualify for Social Security Disability recognized in my case?”
The answer is yes, you can be eligible for disability due to various heart conditions. It just takes effective case building and filing a claim with supportive evidence.
If you’re grappling with the debilitating effects of heart disease, you should explore your eligibility for disability benefits. Continue reading to find out what to expect when filing for Social Security Disability with CHF.
Heart Disability & Social Security Disability Benefits: How Individuals With CHF Qualify
Applying for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) can be daunting. From gathering medical records to understanding the various disability requirements, it’s a complicated process.
If you or a loved one are facing the challenges of living with CHF, know that you’re not alone. Understanding your condition and the potential for financial support is a critical first step in getting the help you need. This involves understanding what is necessary to prove your claim. Having the right information can make all the difference in securing benefits.
Symptoms & Medical Evidence
When you’re applying for SSI or SSDI with CHF, it’s crucial to understand the condition’s impact on work performance. The symptom spectrum of CHF ranges from mild to severe and may fluctuate. Common symptoms include:
- Shortness of breath
- Erratic heartbeat
- Swollen extremities (often leads to mobility impairment)
- Difficulty concentrating
- Rapid weight gain
- Loss of appetite
All of these symptoms and others related to CHF can potentially hinder employment.
The Social Security Administration (SSA) categorizes chronic heart disease as a disability under Section 4.02 in the Blue Book. This section outlines the requirements that must be met before you’re considered disabled. To qualify for benefits under SSA guidelines, a diagnosis of severe heart failure is required despite ongoing medication use. Your heart condition must also be categorized as either systolic failure or diastolic failure.
Additionally, your condition must result in specific symptoms and functional limitations. These include:
- The inability to perform an exercise tolerance test at a workload of 5 METs or less,
- Persistent severe heart failure symptoms limiting daily activities,
- OR at least 3 heart failure and fluid retention episodes in the past year necessitating emergency treatment or hospitalization for over 12 hours.
Diagnosing CHF involves a comprehensive approach. Doctors inquire about patients’ smoking history, blood pressure, cholesterol levels, substance use, and ongoing medications. They also conduct various tests like chest X-rays, electrocardiograms, echocardiograms, MRIs, and exercise stress tests. Documenting these test results is pivotal for establishing eligibility for Social Security Disability.
Adhering to your doctor’s treatment plan is a critical component of qualifying for disability benefits, as well. Managing CHF necessitates ongoing attention to prevent worsening conditions, alleviate symptoms, and enhance quality of life. Treatment typically combines medications and devices aiding heart function. In certain instances, procedures to repair heart valves or regulate abnormal heart rhythms can be beneficial.
Prior to applying for SSDI, consult your doctor frequently to discuss your heart condition. The SSA expects comprehensive medical records, including imaging, bloodwork, and other test results.
After assessing your physical limitations, the SSA’s vocational experts will determine your employability.
The SSA carefully determines when an applicant is expected to adjust to new work. For instance, applicants 55 or older typically fall under a grid rule and are not expected to acquire new job skills. Hence, a 55-year-old applicant lacking transferable skills might be deemed disabled.
Additionally, eligibility for benefits may increase if you have another medical condition, like kidney or thyroid disease. While one disorder might not meet the SSA’s impairment requirements, the SSA must consider the combined impact of multiple health issues on your ability to work and perform daily tasks.
SSA Basic Guidelines
The SSA also enforces the following requirements for any claimant applying for benefits:
- You must have a disability that lasts or is expected to last at least 12 months, or result in death.
- You must have sufficiently and recently contributed to the Social Security System through payroll taxes (for SSDI claimants).
- Your disability must prevent you from performing Substantial Gainful Activity (SGA).
What Can You Do If You Don’t Qualify for Benefits?
Many applicants will struggle to meet the SSA’s eligibility criteria. Fortunately, there is another way to qualify for Social Security Disability for heart disease. Proving that your functional limitations prevent you from resuming your previous job or transitioning to a new one can qualify you for a Medical-Vocational Allowance.
The SSA focuses on how the functional limitations of your impairment affect daily life. CHF complications, like poor concentration or inability to lift over 10 pounds, can influence your capacity for physical or sedentary work. The SSA can conduct a Residual Functional Capacity (RFC) assessment to evaluate your physical and mental capabilities to conclude if you can return to work.
Finally, if your disability claim is denied, you have the right to appeal the SSA’s decision. It is strongly advised that you work with a qualified disability lawyer in order to get the best chances of being approved through the appeals process.
Work With Our North Dakota Social Security Disability Lawyer
If you’re asking, “Can you get SSI for heart problems?” or “How do I file for SSDI for heart failure?” reach out to Ficek Law, PC today.
Meeting the SSA’s requirements can be challenging, and the application process for SSDI or SSI is lengthy and complex. Legal representation significantly boosts approval chances. Our Attorney Anton G. Ficek will assist in completing detailed forms, gathering and submitting relevant medical evidence, preparing doctor questionnaires, and more.
Contact us today to schedule a free case consultation.