How To Quality For Disability For Congestive Heart Failure In Texas
Social Security puts congestive heart failure under the category of chronic heart failure for the purposes of awarding disability benefits.
Youre going to need to prove to Social Security that your case is so severe that you cant work at all. That means you cant continue in your old job or switch to a new job, and your medical condition will last at least a year.
One challenge of winning disability benefits with a heart condition is that sometimes you can still work depending on the severity of your case. That means you also need to make all of the physical demands of your job clear to Social Security.
Social Security says you have to prove you have one of these two types of heart failure:
- Systolic failureYour heart isnt pumping blood as strongly as it should.
- Diastolic failureThe muscle in your heart stiffens, limiting your hearts ability to fill with blood.
This is the kind of evidence youll need to document your heart failure:
- Reports from doctor visits
- Poor performance on an exercise test
- Blood pressure thats too low despite exercise
- Poor blood flow to the brain, causing uncoordinated movement and mental confusion
- Symptoms severe enough that your doctor doesnt think you could safely take an exercise test
- Three serious episodes of fluid retention in the heart requiring significant medical attention, such as hospitalization or emergency room care, over a one-year period
Youll pay no attorney fee until you win benefits and rest easier.
When To Ask Your Doctor For An Opinion
If your application for Social Security disability benefits has been denied and you have appealed, you should get a medical source statement from your doctor to use as evidence at the hearing.
When is the best time to request an opinion from your doctor? Many disability attorneys wait until they have reviewed the file and the hearing is scheduled before requesting an opinion from the treating doctor. This has two advantages.
- First, by waiting until your attorney has fully reviewed the file, he or she will be able to refine the theory of why you cannot work and will be better able to seek support for this theory from the treating doctor.
- Second, the report will be fresh at the time of the hearing.
But this approach also has some disadvantages.
Here is an alternative. Suggest that your attorney request your doctor to complete a medical opinion form on the day you retain your attorney. This will provide a snapshot description of your residual functional capacity early in the case. If you improve and return to work, the description of your RFC provides a basis for showing that you were disabled for a specific period. If you change doctors, your attorney can get an opinion from the new doctor, too. If you stop seeing doctors, at least your attorney has one treating doctor opinion and can present your testimony at the hearing to establish that you have not improved.
There are times, though, that your attorney needs to consider not requesting a report early in the case.
Symptoms And Signs Of Congestive Heart Failure
To establish that you have chronic heart failure for the purpose of receiving Social Security disability benefits, your medical history and physical examination should describe characteristic symptoms and signs of pulmonary or systemic congestion or of limited cardiac output. And these signs and symptoms should be associated with the abnormal findings on appropriate medically acceptable imaging. Factors that cause heart failure, but that can be improved or eliminated, such as heart failure induced by high altitude, arrhythmias, and dietary sodium overload, would not be expected to result in chronic failure.
Symptoms of congestion or of limited cardiac output include:
- Easy fatigue.
- Shortness of breath on exertion.
- Chest discomfort at rest or with activity.
- Shortness of breath on lying flat .
- Sudden shortness of breath while sleeping ).
- Cardiac arrhythmias resulting in palpitations, lightheadedness, or fainting.
Signs of congestion may include:
- An enlarged liver .
- Fluid accumulation in the abdomen .
- Increased jugular vein distention or pressure.
- Rales .
- Peripheral edema .
- Rapid weight gain.
However, these signs need not be found on all examinations because fluid retention may be controlled by treatment.
Also Check: Can You Find Someone By Social Security Number
Chronic Heart Failure Is Caused By A Variety Of Conditions That Overwork And Damage Heart Muscle Including:
- Coronary artery disease arteries that are narrow or blocked decrease blood flow to the heart muscle.
- Heart attack damages heart muscle and results in scarring.
- Cardiomyopathy damage to heart muscle caused by infections, alcohol or drug abuse.
- Hypertension/high blood pressure.
- Loss of appetite, nausea
- Skin that appears blue
Considering A Disability Attorney
While it may seem daunting, disability attorneys are the best possible resource when it comes to preparing for an ALJ hearing. Their legal expertise and case-building knowledge is specifically made to increasing your chances of getting benefits. And, thanks to federal regulation, disability attorneys cannot take payment unless their efforts win you your case. If youre curious as to how a disability attorney may be able to help, consider a free consultation with an attorney in your area.
Don’t Miss: Search Someone By Ssn
Aorta Or Major Branch Aneurysm
Weakness or damage to a blood vessel can cause the vessel wall to bulge at its weakest point. This is known as an aneurysm. While aneurysms can occur almost anywhere in the body, they are often found in the wall of the aorta, the large artery responsible for delivering oxygenated blood from the left ventricle of the heart to the branch arteries. When an aneurysm ruptures, whether in the aorta, the brain, or elsewhere, the results can quickly turn fatal.
Social Security’s Listing 4.10 for aorta or major branch aneurysms is satisfied when an aneurysm in the aorta or major branch artery is demonstrated by appropriate medical imaging and when “dissection” of the artery occurs and cannot be controlled by prescribed treatment.
Please Answer A Few Questions To Help Us Determine Your Eligibility
Congestive heart failure , or chronic heart failure, is a potentially lethal condition where the heart cannot pump a sufficient amount of blood, which can cause blood to accumulate in the vessels leading to the heart and can cause congestion or accumulation of fluid in various parts of the body. CHF is usually accompanied by an enlargement in the size of the heart.
Read Also: How Much Do I Have In My Social Security
Your Next Step: Scheduling An Alj Hearing
Aside from reviewing your initial application, the next step you should take after receiving your decision is scheduling an ALJ hearing. These hearings allow you to retry your case in front of an administrative law judge to try and get your claim decision reversed. These hearings can be scheduled at your nearest Office of Disability Adjudication and Review , and should be made as soon as possible. Even if you aren’t ready for your hearing when you schedule, wait lists tend to be long enough that you will have plenty of time to prepare.
As a general rule of thumb, you should always prepare more than less when getting ready for a hearing. Any additional information you can provide that wasnt on your initial application is most helpful. This may include a variety of documents such as new heart tests, retaken previous tests, medication lists, hospitalization records, physician notes, therapy session notes, financial statements, or testimonies from those who can attest to the severity of your condition.
Types Of Heart Disease
Many types of heart disease qualify for Social Security disability benefits if their manifestation is serious enough to cause disability. In years past, chronic heart disease meant the patient might never return to work however, with todays advancements in treatments, along with new medications, more and more heart patients are returning to the workplace. Although many people respond favorably to effective treatment for a variety of cardiac conditions and go on living actively and working others may not be able to.
You May Like: Social Sercirty
What Heart Conditions Qualify For Disability
You can qualify for disability if you have:
- Chronic Heart Failure.
- Ischemic Heart Disease,
- Chronic Venous Insufficiency,
- Recurrent Arrhythmias.
Chronic Heart Failure: Also called congestive heart failure, there are medical tests administered to measure the flow of blood from your heart. Your heart needs to be performing at 30% capacity to qualify as totally disabled. Additionally, you need to demonstrate that your heart problem causes you pain, even while not exerting yourself. This sort of heart failure can stem from cardiomyopathy, including dilated, hypertrophic, or restrictive cardiomyopathy.
Ischemic Heart Disease. This is a pre-heart attack condition which is caused by problems with your arteries. Those who have this condition have poor oxygen flow within their blood stream. This condition is normally diagnosed as a result of a particularly poor stress test or angiography.
Hypertensive Heart Disease. In order to qualify for Social Security Disability, your hypertension must be so serious that you would also meet the criteria for disability from ischemic heart disease or chronic heart failure.
Heart Transplant. The SSA considers a heart transplant a disability one year following the surgery. They will also evaluate residual impairment under the appropriate listing.
You can find more information and tips for qualifying with a heart condition here: Tips for Applying for Disability with Heart Problems
Dont Give Up After A Denial
If youve been rejected by Social Security, its understandable to feel hurt and frustrated.
But remember: most people are denied on their initial application. You arent alone.
The Social Security Disability appeals process features multiple steps, with chances to win your benefits at each juncture. Your best opportunity may come at a hearing with an administrative law judge , which is the only time you can make your case in person.
In fact, government statistics show that youre three times as likely to win benefits at an appeals hearing if you hire representation.
So dont take a chance when it comes to your financial security. When it comes to claims for Social Security disability if we dont win you benefits, you dont owe us a cent.
You May Like: Sociol Security
Why Was My Heart Failure Disability Application Denied
Every year, around 550,000 new cases of congestive heart failure are diagnosed in the United States. CHF has the capacity to drastically affect ones health and lifestyle, leading many patients to seek disability benefits for help.
However, in many cases , disability applicants find that their initial claim attempt is denied. If this is true for you, do not worry continue below to see how you can continue your disability case moving forward. Some heart defects, such as congestive heart failure, coronary artery disease, and heart transplants, can automatically qualify you for disability benefits through the “Blue Book” List of Conditions.
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 , 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.
You May Like: What Pays For Social Security
Finding Out If Your Heart Conditions Qualify For Disability
The SSA has all medical qualifying criteria listed in their Blue Book. All heart conditions can be found under section 4.00 Cardiovascular System. This section is broken down into subsections:
- Category of Impairments, Cardiovascular System
- Chronic Heart Failure
- Aneurysm of Aorta or Major Branches
- Chronic. Venous Insufficiency
- Peripheral Arterial Disease
Each of these sections explains what is needed to qualify for disability benefits if you are experiencing that condition. This includes things like test results, treatments, symptoms, limitations, and much more.
Even if the condition you are experiencing is not listed as a section, you may still qualify for benefits. Look over the Blue Book with your doctor to see if you meet a Blue Book listing. Your doctor can help you organize any tests that need to be done to meet a listing.
Some heart conditions will also automatically qualify for disability benefits under the Compassionate Allowance Program. For example, if you had a heart transplant or are experiencing Hypoplastic Left Heart Syndrome, you may qualify as a Compassionate Allowance.
When applying, review the listing to make sure you have all the medical evidence that can help support your claim. Many claims are initially denied for a lack of medical evidence.
Group Ltd Insurance Policy: Your Claim Was Turned Down As A Delaying Tactic
Even when a policyholder submits the necessary medical evidence to support their claim of CHF disability, its not uncommon for insurance companies to delay or outright deny a claim when its first submitted. In some instances, they consider only parts of your medical record without looking at the full picture of your disability. The goal is to discourage a policyholder from seeking the benefits to which they are entitled.
Most group employer LTD insurance policies are governed by ERISA laws. Among other things, ERISA gives policyholders the right to appeal an insurance companys decision to deny a claim. The important thing to remember is you have only a limited time in which to submit their appeal.
You May Like: What Would My Social Security Benefit Be
The Blue Book Listings For Common Heart Conditions
If the medical evidence in your case establishes that you meet the requirements of a cardiac impairment listed in Social Security’s “blue book,” your case should be approved without much difficulty. Unfortunately, only the most severe cardiac conditions are found in the blue book, and even some individuals who have received stents or undergone heart attacks don’t meet any of the listings.
The listings for cardiac conditions are found in Section 4.00 of the blue book under The Cardiovascular System. Because these particular listings are rather complex and technical, you should work with your disability attorney and your cardiologist to determine if you meet or “equal” any of the listings.
Here are some common cardiac conditions that may qualify you for disability benefits under a listing .
Social Security Disability Benefits For Congestive Heart Failure In Chicago Il
If you have congestive heart failure and cant work, you may entitled to Social Security Disability benefits. The Social Security Administration lists CHF within its official listing of impairments, but to qualify for benefits, you must be diagnosed with severe continuing heart failure despite taking heart medication. Your medical records must also show that you have experienced fluid retention at some point while suffering from CHF.
Winning disability benefits for CHF or any condition is never an easy process, but success is possible. To qualify for disability benefits when you have CHF, you must have medical records showing you have evidence of systolic or diastolic heart failure.
You May Like: How Much Will I Make In Social Security
Does Heart Failure Qualify For Disability Benefits
Heart Failure is also known as congestive heart failure. Heart pumps 70 to 80 cc of blood with each heartbeats. Five million Americans suffer with heart failure.1 Heart failure is a condition when heart pumps less than 70 cc of blood per beats. Heart failure is an impairment of heart that results in restriction of blood supply to muscles, peripheral tissue, and organs resulting in disability. The following article gives comprehensive information about Heart Failure, functional impairment caused by heart failure and does heart failure qualify for disability benefits? Is it advisable to hire disability attorney for winning SSD benefits for heart failure or CHF? What are the chances of winning social security disability benefits for heart failure or congestive heart failure?
Objective Symptoms Of Congestive Heart Failure
Your medical record must show the following evidence of either systolic or diastolic heart failure.
Systolic failure. This occurs when the heart has weakened pumping strength and can be shown by one of the following:
- the heart’s ejection fraction is 30% or less during a period of stability , or
- the heart’s left ventricular end diastolic dimensions are larger than 6.0 cm.
Diastolic failure. This 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 larger on imaging
- an enlarged left atrium 4.5 cm or larger, and
- normal or elevated ejection fraction during a period of stability .
Also Check: What Determines Social Security Payments
Social Security Benefits For People With Congestive Heart Failure
Congestive heart failure is a serious medical condition that can have a dramatic impact on your ability to work. At the law firm of Jeffrey A Rabin & Associates, Ltd. we represent people seeking Social Security benefits throughout northern Illinois from our five office locations, including one in Chicago.
Please schedule a free initial consultation with a Chicago heart failure disability lawyer today. You may or you may reach us by phone at 888-529-0600.
How The Symptoms Of Chf Affect Disability Benefits
As mentioned above, you must have medical evidence outlining your systolic or diastolic heart failure.Systolic heart failure happens when your heart has weakened pumping strength. This can be shown when:
- Your hearts left ventricular end diastolic dimensions are bigger than 6 centimeters.
- Your hearts percentage of blood pumped out during a heartbeat is 30% or less during a period of stability.
Diastolic heart failure happens when your heart is unable to fill properly. This is shown when all of the following qualifications are met:
- You have an enlarged left atrium thats 4.5 centimeters or larger, and
- The thickness of your left ventricular wall and interventricular septum is 2.5 centimeters or large on imaging, and
- You suffer from a normal or elevated ejection fraction during a period of stability.
If you suffer from complications due to your CHF and can no longer work, you will need medical evidence to present to the SSA. If you have CHF, its important you follow all of your doctors orders for treatment including taking any heart medication your doctor prescribes. If you dont follow all of your doctors orders, it can potentially harm your claim for disability benefits.
Don’t Miss: How Much Is My Social Security Check