Social Security Disability Insurance (SSDI) – Chronic Heart Failure

A person may qualify for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) based on severe, such as chronic heart failure. If a person is not working and has been diagnosed with this severe condition, the Social Security Administration will determine whether the person is disabled under a listing or whether jobs exists considering the person’s residual abilities.

The Listings are just that, they are listings of conditions that qualify someone for disability benefits. A person must show that she meets or equals the listed condition and required severity.  In terms of Chronic Heart Failure, the SSA’s Bluebook or Code of Federal Regulations states:

4.02 Chronic heart failure while on a regimen of prescribed treatment.  The required level of severity for this impairment is met when the requirements in both A and B are satisfied.

A. Medically documented presence of one of the following:

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);

AND

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 MC, 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:

a. Dyspnea, fatigue, palpitations, or chest discomfort; or

b. Three or more consecutive premature ventricular contractions (ventricular tachycardia), or increasing frequency of ventricular ectopy with at least 6 premature ventricular contractions per minute; or

c. 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

d. Signs attributable to inadequate cerebral perfusion, such as ataxic gait or mental confusion.

If a person does not qualify for Social Security Disability Insurance (SSDI) or SSI benefits based on this Listing, the heart disease and any other impairments can still be considered when determining whether she can return to past employment or whether jobs exist in the local and national economy.

To read about the listing for recurrent arrhythmias, click here.

If you need more information about a Social Security Disability/SSI, personal injury, EEOICPA, long or short-term disability, VA disability, Railroad Retirement Board disability, or a workers compensation matter, please contact the Law Offices of Tony Farmer and John Dreiser for a free case evaluation. We can be reached at (865) 584-1211 or (800) 806-4611 or through our website. Our office handles claims throughout Tennessee and surrounding states.