Can You Get Disability For Congestive Heart Failure


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Treatment Of Congestive Heart Failure

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There are many different types of treatment available for congestive heart failure , and the best course of action will vary depending on the patients condition. In general, however, treatment for CHF focuses on relieving symptoms and improving quality of life.

Medications are often useful to treat CHF, and various types can be prescribed. Diuretics, or water pills, are commonly used to help reduce fluid buildup in the body. ACE inhibitors and beta-blockers can help improve blood flow and reduce congestion and strain on the heart. Other medications, such as digitalis, may also be prescribed to help regulate heart rhythm.

In some cases, surgery may be necessary to treat CHF. A procedure called coronary artery bypass grafting can improve blood flow to the heart. Other surgeries, such as valve replacement or repair, may also be necessary.

In addition to medical treatment, lifestyle changes are often recommended for people with CHF. Quitting smoking, eating a healthy diet, and exercising regularly can all help improve symptoms and quality of life. Reducing stress levels and getting enough rest are also important for people with CHF.

Can You Get Disability For Heart Failure

When a person applies for disability benefits, the SSA compares their condition to a list of diseases known as the Blue Book. Each situation that could potentially qualify is listed in there, along with the criteria that an applicant must meet to be eligible for each specific condition.

Chronic heart failure is addressed in Section 4.02 of the Blue Book. According to the Blue Book, to qualify, an applicant with CHF must be able to prove that:

  • You have been diagnosed with this condition while undergoing prescribed treatment.
  • Persistent symptoms are present that seriously limit your ability to independently initiate, sustain, or complete activities of daily living there are three or more separate documented episodes of acute CHF within the past 12 months or you suffer an inability to perform on an exercise tolerance test at a workload equivalent to 5 METs or less.
  • There is medically documented evidence of systolic failure with left ventricular end-diastolic dimensions greater than 6 cm or ejection fraction of 30% or less during a period of stability 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.

Objective Symptoms Of Congestive Heart Failure

Several objective symptoms of congestive heart failure can help diagnose the condition. These include:

  • A feeling of fatigue or tiredness
  • Shortness of breath, especially during activity
  • Swelling in the ankles, feet, legs, abdomen, or veins in the neck
  • Increased urination, particularly at night
  • Weight gain due to fluid retention
  • Difficulty sleeping or waking up rested
  • Irregular heartbeat or palpitations
  • Chest pain or discomfort

If you are experiencing any of these symptoms, it is essential to see a doctor as soon as possible. Congestive heart failure is a severe condition that can be fatal if left untreated. Early diagnosis and treatment can improve your chances of recovery.

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How To Meet The Ssa Criteria For Congestive Heart Failure

If congestive heart failure has made it impossible for you to work, receiving Social Security Disability Insurance benefits can help provide financial relief. The Social Security Administration will consider you eligible for SSDI if your conditions meet the criteria for CHF listed in the Blue Book, a book listing specific criteria for meeting certain disabilities.

According to Section 4.02 of the Blue Book, you can qualify for Social Security disability benefits for CHF if you can prove that:

  • A medical doctor has diagnosed you with CHF while undergoing prescribed treatment.
  • You have medically documented evidence of systolic failure that meets specific conditions.
  • You have persistent symptoms of heart failure that prevent you from independently initiating, sustaining, or completing activities of daily living.
  • You have had three or more separate documented episodes of acute congestive heart failure within a 12-month period.
  • You suffer an inability to perform an exercise tolerance test at a workload equivalent to 5 METs or less.

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If you have a heart condition and it is so severe that you will be out of work for at least 12 months, then you may want seek help from a disability attorney.

A disability lawyer will be able to know what heart conditions qualify for disability and will be able to advice you on what listing to match your symptoms under if you are unsure.

Bear in mind that you may still qualify for Social Security Disability benefits even if your heart problems do not fall strictly within the guidelines for total disability, so long as you can convince the Social Security Administration that your heart problems make it impossible for you to engage in any work.

In addition, you must show them that your heart problem makes training for a job other than your original impossible. A qualified disability advocate can help you determine whether you should pursue a Social Security Disability claim.

If you think you might qualify for Social Security Disability benefits based on a heart problem, the two people you should get in your corner are your doctor and a Social Security Disability attorney.

Your doctor will need to substantiate the medical information, as well as document what attempts are being made to control or improve your heart condition.

An attorney who specializes in Social Security Disability gives you the best chances of having your disability claim accepted, as well as helping you through the appeals process, if it should become necessary.

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Medical Records Needed To Qualify

If you are unable to work because of a heart condition, you may qualify for disability benefits. To be approved for disability benefits, the Social Security Administration requires that specific medical criteria be met. Supporting documentation is essential to your claim.

Disability Determination Services , which reviews the claims filed for Social Security Disability benefits, must be able to confirm the severity of your condition and the diagnosis.

Your medical records should be as detailed as possible, and your records must be able to support your claim and confirm the severity of your condition. As an example, you will need to provide copies of medical tests that confirm your diagnosis.

These tests must show that your heart muscle doesnt function normally and that you suffer discomfort because of activity or emotion, you experience myocardial ischemia, or you suffer from atypical angina.

To do this, you will need to provide the result of an abnormal stress test, ischemic episodes, or abnormal imaging results, and the results of an exercise test. Your exercise test should be a tolerance test with a workload at 5 METS or less, and it must reveal at least one of the following issues:

You can also be approved if you can provide medical records that detail three separate ischemic episodes within 12 consecutive months. Each of those episodes must require revascularization, which refers to bypass surgery or angioplasty.

Can I Qualify For Disability Because Of My Limitations

Many adults have serious heart conditions that make it difficult for them to work, but they don’t meet the strict requirements of the SSA’s impairment listings. For instance, maybe you have coronary artery disease and had one ischemic episode in the past year but not three. Or perhaps you have systolic heart failure, but your ejection fraction is 40%, not 30%, and the results of your exercise test are poor but not as bad as the SSA requires.You still might be eligible for disability benefits . When you don’t automatically qualify for disability benefits under the SSA’s official listings, the SSA is required to consider the effect of your heart condition on your capacity to perform routine daily activities and work. The SSA will then determine whether there’s any kind of job you can safely be expected to do.

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How Congestive Heart Failure Can Lead To Disability

According to the Mayo Clinic, there are almost 200,000 cases of congestive heart failure diagnosed each year. CHF occurs when the heart muscle doesnt pump blood as efficiently as it should. Its a serious, potentially life-threatening condition that can happen suddenly or be an ongoing condition.

The factors that lead to CHF such as narrowed arteries in your heart or high blood pressure cant always be reversed, but medication and lifestyle habits exercising, dieting, watching your salt intake, not smoking, and maintaining a healthy weight can help reduce the chances of future heart failure and improve the quality of life.

Living with the symptoms of CHF can make it difficult to perform many routine daily tasks. Symptoms of CHF can include:

  • Swelling in your legs, ankles, and feet
  • Lack of appetite and nausea
  • Difficulty concentrating or decreased alertness

Heart valve problems, kidney damage or failure, heart rhythm problems, and liver damages, are a few of the complications that can be caused by CHF.

Can I Get Disability For Heart Problems

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Some heart conditions can automatically qualify you for benefits if they are severe enough to meet one of the Agencys Listings of severe impairments. Other heart diseases and conditions could qualify you for benefits even if they do not meet the stringent requirements for a Listing if they cause you to be so limited in the things you can do that you could not be expected to work at a 40-hour per week job, no matter how easy.

In other blog posts weve talked about the two alternative ways a person can meet the SSAs requirements to show they are disabled by:

  • meeting a Listing, or
  • showing a significantly impaired Residual Functional Capacity
  • Whatever your particular type of heart problem, it is absolutely imperative that you have been seeing a doctor and being tested, medicated, and treated for a significant period of time, at least 4-6 months.

    Without a substantial set of medical records, test results, and medication prescriptions to back up your heart condition claim, it is unlikely that you can win your disability case based on heart disease.

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    Qualifying Under Blue Book Listing

    When youre applying for SSA disability benefits, you will have your condition compared to a listing of conditions in the Blue Book. All conditions that can lead to disability are mentioned in the Blue Book, along with the criteria for each of them.

    Congestive heart failure is found under Section 4.02 of the Blue Book. To receive benefits for this medical condition, you need to prove the following:

    • Diagnosis with heart failure even while undergoing appropriately prescribed treatment
    • Medical documentation of systolic failure or ejection fraction within a specific set of numbers set by the SSA
    • Persistent symptoms of heart failure that create a situation where its challenging to complete the activities of daily living or at least three document episode of acute congestive heart failure within one year

    What Are The Chances Of Winning Social Security Disability Benefits For Heart Failure

    Heart failure is considered for disability when symptoms of heart failure causes functional impairment. Impairment is considered disabling when individual is unable to complete daily task at work to the satisfaction of employer. Heart Failure often causes severe disability resulting in inability to perform any sort of work. Such a condition resulting in disability due to heart failure is entitled to get Social Security Disability benefits.

    Chances of winning disability benefits for heart failure depends on detailed case presentation with reports of all the tests. Individual patient should make sure to have all the medical records with regard to all the doctorâs office visits, hospitalizations, emergency room visits, and other tests that have been performed to evaluate the diagnosis and subsequent treatment for Heart Failure. Claimant should collect and save all the reports of blood test, radiological studies, electrocardiogram, echocardiogram and all other test performed to diagnose heart failure. Claimant should document all the treatment prescribed so that the details can be used at the time of case presentation for disability due to heart failure.


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    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

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    The following don’t create problems and you shouldn’t worry about being around them if you have a pacemaker: Microwave ovens, televisions and their remote controls, dental equipment, radios, toasters, electric blankets, CB radios, heating pads, stereos, vacuum cleaners, hair dryers, gardening machinery, electric …

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    Primary Causes Of Congestive Heart Failure

    Most forms of heart disease, including valvular, cardiomyopathy, and pericardial disease, eventually lead to an enlarged heart and CHF. It is usually progressive and commonly develops for months or years.

    The other causes of CHF may include:

    • Poorly controlled hypertension
    • Coronary artery disease, in which arteries that supply blood to the heart muscle are narrowed
    • Endocarditis or myocarditis, in which the heart muscle, valves, or surface tissue become inflamed

    The Blue Book Listings For Common Heart Conditions

    The Blue Book lists common heart conditions covered by the Social Security Administration under section 4.00. If you have one of these conditions, you may be eligible for benefits.

    • Heart transplant: A heart transplant is a procedure to replace your diseased heart with a healthy donor heart. This can be done if you have end-stage congestive heart failure and other treatments have failed.
    • Coronary artery disease: Coronary artery disease is when the arteries that supply blood to your heart become narrowed or blocked. This can lead to chest pain , shortness of breath, and other symptoms. Treatment options include lifestyle changes, medication, and surgery.
    • Aorta or major branch aneurysm: An aneurysm is a weak spot in the wall of a blood vessel. Aortic aneurysms can occur in the aorta or in one of its major branches. If it ruptures, it can cause internal bleeding. Treatment options include lifestyle changes, medication, and surgery.
    • Congestive heart failure: Congestive heart failure is a condition in which your heart cant pump enough blood to meet your bodys needs. This can lead to fatigue, shortness of breath, and other symptoms. Treatment options include lifestyle changes, medication, and surgery.
    • Recurrent heart arrhythmias: Recurrent heart arrhythmias are when your heart beats too fast, slow, or irregularly. This can lead to dizziness, fainting, and other symptoms. Treatment options include lifestyle changes, medication, and surgery.

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    Systolic And Diastolic Types Of Congestive Heart Failure

    The two types of heart failure listed under the SSA guidelines include systolic dysfunction and diastolic dysfunction. Systolic dysfunction is the hearts inability to pump out adequate amounts of blood one way to evaluate the severity of this condition is by measuring the hearts ejection fraction. Diastolic dysfunction is the hearts inability to relax and draw more blood into the heart after contraction.

    How Does The Social Security Administration Decide If I Qualify For Disability Benefits For Congestive Heart Failure

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    If you have congestive heart failure, Social Security disability benefits may be available. Congestive heart failure is called chronic heart failure by the Social Security Administration. To determine whether you are disabled by CHF, the Social Security Administration first considers whether your heart failure is severe enough to meet or equal a listing at Step 3 of the Sequential Evaluation Process. See Winning Social Security Disability Benefits for Congestive Heart Failure by Meeting a Listing. If you meet or equal a listing because of CHF, you are considered disabled.

    If your chronic heart failure is not severe enough to equal or meet a listing, the Social Security Administration must assess your residual functional capacity , to determine whether you qualify for disability benefits at Step 4 and Step 5 of the Sequential Evaluation Process. See Residual Functional Capacity Assessment for Congestive Heart Failure.

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    Other Issues Affecting Disability And Heart Failure

    Right Ventricular Function

    The listing for chronic heart failure says nothing about right ventricular function, and often medical evidence contains no information about the right side of the heart. Most claimants for disability benefits have left ventricular dysfunction caused by ischemic heart disease, specifically coronary artery disease. See Can I Get Social Security Disability Benefits for Ischemic Heart Disease?

    When cardiac catheterization data is available, it usually involves only the left side of the heart, because the cardiologist performing the procedure is interested in evaluating the large epicardial coronary arteries supplying the heart muscle with blood these arteries have to be approached from the left heart. Catheterization of the right side of the heart would require a separate procedure.

    Figure 6: Closed heart valves with views of the coronary arteries.

    The Social Security Administration adjudicator should not disregard right ventricular dysfunction. Yet this can happen when the adjudicatorsuch as a disability examiner or SSA hearing officeris not a physician and therefore does not have the medical knowledge necessary to evaluate cardiac cases.


    Even modest anemia can justify further lowering your RFC and sometimes even a finding that your impairment equals a listing.

    Left Bundle Branch Block

    Ssas Functional Limitations Criteria For Congestive Heart Failure

    The following symptoms must be present and documented in order to qualify for SSDI or SSI benefits:

    -Unable to successfully perform an exercise tolerance test at a workload equivalent to 5 METs or less due to symptomatic difficulties

    -For those whose condition makes an ETT too great of a risk, there must be persistent symptoms of heart failurethat severely limit activities of daily living

    -No less than three incidents of heart failure and fluid retention within the past year that required emergency room treatments or hospitalization for no less than 12 hours.

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