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Postural Orthostatic Tachycardia Syndrome (POTS) and Social Security Disability

Postural orthostatic Tachycardia Syndrome, or POTS, is a form of dysautonomia. It causes a rapid increase in heart rate when changing positions, most often when moving from a vertical to an upright position, but it can occur even when sedentary or when making less pronounced changes in position.

Severely decreased blood flow to the brain is often seen in patients with POTS, and the condition can vary significantly in severity level from one patient to the next. Though some are able to continue working or otherwise leading an active life, POTS is often debilitating and can be completely incapacitating in the most severe cases.

The list of symptoms that can result from POTS is extensive and a well documented case file for Social Security Disability (SSD) benefits will include as much detail of those symptoms as possible, including how they affect you on a daily basis. Medical records are an important part of any SSD application, and can make it possible to clearly match a Social Security Administration’s (SSA’s) listing for POTS or to qualify for benefits under a “medical vocational allowance” following an evaluation of your residual functional capacity (RFC).

SSA Listings for POTS

The SSA maintains a manual, known as the Blue Book, of potentially disabling conditions. There is no distinctive listing for POTS in the Blue Book, and therefore you cannot “meet” predefined criteria for SSD qualification with POTS. There are however, several listings in the Blue Book that your POTS application for disability benefits may “match”.

When the SSA reviews your application to see if it matches a listing, your medical records and all your other documentation are evaluated to see if your condition is equally as severe as a listing that does appear in the Blue Book. Based on the kinds of symptoms you experience, the listings which may apply to your POTS application include, among others:

  • Section 4.00 – Cardiovascular
  • Section 5.00 – Digestive System
  • Section 11.00 – Neurological

Residual Functional Capacity and POTS

If your POTS doesn’t match a listing in the SSA’s Blue Book, you may still qualify for SSD benefits under a medical vocational allowance, which simply means that while you don’t suffer from a listed condition, you are still severely disabled, unable to maintain gainful employment, and therefore eligible for disability benefits.

To qualify for SSD under a medical vocational allowance, your residual functional capacity (RFC) will be evaluated by the SSA. Your medical records play a big part in determining your RFC and the more detailed those records, the easier it is to substantiate your claim.

In addition to your medical records, the SSA must also look at your employment history, including your acquired job skills. Your education level and your overall employment qualifications are also evaluated. Your RFC results must show that your POTS so severely limits you that you’re unable to find and maintain gainful employment in any field of work for which you would otherwise be qualified.

Medical Documentation and your SSD Application for POTS

Medical evidence is a crucial aspect of the SSA finding you eligible for disability benefits, regardless of whether it’s your RFC that qualifies you or the fact that your application matches a listed condition in the Blue Book. Your records should include:

  • Records of the formal diagnosis of the condition
  • Diagnostic test results that show there is an organic cause of your POTS
  • Treatment records, including all treatments attempted and their affect on your symptoms and overall condition
  • Results of mental or psychological evaluations, if applicable
  • Documentation of the frequency, duration and severity of syncope episodes (loss, or near loss of consciousness)
  • Statements from your treating physician(s) documenting diagnosis, prognosis and your functional capacity

Seeking Assistance with your POTS SSD Application

Because there is no single, dedicated listing for POTS in the SSA’s Blue Book, and because proving disability can be challenging, particularly if your symptoms are not consistently present, you may wish to consider getting assistance from a Social Security advocate or disability attorney when filing your claim.

Free Evaluation of your POTS Claim