The Social Security Application Process for Heart Failure

If you have heart failure, you may qualify for disability benefits which are administered by the Social Security administration (SSA).

The Initial Application for Disability Benefits for Heart Failure

There are two ways that a person with heart failure may apply for disability benefits. The first is by using work credits accumulated through paying Social Security Disability Insurance (SSDI). The second method is called Supplemental Security Income (SSI) which is financed through general taxation. If you do not have the work history/credits to be eligible for SSDI benefits, you might still qualify for SSI payments. In both cases, medical requirements must be met before qualifying for either disability benefits.

Before an application can be submitted, the heart failure condition must meet the Blue Book requirements and supporting evidence must be submitted with the application. The criteria for SSD benefits due to heart failure include not being able to perform everyday activities including going to work. This is mainly confirmed by the applicant failing an exercise stress test. During the initial stage of your application you will submit your application to the SSA along with all your medical evidence and supporting documentation such as your doctor’s diagnosis as outlined in the Blue Book. It takes up to 120 days to go through this stage but only 30 percent of applications will be approved. Most our denied due to insufficient evidence confirming the heart failure. You can ask for a Residual Functional Capacity (RFC) assessment to be completed by your doctor which may help to support your SSD claim.

If you are denied benefits, you can file a request for reconsideration.

Request for Reconsideration of Disability Claim with Heart Failure

If your claim has been denied by the SSA you will be sent a denial letter informing you of the reason for the denial. You will be told what time you are given to file an appeal which is called a request for reconsideration. At this stage the claim may still be denied and you will have to submit a request for a hearing before an administrative law judge (ALJ). This is the best chance you will have of being awarded disability benefits as the judge will ask for a medical expert to testify on your behalf and state your heart failure stops you going to work. You are given 60 days to request a hearing from your denial at the reconsideration stage. The ALJ will make a final decision and these can take years to be reached, but 63 percent of cases which reach this stage are typically approved.

The Appeals Council is almost the last resort if the ALJ has denied your SSD claim and you are given 60 days from the ALJ decision to request a review to the Appeal’s Council. The role of this stage is to determine if the ALJ has made a mistake with the decision. If a decision is made you don’t wish to accept you can seek help from the Federal District Court where many claims are won.

Help With the Disability Application Process for Your Heart Failure

Working with a disability lawyer can have a significant impact on the outcome of your claim for disability benefits and evidence has shown you are far more likely to have your claim approved.

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