How Severe Does My Heart Failure Have To Be To Get Disability?

If you have been diagnosed with heart failure and you can’t work any longer, you may be eligible for Social Security disability benefits. There are hundreds of medical conditions that qualify someone to receive disability benefits, but your medical condition must be severe in order to qualify for them. If you do qualify for disability benefits, you can use the money you receive to pay any of your living or medical expenses.

Blue Book Listing For Heart Failure

Every condition that is listed in the Blue Book has a set of requirements that you must show you meet before your application for Social Security disability (SSD) benefits will be approved. And your symptoms must be severe in order to qualify for approval. Common symptoms of heart failure like:

  • Shortness of breath with activity or when lying down.
  • Fatigue and weakness.
  • Swelling in the legs, ankles and feet.
  • Rapid or irregular heartbeat.
  • Reduced ability to exercise.
  • Persistent cough or wheezing with white or pink blood-tinged mucus.
  • Swelling of the belly area (abdomen)

If they are severe enough to meet the Blue Book listing requirements and you are able to provide documentation via medical records to back them up in your claim, these symptoms can qualify you to be approved for disability benefits.

Proving Your Heart Failure Is Severe Enough for SSD

The Blue Book listing for heart failure is very specific. It says that you must have:

Systolic failure of the heart with left ventricular having end diastolic dimensions of more than 6.0 cm or have an ejection fraction reaching 30% or less when the heart is stable and not during an acute episode.

AND

The previously mentioned condition results in the persistent symptoms of heart failure that cause serious limitations impairing your ability to independently take care of daily tasks. Also, you cannot perform any exercise tests without having significant health risks.

OR

You have experienced three or more unique congestive heart failure episodes within a year. There must also be fluid retention that can be validated using clinical and imaging assessments at the time of the attack and extended physician intervention was required.

OR

You cannot perform an exercise test with a workload of 5 METS or less because of severe symptoms, three or more episodes of tachycardia, left ventricular dysfunction causing a decrease of 10mm HG or more systolic pressure, or ataxic gait or mental confusion, or one of several other problems.

You will need to submit a letter of diagnosis, notes from your doctor, stress test results, an EKG, and other medical documentation showing that you meet these requirements.

Applying for Disability Benefits

When you apply for Social Security disability benefits, you may be denied the first time. That is not unusual. Approximately 2/3 of initial applications for disability benefits are denied because of technical problems with the application, not having medical evidence for disability, or failing to complete the application properly. This is why working with an experienced disability lawyer can help ensure that your application is filled out correctly and that you have all of the required documentation. In fact, according to the SSA’s data on approval rate for disability applicants that work with an attorney versus those who do not, they found that applicants who work with an attorney are approved for disability more than those who do not. Ultimately, working with a disability attorney increases your chances of having your claim approved by the SSA on the first try.

Get Help With Your Disability Claim

The most important part of filling out your Social Security disability claim is providing medical evidence that shows you meet the SSA’s criteria. Fill out a Free Case Evaluation form on this page now to get connected with and receive personalized advice from a disability attorney—completely free of charge to you.

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