If you have been suffering from atrial fibrillation and have been off work because of the disability, you have probably applied for SSDI or SSI benefits already. It is quite common for applications for either benefit to be denied at the first attempt.
This may be disheartening, but you shouldn’t give up as there is an established appeal procedure available through which you have a good chance of having the original decision reversed.
There are several stages to the appeal process and it is important to be well prepared with evidence of your disability as it fits the Blue Book description and increase your chances of winning an appeal by using the expertise of a disability attorney.
How to Appeal the Decision
There are several steps that can be taken following a notification that your application for disability benefits has been denied. Generally, the better prepared you are and the more comprehensive the documentation and confirmation of the description of your atrial fibrillation by medical personnel the more likely you will have the decision to deny a benefit overturned.
The first step is to ask for a reconsideration of the decision to deny a benefit. All states now allow a review of the decision before an appeal goes to a formal hearing. In a reconsideration, your original claim is fully reviewed again by an examiner and a medical consultant at Disability Determination Services (DDS). Whoever was involved in examining your application originally is barred during the reconsideration.
If your reconsideration is again denied, you have the option of taking your appeal to the next level which is a hearing before an Administrative Law Judge (ALJ). This must be done within 60 days of receiving a denial letter. Decisions made by an ALJ at a hearing tend to result in benefits approved or restored in about 50% of cases.
Failing a positive decision by an ALJ, further steps possible by the determined are a review by the Appeals Council and then, failing that, a Federal review. Reversals of original decisions are seldom made if it gets to this stage.
Blue Book for Condition
Atrial fibrillation is one of the most common types of irregular heart beat or arrhythmia. It is covered in the SSA’s Blue Book in section 4.05. A brief overview of the criteria that the Blue Book listing is looking for includes:
- A complete medical history of your condition as provided by medical records;
- Test results showing that you were suffering from the condition. These could include results from a12-Lead ECG, Holter Monitor, Stress Test, Echocardiogram and a cardiac event recorder;
- Full records of hospitalization.
Consider an RFC
Although the Blue Book has a clear description of atrial fibrillation, your condition may not exactly fit the description as determined by the DDS. You may still be able to win an appeal by having an assessment made for your residual functional capacity (RFC). This is a measure of what work you can or cannot do because of the condition you are suffering from.
An RFC assessment and evaluation may allow you to be granted a medical vocational allowance which is basically another way of granting you eligibility for disability benefits.
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Many attempts at obtaining SSDI or SSI for atrial fibrillation are due to insufficient documentation. The best advice is to liaise with your physician throughout the whole application process. Ensure you have everything to hand that the Blue Book requires for confirmation of your disability and use a disability attorney to advise you if you need to appeal a decision on granting a benefit.