Mitral Valve Prolapse and Social Security Disability

Mitral Valve Prolapse affects the valve of the heart that directs the flow of blood from the left to the right chamber of the heart. The valve is usually enlarged, which can lead to a variety of heart complications, including blood washing back into the left ventricle from the right in addition to irregular heartbeats (fibrillation). In rare and severe cases, the condition can cause heart attacks.

Symptoms of mitral valve prolapsed include shortness of breath, chest pain, heart palpitations, and generalized weakness. While most people with this condition live free of symptoms, some do experience serious issues. In these more severe cases, valve replacement surgery may be required.

Mitral valve prolapse does not always qualify for Social Security Disability (SSD) benefits, but can meet the medical eligibility requirements when it prevents gainful employment for a period of 12 months or longer.

Medically Qualifying with Mitral Valve Prolapse

Within the Blue Book manual, the Social Security Administration (SSA) maintains a standard listing of disabling conditions. Each listing details the evidence requirements for medically qualifying for benefits. Although there is no specific listing for Mitral Valve Prolapse or even heart valve dysfunction, the SSA will try to match your application and medical records to another listing. The listings they typically examine include:

  • Section 4.05 – Recurrent Arrhythmias
  • Section 4.06 – Symptomatic Congenital Heart Disease
  • Section 4.10 – Aneurysm of aorta or major branches

Even if your condition does not closely match one of these listings, you may still be able to qualify for benefits by proving your symptoms are so severe that they prevent you from working. This requires you and your doctor both complete “Residual Functional Capacity” (RFC) report forms.

  • The report from your physician must detail the history of your symptoms as well as the manner in which they affect your daily life, including your ability to perform typical job functions.
  • The RFC form you complete will describe how your handle your “activities of daily living” or ADLs. It will also detail how your symptoms limit your everyday activities. Activities like lifting, pushing, pulling, and walking might be among the ADLs your symptoms limit. You may be too weak to work full-time, even if you typically work in sedentary jobs.

If your RFC analysis shows you’re so limited by your condition that you’re unable to earn a gainful living, then you will receive disability benefits under a “medical vocational allowance.” This simply means that although you don’t meet or match a Blue Book-listed condition, you’re still medically eligible for benefits.

Getting Help with Your Mitral Valve Prolapse Claim

Most applications are denied at the first review stage, even those filed for listed conditions. Since there is no Blue Book listing for Mitral Valve Prolapse, your odds of denial increase. You may have a difficult time getting approved for benefits and should be prepared to receive a denial notice and ready to request a second review and file an appeal if necessary.

A Social Security Disability attorney or advocate can assist you throughout this entire process. They can help you build a strong application and collect the necessary evidence in your medical records for proving you are disabled. If an appeal hearing is required, a lawyer can help you prepare and can represent you at the hearing as well.