Heart Disease and Social Security Disability Benefits

Ian C. Langtree - Writer/Editor for Disabled World (DW)
Published: 2010/05/18 - Updated: 2024/08/31
Publication Type: Informative
Topic: Disability Insurance - Publications List

Page Content: Synopsis - Introduction - Main

Synopsis: Social Security sets forth specific criteria when qualifying heart disease applicants for SSDI disability benefits. With regard to heart disease specifically, the medical evidence must be consistent with SSA's classification.

Introduction

Heart disease is a broad term used to describe a range of diseases that affect your heart, and in some cases, your blood vessels. The term "heart disease" is often used interchangeably with "cardiovascular disease" - a term that generally refers to conditions that involve narrowed or blocked blood vessels that can lead to a heart attack, chest pain (angina), or stroke. Other heart conditions, such as infections and conditions that affect your heart's muscle, valves, or beating rhythm also are considered forms of heart disease.

Main Item

Heart disease is the No. 1 worldwide killer of men and women, including in the United States. Responsible for 40 percent of all the deaths in the United States, more than all forms of cancer combined, heart disease is a legitimate fear. Here, we will discuss the specifics regarding heart disease and how someone with heart disease may qualify for Social Security Disability benefits (or SSDI).

The causes of heart disease vary by type of heart disease. While cardiovascular disease can refer to many different types of heart or blood vessel problems, the term is often used to mean damage caused to your heart or blood vessels by atherosclerosis, a buildup of fatty plaques in your arteries, blood vessels that carry oxygen and nutrients from your heart to the rest of your body.

Healthy arteries are flexible and strong. Over time, however, too much pressure in your arteries can create excessive wear and make the walls thick and stiff, therefore restricting blood flow to your organs and tissues. This process is called arteriosclerosis, or hardening of the arteries. Atherosclerosis is the most common form of this disorder. Atherosclerosis is also the most common cause of cardiovascular disease, and it is caused by a variety of factors, including an unhealthy diet, lack of exercise, being overweight and smoking. All of these are major risk factors for developing atherosclerosis and, in turn, cardiovascular disease.

Cardiovascular disease may continue to be undiagnosed until the condition worsens to the point of a heart attack, chest pain (angina), stroke, heart failure, or sudden cardiac death. It's important to watch for cardiovascular symptoms and discuss any concerns with your doctor.

Some of these symptoms include the following:

• Chest pain (angina).
• Shortness of breath.
• Pain, numbness, weakness or coldness in your legs or arms, if the blood vessels in those parts of your body are narrowed.

Cardiovascular disease can sometimes be found early with regular doctor visits.

Heart disease treatments vary.

Most treatments of cardiovascular disease focus on opening narrowed arteries that cause the symptoms. Depending on how severe the blockages, treatments may include lifestyle changes, medications, and/or surgery.

Applying for Social Security Disability Benefits

Social Security Disability Insurance (SSDI) is a federal program designed to pay monetary benefits to qualified applicants who have worked long enough and paid their social security taxes. Based on medical evidence, work history, and education history, the Social Security Administration determines whether or not applicants qualify for benefits and how much each applicant can receive.

The Social Security Administration (SSA) sets forth specific criteria when qualifying applicants for benefits. With regard to heart disease specifically, the medical evidence must be consistent with SSA's classification within the following criteria: Coronary artery disease, demonstrated by angiography (obtained independent of Social Security disability evaluation) or other appropriate medically acceptable imaging, and in the absence of a timely exercise tolerance test or a timely normal drug-induced stress test, an MC, preferably one experienced in the care of patients with cardiovascular disease, has concluded that performance of exercise tolerance testing would present a significant risk to the individual, with both 1 and 2:

1. Angiographic evidence showing:

• 50 percent or more narrowing of a non-bypassed left main coronary artery.
• 70 percent or more narrowing of another non-bypassed coronary artery.
• 50 percent or more narrowing involving a long (greater than 1 cm) segment of a non-bypassed coronary artery.
• 50 percent or more narrowing of at least two non-bypassed coronary arteries.
• 70 percent or more narrowing of a bypass graft vessel.

2. Resulting in very serious limitations in the ability to independently initiate, sustain, or complete activities of daily living.

These criteria are addressed in much more detail by the Social Security Administration (SSA). However, keep in mind that the heart disease symptoms which meet the criteria for receipt of benefits may develop as a result of the disease process and/or the medications prescribed and used, or the residual effects of surgical procedures used to treat the disease.

The medical evidence supporting one's argument that he or she may meet these criteria, and therefore qualify for disability benefits, is crucial to obtaining a favorable finding. Physicians are considered experts in their field of practice, and their diagnosis, treatment and prognosis concerning a person's condition are key to determining if someone who suffers with heart disease qualifies for Social Security Disability benefits.

Related Information

• Compassionate Allowances List for Social Security: Social Security Compassionate allowance benefits are fast-tracked for diseases and medical conditions that invariably qualify under the listing of impairments.
• How to Get and Not Lose SSDI: This article outlines how to get SSDI benefits and what can deprive you of the right to receive this money.
• SSDI Claims: Consultative Examinations: Consultative examinations are sometimes requested in an effort to obtain the opinions of outside medical professionals in order to evaluate disability claims.
• Factors For Winning SSDI Claims: Age, Employment, Education: SSDI Judges will consider information into their decision-making process, including your age, your work history background, and your level of education.
• Working After SSDI Approval - Disability Employment: This article reviews the basic social security rules concerning earnings after a finding of disability.
• SSI and SSDI Benefits for Children with Disability: Children who are diagnosed as disabled may be eligible for SSI or SSDI benefits.
• Social Security Video Hearings for Disability Cases: Video hearings may help with the backlog of SSA disability cases caused by increased demand inadequate funding and under-staffing.
• Importance of Medical Records in SSDI Claims: A critical factor involved in evaluating SSDI benefits is medical evidence presented on your behalf.

Author Credentials: Ian was born and grew up in Australia. Since then, he has traveled and lived in numerous locations and currently resides in Montreal, Canada. Ian is the founder, a writer, and editor in chief for Disabled World. Ian believes in the Social Model of Disability, a belief developed by disabled people in the 1970s. The social model changes the focus away from people's impairments and towards removing barriers that disabled people face daily. To learn more about Ian's background, expertise, and achievements, check out his bio.