Social Security Disability Benefits With Heart Disease

Coronary heart disease, also called coronary artery disease, is the No. 1 killer in America, affecting more than 13 million Americans.  Heart disease is a result of plaque buildup in your coronary arteries — a condition called atherosclerosis — that leads to blockages.

The most common symptom of heart disease is angina.  Angina is chest pain or discomfort that occurs if an area of your heart muscle doesn’t get enough oxygen-rich blood.  Angina may feel like pressure or squeezing in your chest. The pain also can occur in your shoulders, arms, neck, jaw, or back.  Angina pain may even feel like indigestion.

Other symptoms that can occur with coronary artery disease include:

  • Shortness of breath
  • Palpitations (irregular heart beats, skipped beats, or a “flip-flop” feeling in your chest)
  • A faster heartbeat
  • Weakness or dizziness
  • Nausea
  • Sweating

Common medical tests to prove your disability include stress tests, angiographies and an ECG test.  You must also show consistent treatment with your treating physicians.

To qualify for Social Security Disability benefits with heart disease, you must either meet or equal a Social Security “listing”, or if you do not meet or equal the listing, you must prove that you cannot return to your previous job and there are no other jobs you can perform based on your age, education and residual functional capacity.  The Social Security Listing for heart disease is found at 4.04 of the Blue Book listings.

4.04 Ischemic heart disease, with symptoms due to myocardial ischemia, as described in 4.00E3-4.00E7, while on a regimen of prescribed treatment (see 4.00B3 if there is no regimen of prescribed treatment), with one of the following:

A. Sign- or symptom-limited exercise tolerance test demonstrating at least one of the following manifestations at a workload equivalent to 5 METs or less:

1. Horizontal or downsloping depression, in the absence of digitalis glycoside treatment or hypokalemia, of the ST segment of at least -0.10 millivolts (-1.0 mm) in at least 3 consecutive complexes that are on a level baseline in any lead other than a VR, and depression of at least -0.10 millivolts lasting for at least 1 minute of recovery; or

2. At least 0.1 millivolt (1 mm) ST elevation above resting baseline in non-infarct leads during both exercise and 1 or more minutes of recovery; or

3. Decrease of 10 mm Hg or more in systolic pressure below the baseline blood pressure or the preceding systolic pressure measured during exercise (see 4.00E9e) due to left ventricular dysfunction, despite an increase in workload; or

4. Documented ischemia at an exercise level equivalent to 5 METs or less on appropriate medically acceptable imaging, such as radionuclide perfusion scans or stress echocardiography.

OR

B. Three separate ischemic episodes, each requiring revascularization or not amenable to revascularization (see 4.00E9f), within a consecutive 12‑month period (see 4.00A3e).

OR

C. 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:

a. 50 percent or more narrowing of a nonbypassed left main coronary artery; or

b. 70 percent or more narrowing of another nonbypassed coronary artery; or

c. 50 percent or more narrowing involving a long (greater than 1 cm) segment of a nonbypassed coronary artery; or

d. 50 percent or more narrowing of at least two nonbypassed coronary arteries; or

e. 70 percent or more narrowing of a bypass graft vessel; and

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

As every case is different, please call our office to discuss your situation whether you suffer from heart disease or any other condition that prevents you from working.