A heart attack can keep you out of work indefinitely. When this happens, you will likely be facing high medical bills and no way to pay them or support your family. Fortunately, you might be able to qualify for Social Security disability (SSD) benefits if you meet certain criteria. For more information on qualifying for Social Security disability for a heart attack in Pittsburgh, call a disability lawyer from Berger and Green today: 412-661-1400.
Am I eligible for SSD?
For the Social Security Administration (SSA) to consider you for disability benefits, you must meet some basic criteria:
To be eligible for SSDI, you must have earned enough work credits over time by contributing to the Social Security system. Your age and the number of years worked will determine how many credits you need to be eligible. Your earnings will determine how many work credits you have.
Does a heart attack qualify me for SSD benefits?
A heart attack by itself may not get you SSD benefits. This is because many people who suffer a heart attack are able to go back to work less than 12 months after the incident. To qualify, a claimant must have a condition that has lasted — or is expected to last — 12 months, or result in death
However, there are many heart disease-related conditions and complications resulting from heart attacks that could qualify you for benefits. The SSA lists some of these heart conditions in Section 4.00 of the Blue Book. These conditions include:
Ischemic heart disease: To qualify under this listing, your medical records will need to indicate “Sign- or symptom-limited exercise tolerance test demonstrating at least one of the following manifestations at a workload equivalent to 5 METs or less:
- A: 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
- 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
- Decrease of 10 mm Hg or more in systolic pressure below the baseline blood pressure or the preceding systolic pressure measured during exercise due to left ventricular dysfunction, despite an increase in workload; or
- 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, within a consecutive 12-month period OR
- Coronary artery disease”
Chronic heart failure: You must prove that, despite treatment, you have a:
- Medically documented presence of systolic failure or diastolic failure; AND
- “Persistent symptoms of heart failure which very seriously limit the ability to independently initiate, sustain, or complete activities of daily living in an individual for whom an MD, preferably one experienced in the care of patients with cardiovascular disease, has concluded that the performance of an exercise test would present a significant risk to the individual; or
- Three or more separate episodes of acute congestive heart failure within a consecutive 12-month period, with evidence of fluid retention, requiring acute extended physician intervention such as hospitalization or emergency room treatment for 12 hours or more, separated by periods of stabilization; or
- Inability to perform on an exercise tolerance test at a workload equivalent to 5 METs or less due to dyspnea, fatigue, palpitations, or chest discomfort; or three or more consecutive premature ventricular contractions, or increasing frequency of ventricular ectopy with at least 6 premature ventricular contractions per minute; or decrease of 10 mm Hg or more in systolic pressure…due to left ventricular dysfunction, despite an increase in workload; or signs attributable to inadequate cerebral perfusion, such as ataxic gait or mental confusion.”
Heart transplant: If you have had a heart transplant, you will qualify for benefits for at least one year after transplantation.
What happens if my condition is not in the Blue Book?
If your condition is not in the SSA’s Blue Book, it will look at a different set of criteria to determine whether you have a disability. These criteria include:
- Current employment status: If you are earning less than $1,170 per month, you may qualify for disability benefits.
- Ability to do previous job: You may qualify for benefits if you are unable to do the last job you had because of your heart condition.
- Ability to do another job: If you are not able to do your old job, the SSA will consider your experience, age, health and other factors to determine if you can do any other kind of job. If you cannot, you may receive benefits. To determine your ability to work, the SSA will ask you to submit to a residual functional capacity (RFC) assessment.
- Severity of the condition: You must be able to prove that your condition is so severe that it keeps you engaging in substantial gainful activity.
- How long the condition has lasted: The condition must have lasted 12 months, be expected to last a minimum of 12 months, or result in death.
To better understand what listing your condition fits under, you should work with your physician when applying for benefits.
What documentation should I submit with my application?
Whether you are applying for disability benefits under SSDI or SSI, you will need to provide the SSA with some documentation of your medical condition. The documentation should always include:
- Information detailing your medical history and contact information for all your physicians
- Financial records to establish your income and assets
- Personal information regarding your work history, skills, and education
Based on information that you provide about your treatment history, SSA will order:
- Doctor’s report of treatment, symptoms, medications, and other details regarding your condition
- Diagnostic and cardiovascular test results (e.g., EMGs, stress tests)
- Reports detailing surgeries
- Scans including MRIs, x-rays, etc.
If you have experienced a heart attack, you may be unable to work for months or even years, making it nearly impossible to pay your mounting medical bills or support your family.
That is why filing a successful application for SSD benefits is so important. However, denials are very common, which can make a claimant feel as though s/he has run out of options.
Fortunately, the SSA provides an appeals process through which you can obtain benefits.
With so much at stake, you should consult with an attorney who knows the ins and outs of the SSD application process.
The team at Berger and Green has decades of experience helping claimants determine eligibility, gather evidence, and navigate the appeals process. Call us today to see how we can help you recover the benefits you deserve: 412-661-1400.