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If you have had a heart attack will you qualify for Social Security disability?How to prove you are disabled and win disability benefits There is no simple answer to this question, but a heart attack does not guarantee your entitlement to a Social Security disability or SSI benefit. This can be explained by the definition of disability, which states that an individual, to be considered disabled by the social security administration, must have been unable to perform work substantial and gainful work activity for twelve months, or must be expected (through a review of the existing medical records) to be unable to perform substantial and gainful work activity for twelve months due to a medically determinable impairment. If your heart attack has caused little or no damage to the heart, then it is very unlikely that you will qualify for Social Security disability. On the other hand, if your heart attack has left you with physical limitations then you may qualify for Social Security disability or SSI disability, since both disability programs are based on an individual’s level of functionality, which SSA refers to as their RFC, or residual functional capacity, level. However, those limitations must exist to the extent that you are no longer able to work at a job you have done in the past, and are no longer able to perform any other type of work, as determined by your age and work skills and rated limitations. Are many cases filed on the basis of an MI (myocardial infarction, the medical term for heart attack) approved? Yes, but a very high percentage of these cases are not. This is because, due to modern technology, heart attacks are increasingly non-fatal and are more likely to be events from which patients may make strong recoveries. This is not to say, certainly, that a case based on a heart condition cannot be won, but only that in the event that the claim is denied, the claimant will need to file a first and, probably, a second appeal. The first appeal is a request for reconsideration and the second appeal is a request for a hearing before a federal judge. At the hearing level where the case preparation is usually handled by a disability attorney or representative, the statistical odds of winning shift considerably in favor of the claimant. This is because the representative will have worked to obtain evidence showing that the claimant no longer possesses the functional capability to return to a former job, or adapt to some type of other work. Speaking as a former disability examiner for the social security administration's DDS, or disability determination services, I can point out the "road map" for cases involving heart attacks. The disability examiner, or the administrative law judge, if the case has gone to the hearing level, will first look to see if the claimant meets a listing in the blue book, which is the social security disability and SSI list of impairments. For a heart patient, this will be under the listing for Ischemic heart disease. Ischemia can be defined as a restriction in blood supply and so ischemic heart disease simply means heart disease that occurs because of insufficient oxygenated blood arriving to the heart via the arteries.Typically, of course, this is because of blockages or occlusions in the arteries. Therefore, for this reason, the decision-maker, an examiner or judge, will be looking for angiographic evidence showing fairly high levels of occlusions, or narrowing, in either non-bypassed arteries or in a bypass graft vessel. Accompanying these occlusion levels must be the fact that, as a result of the condition, the claimant has serious limitations in their ability to engage in, sustain, and complete normal activities of daily living (normals ADLs would include dressing, shopping, cleaning, meal preparation and so forth). Verifiable levels of occlusions are not the only indicators of ischemic heart disease, of course. Ischemic heart disease can be measured through heart stress testing that replicates an exercise level of 5 METs or less (a MET is a metabolic equivalent of task) and which is documented on imaging such as a stress echocardiogram. Most doctors will agree that a METS level of 6 or above is desirable while a METs rating of anything below 5 signals that the patient is severely impaired. However, occlusion levels tend to be one of the first things that disability examiners look for when a heart attack case is being checked to see if the Ischemic heart disease listing can be met. What happens if the listing cannot be met? The same thing that happens to most claims. The claimant's case is reviewed under the five step sequential evaluation process which looks to see if the claimant has strong enough residual functional limitations such that they cannot be expected to return to a former job (past work performed sometime in the last 15 years) or switch to some type of other work that might suit their education and training. 
Return to: SSDRC, or the Questions, Answers, Tips, and Advice page Individual Questions and Answers SSD and SSI are Federal Programs The title II Social Security Disability and title 16 SSI Disability programs operate under federal guidelines and, therefore, the program requirements--medical and non-medical--apply to all states: Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, Florida, Georgia, Hawaii, Idaho, Indiana, Illinois, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, Wyoming Recent approval and denial statistics for various states can be viewed here: Social Security Disability, SSI Approval and Denial Statistics by state Special Section: Disability Lawyers and unnecessary claim denials |