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SSD SSI Definitions
SSDRC authored by Tim Moore
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If you have had a heart attack will you qualify for Social Security disability?
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 individualís 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: Social Security Disability Resource Center, or read answers to Questions
Related Body System Impairments:
If you have had a heart attack will you qualify for Social Security disability?
Angina and Filing for Disability
Arrhythmia and Filing for Disability
Brain Aneurysm and Filing for Disability
Cardiomyopathy and Filing for Disability
Cardiovascular Heart Stenosis and Filing for Disability
Congenital Heart Defects and Filing for Disability
Congestive Heart Failure and Filing for Disability
DVT Deep Venous Thrombosis and Filing for Disability
Heart Attack and Filing for Disability
Heart Murmur and Filing for Disability
High Cholesterol and Filing for Disability
Lymphedema and Filing for Disability
Mitral Valve Prolapse and Filing for Disability
Peripheral Arterial Disease and Filing for Disability
Triple Bypass Surgery and Filing for Disability
Thrombosis and Filing for Disability
Tachycardia and Filing for Disability
Wolff-Parkinson-White and Filing for Disability
Congestive Heart Failure, Social Security Disability, and Applying for Benefits
Heart Attack, Social Security Disability, and Applying for Benefits
Contacting a Congressman to help a disability case
Information on the following topics can be found here: Social Security Disability Questions and in these subsections:
Frequently asked questions about getting Denied for Disability Benefits | FAQ on Disability Claim Representation | Info about Social Security Disability Approvals and Being Approved | FAQ on Social Security Disability SSI decisions | The SSD SSI Decision Process and what gets taken into consideration | Disability hearings before Judges | Medical exams for disability claims | Applying for Disability in various states | Selecting and hiring Disability Lawyers | Applying for Disability in North Carolina | Recent articles and answers to questions about SSD and SSI
These pages answer some of the most basic questions for individuals who are considering filing a claim.
Filing for disability - How to file for SSD or SSI and the Information that is needed by Social Security
How to Apply for Disability - What medical conditions can you apply and qualify for?
Applying for Disability - How long does it take to get Social Security Disability or SSI benefits?
What happens if I file a disability application and it is denied by a disability examiner or Judge?
How to Prove you are disabled and qualify to win disability benefits
How do you prove your disability case if you have a mental condition or impairment?
Social Security Disability Back pay and How Long it Takes to Qualify for it and receive it
Social Security Disability SSI - Eligibility Requirements and Qualifications Criteria