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Facts about Cardiomyopathy and Filing for Disability

How to prove you are disabled
and win disability benefits

1. Cardiomyopathy is a disease affecting the heart muscle, with several causes and subtypes.

2. Cardiomyopathy can come from a condition outside of the heart muscle (extrinsic) or from actual heart muscle weakening (intrinsic).

3. Examples of extrinsic cardiomyopathy include congenital heart disease, nutritional disease, ischemia, substance abuse, pregnancy and diabetic cardiomyopathy.

4. Intrinsic cardiomyopathy is a weakened heart without an obvious condition that leads to cardiomyopathy. Conditions like coronary artery disease must be ruled out before the cardiomyopathy can be considered intrinsic. Intrinsic cardiomyopathy may come from infections or genetics.

5. There are four main types of intrinsic cardiomyopathy: the mostcommon is dilated (DCM), hypertrophic (HCM), arrhythmogenic right ventricular (ARVC), and finally there is restrictive (RCM), which is the least common. DCM is inherited and occurs when the heart becomes enlarged and decreases blood pumping. HCM is characterized by thickening of the heart which restricts blood flow and proper function in the heart. It is a genetic condition. ARVC occurs when the electrical impulses of the heart do not function properly and muscle becomes replaced by scar tissue. RCM is when the ventricle walls stiffen and do not allow the heart to fill with blood.

6. Symptoms may not appear in the early stages of cardiomyopathy. As the condition progresses symptoms may include difficulty breathing, swelling below the heart including fluid in the abdomen and swollen legs and feet, irregular heartbeat, as well as dizziness and fainting.

7. Prescription drug treatment aims to manage symptoms and limit the condition from progressing, to help avoid complications including heart failure, cardiac arrest, blood clots and heart murmur. Cardiomyopathy can be life threatening if the heart stops beating or pumping blood.

8. Other treatment includes implanting devices to keep the heart pumping blood regularly. In severe cases of cardiomyopathy, heart transplants may be necessary.

Can you qualify for disability benefits with this condition?

Whether or not you qualify for disability and, as a result, are approved for disability benefits will depend entirely on the information obtained from your medical records. This includes whatever statements may have been obtained from your treating physician (a doctor who has a history of treating your condition and is, therefore, qualified to comment as to your condition and prognosis).

It will also depend on the information obtained from your vocational, or work, history if you are an adult, or academic records if you are a minor-age child. The important thing to keep in mind is that the social security administration does not award benefits based on simply having a condition, but, instead, will base an approval or denial on the extent to which a condition causes functional limitations. Functional limitations can be great enough to make work activity not possible (or, for a child, make it impossible to engage in age-appropriate activities).

Why are so many disability cases lost at the disability application and reconsideration appeal levels?

Speaking as a former Disability Claims Examiner, I can state that there are several reasons:

1) Social Security makes no attempt to obtain a statement from a claimant's treating physician. By contrast, at the hearing level, a claimant and his or her disability attorney will generally obtain and present this type of statement to a judge;

2) Prior to the hearing level, a claimant will not have the opportunity to explain how their condition limits them, nor will their attorney or representative have the opportunity to make a presentation based on the evidence of the case. At the hearing level, of course, this is exactly what happens. And a number of disability representatives will also take such steps even earlier, at the reconsideration appeal level;

3) Disability judges, unlike disability examiners who decides cases at the first two levels of the system, can make independent decisions without being overturned by immediate supervisors--which happens frequently.

Return to:  Social Security Disability Resource Center, or read answers to Questions

Information on the following topics can be found here: Social Security Disability Questions

Social Security Disability SSI decisions | The Disability Decision Process and What gets taken into Consideration | Getting Denied for Disability Benefits | Questions about Social Security Disability Approvals and Being Approved | Social Security Disability Hearings | Social Security Medical Examinations | Social Security SSI Doctors | Social Security Disability Representation | Social Security Disability SSI Reviews