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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 eligibility for Social Security Disability or SSI. 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 Social Security Disability 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 past 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.








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These pages answer some of the most basic questions for individuals who are considering filing a claim.

Can you get temporary Social Security Disability or SSI benefits?

Permanent Social Security Disability

What is the difference between Social Security Disability and SSI?

Who is eligible for SSI disability?

Can I Be Eligible For SSI And Social Security Disability At The Same Time?

What makes a person eligible to receive disability benefits?

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?









For the sake of clarity, SSDRC.com is not the Social Security Administration, nor is it associated or affiliated with SSA. This site is a personal, private website that is published, edited, and maintained by former caseworker and former disability claims examiner, Tim Moore, who was interviewed by the New York Times on the topic of Social Security Disability and SSI benefits in an article entitled "The Disability Mess" and also by the Los Angeles Times on the subject of political attempts to weaken the Social Security Disability system.

The goal of the site is to provide information about how Social Security Disability and SSI work, the idea being that qualified information may help claimants pursue their claims and appeals, potentially avoiding time-consuming mistakes. If you find the information on this site helpful and believe it would be helpful to others, feel free to share links to its homepage or other pages on website resource pages, blogs, or social media. Copying of this material, however, is prohibited.

To learn more about the author, please visit the SSDRC.com homepage and view the "about this site" link near the bottom of the page.