Can I Get Disability for Heart Problems or Cardiovascular Disease?

Various types of heart disease and cardiovascular problems qualify for disability through the Social Security Administration (SSA). For most common heart problems, the SSA doesn't evaluate disability according to the underlying heart problem like:

• cardiomyopathy
• arteriosclerosis
• cardiac arrest
• myocardial infarction (heart attack), or
• pericarditis.

Rather, the SSA focuses on whether your ability to work is limited by your heart's reduced capacity to pump blood or by your heart muscle's not getting enough blood.

How Does Social Security Decide If I'm Disabled?

The SSA will look at various tests to see if your heart condition meets the requirements of an SSA impairment listing (the SSA's Blue Book), including:

• exercise tests
• EKGs, and
• cardiac imaging.

If your heart condition doesn't meet the requirements for an automatic disability determination, the SSA will look at the "exertional restrictions" your doctor has put on you (such as no heavy lifting) to see if there are any jobs you can do (more on this below).

Which Disability Listing Will Social Security Use for My Heart Problem?

You can qualify for disability by meeting Social Security's impairment listings for any of the following:

• chronic heart failure (congestive heart failure): the heart's pumping action is compromised
• ischemic heart disease (coronary artery disease): reduced blood flow to the heart muscle
• recurrent arrhythmias: abnormal heart rhythm causing "syncope" (loss of consciousness)
• symptomatic congenital heart disease: structural defects leading to malfunction, causing "cyanosis" (bluish skin from oxygen deprivation)
• aneurysm of the aorta or major heart branches: swelling due to weakness in the blood vessel wall
• chronic venous insufficiency: leg veins can't pump enough oxygen-poor blood back to the heart
• peripheral arterial disease (PAD): narrowed arteries can't carry enough blood to your limbs, or
• heart transplant (to remedy end-stage heart failure or severe coronary heart disease).

Unless you're a doctor, it can be difficult to determine which SSA impairment listing your heart condition falls under. For example, coronary artery disease is usually evaluated under the listing for ischemic heart disease, though it can also cause congestive heart failure (CHF).

When your heart can't pump blood properly, the cause can determine which listing the SSA will use. For example, "dilated cardiomyopathy" (caused by an enlarged, weakened left ventricle) can lead to congestive heart failure, but "ischemic cardiomyopathy" (not enough blood getting to the heart muscle) leads to ischemic heart disease. And arrhythmias are most often caused by ischemic heart disease but have a separate listing.

Most people who apply for disability for heart conditions generally fall into one of two categories:

• ischemic heart disease or
• chronic heart failure.

Most patients who've had a heart attack or have heart disease are evaluated under ischemic heart disease because their doctor has diagnosed them with coronary artery disease. But if you have chronic or congestive heart failure, which means your heart isn't pumping out enough blood, whether it's from high blood pressure, atherosclerosis, cardiomyopathy, or congenital heart disease, Social Security would use the chronic heart failure listing.

The SSA used to have an impairment listing for high blood pressure, but not anymore. Now, if you have severe hypertension, you simply are evaluated under the condition your hypertension has caused, such as congestive heart failure, coronary artery disease, stroke, or kidney damage.

What Evidence Do I Need for My Heart Condition?

Test results are very important to the SSA's determination. For instance, an EKG can indicate several heart conditions, including the following:

• Your heart muscle isn't getting as much oxygen as it needs (ischemia).
• Your heartbeat or heart rhythm is abnormal (arrhythmia).
• There are other abnormalities of your heart, such as left ventricular enlargement (which can be a sign of heart failure).

Results of an exercise tolerance test (ETT), also called a stress test, are also important because they tell the SSA how much physical activity you can do before having heart symptoms like shortness of breath, angina (chest pain), or exhaustion.

Can I Qualify for Disability Because of My Limitations?

Many adults have serious heart conditions that make it difficult for them to work, but they don't meet the strict requirements of the SSA's impairment listings. For instance, maybe you have coronary artery disease and had one ischemic episode in the past year but not three. Or perhaps you have systolic heart failure, but your ejection fraction is 40%, not 30%, and the results of your exercise test are poor but not as bad as the SSA requires.

You still might be eligible for disability benefits (unless your heart medication or other treatment returned you to full functional capacity). When you don't automatically qualify for disability benefits under the SSA's official listings, the SSA is required to consider the effect of your heart condition on your capacity to perform routine daily activities and work. The SSA will then determine whether there's any kind of job you can safely be expected to do.

What Is Your Residual Functional Capacity (RFC)?

If you've had an episode of heart failure or ischemia, or you have shortness of breath, exhaustion, or angina (chest pain) when you do physical work, the SSA should rate the type of work the agency thinks you can do. That rating is called your "residual functional capacity (RFC)." To determine your RFC, the SSA will consider:

• your lab tests
• your exercise tests
• your imaging tests
• your doctor's notes on your functional limitations and restrictions, and
• your reports of angina and other symptoms.

An RFC will rate your ability to do sedentary work, light work, or medium work. For instance, if your doctor has limited you to standing and walking no more than four hours a day, your RFC will be for sedentary work. If your doctor has limited you to lifting no more than 20 pounds but okays standing or walking for six to eight hours per day, your RFC will be for light work.

If a CT scan shows you have an enlarged heart due to congestive heart failure, despite several months of treatment, you should get an RFC for light work. Depending on your symptoms, your RFC should be for medium work or lower if:

• you've had a heart attack
• you have a partial blockage in a coronary artery, or
• you've had coronary bypass surgery or angioplasty (balloon or stent).

The SSA needs to know how much physical exertion you can do before developing symptoms. Exercise tests are essential in this regard. For instance, if you have an exercise stress test that's close to what the impairment listings require for heart failure or coronary artery disease, you'll probably get a light RFC.

What Jobs Can You Do With Your RFC?

Next, the SSA will determine if you can do your prior job given the limitations of your RFC. If you can't, the agency will look at your education level, age, and experience to determine if there's any other kind of work you can safely be expected to do.

If you were given a sedentary RFC, for instance, the SSA would see if there are any desk jobs you can do. If you can read and write, the SSA is likely to find that there are desk jobs you could do and won't find you disabled. But if you're over 50 or 55 with little formal education and skills, your chances of getting disability benefits through what's called a "medical-vocational allowance" are much greater.

Applying for Disability Benefits for Heart Conditions

To apply for disability, you can call the SSA at 800-772-1213 to set up an appointment to apply for SSDI benefits at your local SSA office. You can also apply online at ssa.gov.

Detail Your Heart Condition on Your Disability Application

In your application, include how your heart condition affects your ability to exercise, work, and take care of your daily needs. Include details such as needing to use the bathroom more than once per hour because of congestive heart failure or medication side effects or needing to sleep on pillows because of lung congestion.

Include All Other Physical Problems on Your SSDI Application

If you have other physical problems as well, include them on your application. For instance, diabetes, obesity, and high blood pressure are common in people with heart failure or heart disease. In addition, it's not uncommon for people who've had a heart attack to develop anxiety disorders. If you have panic attacks, you should see a psychologist or psychiatrist and include details about your anxiety on your application.

Get Your Doctor's Help With Your SSDI Application

You'll need your doctor to document your medical condition and how it limits your ability to work. Your doctor's statement should include how long you can stand, walk, and sit in an eight-hour workday and any other limitations you have. The SSA will give serious consideration to your doctor's opinion, so it's often extremely helpful to ask your doctor to submit a statement.

For more information on providing good evidence, read about the medical evidence you need to prove disability. If you're not sure how to present your case or need help putting together a strong disability case, consider working with a disability lawyer.

_{Updated June 9, 2022}