Qualifying for Disability Benefits with Heart Disease

I was born with a congenital heart defect—two in fact! I have Ebstein’s anomaly VSD. Ebstein’s anomaly is a deformation of my right ventricle, while a VSD is a hole in the wall of my heart’s two lower chambers. What does this mean for me? Fortunately, not much. I’ve had two surgeries so far to improve my health, and both have gone well. I’m not restricted from any physical activities, and I’m not even on any medication.

I’m very lucky. Not everyone with heart disease is so fortunate. I am able to walk to my office every day, but some people with heart disease are so ill, they’re completely unable to work at all. If this describes you or a loved one, there could be financial resources available for your family. The Social Security Administration (SSA) offers benefits for people with heart disease who are unable to work.

Types of Programs Available for People with Heart Disease:

There are two forms of Social Security disability benefits. Medically qualifying for both will be exactly the same with heart disease; however, each program does have its own technical qualifications.

The first type of disability benefits is Social Security Disability Insurance (SSDI). SSDI is only available for adults aged 18-66 who have worked throughout their lives and paid Social Security taxes. The SSA evaluates how much you’ve worked with an earned income called a “work credit.” While the amount of income you need to have contributed to taxes varies depending on your age, most SSDI applicants will qualify if they’ve worked at least part-time for any five of the past ten years.

The other form of disability benefits, Supplemental Security Income (SSI) is for people of all ages, but is only available to the most needy families. This means that if you or a spouse earns a living wage, you will not be able to qualify for SSI as an adult.

If your child has a heart problem and needs disability income, your household income will be evaluated. While childhood SSI income limits are not as strict as adult SSI limits, it may be hard for your son or daughter to qualify for SSI due to technical limitations. For example, a single parent with one child cannot be earning more than around $36,000 per year to qualify. If you have a spouse or other children, your SSI household income limit will be higher. You can determine whether or not your household income is too high for SSI by using a chart on the SSA’s website.

Medically Qualifying with Heart Disease:

If you want to qualify for disability benefits for heart disease, you will need to meet a listing in the SSA’s Blue Book. The Blue Book is a medical guide containing hundreds of disabilities and the exact symptoms or test results you’ll need to qualify.

Some qualifying conditions for adults include:

Conditions listed in the children’s version of the Blue Book include:

Each listing is complicated and requires various medical tests. For example, both heart failure listings require that your cardiologists test your tachycardia (rapid heart rate) at rest, and your ability to exercise. Other conditions, such as CHD, require cardiac imaging or catheterization that prove your oxygen levels are low due to your CHD. Because the entire Blue Book is available online, you can speak with your doctor about your heart disease’s listing and determine whether or not your medically qualify.

Some conditions are clearly disabling and will not require as much medical evidence to qualify. One such procedure is a heart transplant. If you or your child receives a heart transplant, you will automatically medically qualify for disability benefits for at least 12 months. After one year, the SSA will revaluate your claim and determine if you are ill enough to continue receiving benefits.

How to Apply for Disability Benefits:

There are two ways to apply for disability benefits: Either online, or at your nearest SSA office. If you’ve worked in the past and are applying for yourself, you can apply entirely online. If you are applying on behalf of your child, you will need to schedule an appointment at your nearest SSA office. You can do so by calling the SSA toll-free at 1-800-772-1213.

If your claim is initially rejected, do not give up! The vast majority of initial applications are denied, but there is a thorough appeals process available to you and your family. Nearly 50% of appealed claims are eventually approved.

This article was provided by Deanna Power, Director of Community Outreach at Social Security Disability Help. She specializes in helping potential applicants determine whether or not they medically qualify for benefits. If you need any help with your claim, or have any questions about the article, feel free to contact her at drp@ssd-help.org.


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