Blog Post

Applying for Disability with Heart Valve Disease


GUEST POST from Bryan Mac Murray, Outreach Specialist, Social Security Disability Help

A heart valve problem can be present from birth or develop later in life, and many people are unaware they have an issue until it causes serious complications. If your heart valve disease has stopped you from working or has significantly decreased your ability to earn a living, then you may qualify for disability benefits.

Once approved, Social Security Disability affords ongoing income that can replace your lost wages. Supplementary or auxiliary benefits may be available to your children and spouse as well. These benefits can keep you and your family afloat, covering every day expenditures, bills, and medical costs.

Medically Qualifying with a Valve Disorder

Heart valve problems can be caused by other medical issues, like infections and heart failure. A valve that doesn’t work properly can also contribute to other serious health complications, like cardiovascular disease, breathing issues, and circulatory problems. Although there is no heart valve disease disability listing among the Social Security Administration’s (SSA’s) recognized disabilities, you may qualify under one of these other listings instead:

  • Chronic Heart Failure (4.02)
  • Ischemic Heart Disease (4.04)
  • Recurrent Arrhythmias (4.05)
  • Congenital Heart Disease (4.06)

The symptoms and complications you experience determine the disability listing under which you may qualify. Each listing outlines specific records, tests, or other proof necessary for approval. Your cardiologist or primary care physician can help you understand the SSA’s medical requirements. Generally though, the following documentation must be found in your medical history for you to qualify for disability with a heart valve disorder:

  • A report from your doctor, summarizing the:
    • formal diagnosis, symptoms, treatments, and prognosis for your valve disease
    • progression of any symptoms or onset date of new symptoms and complications
    • affects of your symptoms on not just your heart function but on other organs and body systems
    • limitations your symptoms impose on your everyday, functional abilities
  • Diagnostic tests completed, including dates, times, locations, physicians who ordered them, and test results
  • Surgical procedure notes and post operative reports, if applicable

Qualifying for Disability without Meeting a Listing

If you don’t meet or closely match one of the SSA’s cardiovascular impairment listings, then you’ll go through an additional review to determine your eligibility for benefits. This review is an RFC, or “residual functional capacity” analysis.

During the RFC, the SSA looks at:

  • your mental and physical limitations,
  • your medical records,
  • and your age, employment history, education, and job training.

If all of these things combined show that you cannot perform essential job functions in any job for which you’re otherwise qualified, then you will be found eligible for disability benefits.

The RFC process lengthens the wait for benefits in many cases and requires you and your doctor to submit more details and records about your valve disease and everyday limitations. You’ll receive questionnaires in the mail and must complete and return these within just 10 days. Be sure to hit the deadline, or your application will be closed and you’ll be denied benefits.

Submitting an Application for a Heart Valve Disease

The disability application process may seem intimidating, but you don’t have to go it alone. Your doctor is an essential in applying, and you can get help from a friend, family member, or Social Security advocate or attorney. If you’re denied benefits, an attorney or advocate can help you file an appeal as well.

If applying for Social Security Disability Insurance (SSDI), you can complete your application online or at the local office. For Supplemental Security Income (SSI) benefits however, you must participate in a personal interview, which usually happens at the local SSA branch.