You might think that Congestive Heart Failure (CHF) would automatically qualify for Social Security Disability (SSDI) benefits. That's not necessarily the case.
The Social Security Administration (SSA) has specific criteria to evaluate whether your CHF is a disabling medical condition or not. In order to prove you meet the criteria your medical records must show that you suffer from severe, continuing heart failure even after treatment.
If you look up CHF on the Social Security website, you will probably see criteria for meeting a "Blue Book Listing." If you meet the Listing requirements you will qualify for benefits. However, a lot of claimants who don't meet the Listing criteria may still qualify for disability benefits.
Social Security will consider your heart function and severity of symptoms. Heart function is usually based on echocardiogram tests which measure the Left Ventricle Ejection Fraction (LFEF). This measures how much blood your heart is pumping.
If your reduced heart function results in such symptoms as severe shortness of breath, extreme fatigue or other symptoms which prohibit your ability to perform full-time work, you may qualify for benefits.
It's best if your CHF is treated by a cardiologist, a specialist in heart disease. Medical testing will be needed to determine the severity of heart function, as well as the severity of symptoms--or how the disease restricts your ability to perform activities of daily living (sitting, standing, walking, lifting, bending, etc.). It is very helpful if your treating cardiologist will provide Social Security with a "Residual Functional Capacity" (RFC) form which details your restrictions in specific activities. The claimant will need to provide this form to the cardiologist and ask him/her to complete it. Doctors usually don't have this form, so you must get it and provide it to the doctor. You may get the RFC form from most disability attorneys/advocates. The Forsythe Firm, my firm, will provide this form free to anyone who asks for it.
Keep in mind that the Social Security disability system is far from perfect. It denies many claimants who really ARE qualified for benefits. It is often necessary to appeal a denial and have a decision maker higher up the chain of command review the claim. This is called the "appeals process." Often, it's necessary to have a federal Administrative Law Judge (ALJ) hold a hearing before benefits are paid.
Your chances of getting approved earlier are better if you use an attorney/advocate who knows about Congestive Heart Failure and Social Security's regulations and rules.
A study by the GAO - the Government Accountability Office - finds that only 31 percent of claimants get approved without a lawyer. But twice that many (60 percent) who use a lawyer/advocate get approved.
If you have CHF you may not be able to wait 2 to 3 years for the Social Security system to grind through the process. Using a qualified advocate or attorney may help you get an earlier approval (and pay) because these professionals know what evidence is required and how the SSDI system works.
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The Forsythe Firm in Huntsville has assisted claimants in 10 states to get disability benefits. Our advocates know what is required to get you approved. Call us for a FREE consultation and case evaluation. We will only charge a fee if you win your case and also receive backpay benefits or "past due benefits." Otherwise, our work is free. Call us today at (256) 799-0297.
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