The area of heart related diseases is one of the most difficult to interpret.
The testing performed generates complicated results and your selection
of an attorney that is familiar with cardiac terminology is critical to
your case. Social Security has set forth a list of cardiac conditions
which should automatically qualify you for disability benefits. These
are known as "listing level" conditions. They are conditions
which are so severe they are considered to preclude substantial employment.
The following is just an example of one of the many cardiac listings.
Bear in mind that most people with severe heart disease also have co-morbid
conditions, like obesity or lung disorders, which must also be considered
when determining work limitations.
Again, the following is simply one stand alone example of a condition that
is considered disabling. It is reproduced in simple form from Social Security's
medical listings to give you an idea of how complicated the cardiac listings
are and why you need an attorney with a lot of Social Security experience.
Social Security Listing 4.02 Chronic heart failure - while on a regimen of prescribed treatment, with symptoms and signs de
scribed in 4.00D2. The required level of severity for this impairment
is met when the requirements in both A and B are satisfied.
A. Medically documented presence of one of the following:
1. Systolic failure (see 4.00D1a(i)), with left ventricular end diastolic
dimensions greater than 6.0 cm or ejection fraction of 30 percent or less
during a period of stability (not during an episode of acute heart failure); or
2. Diastolic failure (see 4.00D1a(ii)), with left ventricular posterior
wall plus septal thickness totaling 2.5 cm or greater on imaging, with
an enlarged left atrium greater than or equal to 4.5 cm, with normal or
elevated ejection fraction during a period of stability (not during an
episode of acute heart failure);
B. Resulting in one of the following:
1. Persistent symptoms of heart failure which very seriously limit the
ability to independently initiate, sustain, or complete activities of
daily living in an individual for whom an MC, preferably one experienced
in the care of patients with cardiovascular disease, has concluded that
the performance of an exercise test would present a significant risk to
the individual; or
2. Three or more separate episodes of acute congestive heart failure within
a consecutive 12-month period (see 4.00A3e), with evidence of fluid retention
(see 4.00D2b (ii)) from clinical and imaging assessments at the time of
the episodes, requiring acute extended physician intervention such as
hospitalization or emergency room treatment for 12 hours or more, separated
by periods of stabilization (see 4.00D4c); or
3. Inability to perform on an exercise tolerance test at a workload equivalent
to 5 METs or less due to:
a. Dyspnea, fatigue, palpitations, or chest discomfort; or
b. Three or more consecutive premature ventricular contractions (ventricular
tachycardia), or increasing frequency of ventricular ectopy with at least
6 premature ventricular contractions per minute; or
c. Decrease of 10 mm Hg or more in systolic pressure below the baseline
systolic blood pressure or the preceding systolic pressure measured during
exercise (see 4.00D4d) due to left ventricular dysfunction, despite an
increase in workload; or
d. Signs attributable to inadequate cerebral perfusion, such as ataxic
gait or mental confusion.
There are many more listing level conditions in the cardiac section, dealing
with ischemic heart disease, coronary artery disease (blockage of the
arteries), recurrent arrhythmias, symptomatic congenital heart disease,
aneurysm of the aorta or other major branches, chronic venous insufficiency,
peripheral arterial disease and the effects of heart transplant.
Each listing carries with it a summary of the test results which support
listing level severity and in some cases, the expected symptoms resulting
from the condition.
When applying for Social Security disability, you will list all your treating
physicians. The Administration will obtain records from your heart specialist
and interpret the results. In complicated matters, Social Security may
have you examined by a doctor of their choosing, or have your records
reviewed by a medical doctor. Even if your condition does not specifically
match a listed condition, you may still be approved if your condition
is substantially equivalent to a listed condition. The trick is to pick
out the testing detail that supports your claim.
Sometimes Social Security finds it, sometimes they don't. We have encountered
many cases where we argued listing level conditions existed. In such cases,
we select the records that support listing level severity and ask your
treating cardiologist to confirm our findings. It can be a complicated
process as you can glean from the listing above.
Contact Us For Representation
If you have questions related to your cardiac condition, call one of the
attorneys at Harris & Riviere. We have over 25 years experience handling
cardiac cases. Give us a call at the Tampa office (813) 229-2667, fill out a
case evaluation form, or