Heart disease can be a very serious condition with deadly consequences if not taken care of properly. There are many forms of heart disease that can affect an individual's well being. One of these is symptomatic congenital heart disease. Individuals who suffer from this condition often experience a significant impact on their quality of life and their ability to perform normal day-to-day tasks. There is no question that full-time work activity can be completely out of the question in such cases. For these individuals, the inability to work can create significant financial stress. Fortunately, in cases such as this, Social Security Disability benefits such as Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) may be able to help.
Symptomatic Congenital Heart Disease - Condition and Symptoms
Individuals who have congenital heart disease suffer from a problem with the structure and function of the heart. Those who have the condition are born with it, and the problem developed before the individual was born as the heart was forming while the person was growing in the womb as a fetus. Not all cases of congenital heart disease are the same. Some cases can be treated with medication and/or surgery. Other, however, are more severe and prevent a person's daily functioning.
The cases of congenital heart disease are generally divided into two different categories including cyanotic and non-cyanotic. Cyanotic cases cause a blue discoloration that is the result of a lack of oxygen. Non-cyanotic cases usually involve an aortic pulmonic stenosis or atrial septal defect. Whether cyanotic or non-cyanotic, the individuals who suffer from symptomatic congenital heart disease may qualify for Social Security Disability benefits if they can prove that the condition is so severe that it prevents them from performing any type of work activity.
Filing for Social Security Disability with Symptomatic Congenital Heart Disease
The Social Security Administration (SSA) does recognize symptomatic congenital heart disease as a qualifying disability, but a diagnosis of the condition itself is not enough to qualify you for Social Security Disability benefits. When applying for Social Security Disability benefits due to symptomatic congenital heart disease, you will need to prove that your condition interferes with your ability to perform day-to-day activities and prevents you from maintaining any form of full-time work activity.
Symptomatic congenital heart disease is covered under Section 4.06 of the SSA's disability guidelines. In order to qualify for Social Security Disability benefits under these guidelines, your condition must be documented with medical imaging or cardiac catheterization. You must also have medical documentation proving that you experience cyanosis while at rest and a hematocrit of 55 percent or higher or an arterial 02 saturation of less than 90 percent in room air. You may also qualify for benefits if you experience intermittent right-to-left shunting which results in cyanosis on exertion.
In addition to medical evidence documenting that your condition meets the SSA's published criteria, you will also want to provide a complete copy of your medical records including treatment histories and written statements from your treating physicians. The answers that you provide on the disability application forms will also play a role in the outcome of your disability application.
If your specific case of symptomatic congenital heart disease does not meet the criteria set forth in Section 4.06 of the SSA's disability guidelines, you may still be able to qualify for Social Security Disability benefits but you will have to prove that the condition prevents you from performing any type of substantial gainful activity. In most cases, this will mean the need for a disability appeal.
Symptomatic Congenital Heart Disease and Your Social Security Disability Case
If your case of symptomatic congenital heart disease meets the guidelines that are published by the SSA, you may be approved for Social Security Disability benefits during the initial stage of the application process. If, however, you do not meet the SSA's specific guidelines but are still unable to work due to your condition, you will need to provide sufficient evidence of this fact during the initial application stage or you will need to pursue the disability appeal process. Pursuing a disability appeal in order to obtain your benefits will likely involve a disability hearing before an administrative law judge.
If you do need to pursue a claim for disability benefits, it is in your best interests to retain the services of a qualified Social Security Disability lawyer. These professionals will understand how the laws pertain to your specific disability case and will work with you to gain the evidence that you need in order to prove your case to the SSA. Statistics show that your chances of getting your disability claim approved are much higher with proper representation.
