Qualifying for Social Security Disability Benefits as an Adult with CHD
Tens of thousands of adults are thriving with congenital heart defects. While many are able to live full lives, it’s possible that at some point your heart function will decrease and you’re unable to maintain employment. If you’re no longer able to work due to your heart condition, you may be eligible for Social Security disability benefits. The Social Security Administration (SSA) offers monthly resources for people who cannot work. While a CHD does not automatically qualify, thousands of adults may be eligible.
Medical Eligibility for Social Security
The SSA uses its own medical guide, known colloquially as the Blue Book, when determining whether an applicant will be eligible for disability benefits. The Blue Book lists exactly what medical results or symptoms you’ll need to be approved for Social Security with your CHD. There are many cardiovascular disorders under which someone with a CHD could be eligible. Here are a couple of examples:
Chronic heart failure: this will qualify if you have systolic heart failure with diastolic dimensions greater than 6.0 cm or ejection fraction of 30% or less. You can also qualify with diastolic failure with left ventricular posterior wall plus septal thickness totaling 2.5 cm or greater, OR an enlarged left atrium greater or equal to 4.5 cm.
Arrhythmias: these will qualify if they’re uncontrolled with medication and you have episodes that cause you to faint or nearly faint.
Symptomatic congenital heart disease: there are three ways to qualify under this listing. If you have cyanosis (blue discoloration of skin) at rest, plus hematocrit of 55% or greater OR arterial O2 saturation of less than 90% in typical room air.
You can also qualify if you have “intermittent right-to-left shunting resulting in cyanosis, plus an arterial PO2 of 60 Torr or less.
Finally, someone with symptomatic congenital heart disease will qualify if they have secondary pulmonary vascular obstructive disease with pulmonary arterial systolic pressure elevated to at least 70% of the systemic arterial systolic pressure.
The entire Blue Book is available online, but (as you can see) the listings were written for medical professionals and can be very challenging to read for typical CHD patients. If you’re not sure if you’re eligible for benefits, you should review the Blue Book with your cardiologist to get an idea as to whether you’ll qualify.
Starting Your Application
The easiest way to apply for Social Security benefits is online on the SSA’s website. If you’d like the help from a Social Security representative, you can always apply in person at your local SSA office. Call the SSA toll free at 1-800-772-1213 to schedule an appointment to apply online today.
It should take five months or so to hear back from the SSA regarding your claim. Once approved, you can spend your monthly benefits on your upcoming medical care, childcare, home modifications, rent or a mortgage, groceries, or any other daily living needs.
You can apply for Social Security online at www.ssa.gov.
For more on when and how to apply, more helpful links include:
https://www.ssa.gov/disability/professionals/bluebook/4.00-Cardiovascular-Adult.htm (Blue Book)
https://www.disability-benefits-help.org/social-security-disability-locations (SSA offices nationwide)
Deanna Power is the Director of Outreach at Disability Benefits Help, an independent organization dedicated to helping people of all ages receive Social Security disability benefits. She’s currently thriving with Ebstein’s Anomaly w/VSD and is forever grateful for the Adult Congenital Heart Program at Boston Children’s Hospital. If you have any questions on how you or your child could be eligible for Social Security disability benefits, she can be reached at firstname.lastname@example.org