When an individual suffers from heart failure, it can be impossible to maintain a full time job. Working a job with heart failure can be dangerous, yet the lack of income caused by an inability to work can result in significant financial stress. While it may seem like a vicious cycle, the good news is that Social Security Disability benefits may be the solution to this problem. Social Security Disability benefits can provide an individual who is suffering from heart failure with a monthly income as well as medical insurance to cover medical expenses.
Qualifying for SSI and SSDI
The Social Security Administration (SSA) operates two disability programs including Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI). Each of these programs has its own criteria that an applicant must meet in order to qualify.
To qualify for SSDI benefits, an applicant must have earned enough work credits through prior work history. As of 2014, for every $1,200 earned, a worker earns one work credits and can earn a total of four work credits each year. The number of credits needed to qualify for SSDI benefits will vary depending on your age.
Unlike SSDI benefits, an applicant does not need any work history or work credits to qualify for SSI benefits. Instead, SSI is a needs-based program. Benefit eligibility is based on household income and assets. As of 2014, an individual cannot have a household income of more than $721 per month as an individual or $1,082 per month as a couple or household assets exceeding $2,000 as an individual or $3,000 for a couple in order to qualify for SSI benefits.
For both SSDI and SSI benefits, an individual must meet the medical criteria set forth by the SSA to qualify.
For more information on the disability programs visit: http://www.ssa.gov/disability/
Meeting the Medical Criteria for Social Security Disability with Heart Failure
When applying for Social Security Disability benefits, the SSA will compare your condition to a listing of conditions known as the Blue Book. Each condition that could potentially qualify an individual for disability benefits is listed in this Blue Book, along with the criteria that must be met to qualify with each specific condition.
Chronic heart failure is addressed in Section 4.02 of the Blue Book. According to the Blue Book, in order to qualify for Social Security Disability benefits due to heart failure, you must be able to prove that:
- You have been diagnosed with chronic heart failure while undergoing prescribed treatment; and
- There is medically documented evidence of systolic failure with left ventricular end diastolic dimensions greater than 6.0 cm or ejection fraction of 30 percent or less during a period of stability or diastolic failure 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; and
- Persistent symptoms of heart failure are present that seriously limit the ability to independently initiate, sustain, or complete activities of daily living or there are three or more separate documented episodes of acute congestive heart failure within a 12-month period or you suffer an inability to perform on an exercise tolerance test at a workload equivalent to 5METs or less.
For more information on qualifying for benefits with heart failure, visit: http://www.disability-benefits-help.org/disabling-conditions/heart-failure-and-social-security-disability
Applying for Disability Benefits
You can apply for Social Security Disability benefits online or in person at your local Social Security office. You will be asked to fill out a number of forms, which you should complete with as much detail as possible, and you may be asked to attend a consultative exam. After completing the disability application process, you will receive a decision from the SSA within two to four months. If you are approved for benefits, this notice will tell you when benefits will begin, which benefits you will be receiving, and how much you will be receiving each month. If you are denied benefits, you have 60 days from the date of denial to appeal the SSA's decision to deny benefits.
If you do need to pursue a Social Security Disability appeal, do not give up hope. A number of applicants who are denied during the initial stage of the application process go on to successfully receive benefits through the process of an appeal