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Chronic Heart Failure

How Do I Get Social Security Disability Benefits for Chronic Heart Failure?Chronic Heart Failure and Disability

Cardiovascular disease includes disease of the coronary arteries, heart muscle, nerves of the heart, the heart valves, or congenital heart disease. The Social Security Administration uses the documentation you provide that includes physical signs, symptoms, and lab tests to make their determination for benefits. For those suffering from chronic heart failure, the Social Security Administration requires these medical records to be over a period of at least three months. In some cases, the Social Security Administration will need six months of documentation to make an accurate decision. If you are disabled because of your chronic heart failure, contact the experienced Orange County disability benefit attorneys at Howard Law, PC today.

The most common causes of Chronic Heart Failure that the Social Security Administration sees are coronary artery disease and alcoholic cardiomyopathy. Most cases of Chronic Heart Failure can be improved with medical treatment, but the underlying disease may still be present.

To qualify for Social Security Disability benefits due to Chronic Heart Failure you must currently suffer from chronic heart failure with medically documented presence of one of the following;

(1) 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

(2) 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.

Additionally, either 1 or 2 above must result 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 a medical consultant 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, with evidence of fluid retention 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, or

(3) inability to perform on an exercise tolerance test at a workload equivalent to 5 MET's or less due to,

(a) dyspnea, fatigue, palpitations, or chest discomfort; or

(b) three or more consecutive premature ventricular contractions, 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 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.

If you suffer from Cardiovascular Disease, cannot work, and have been denied Social Security Disability benefits, call the experienced Anaheim Social Security Disability Attorneys at Howard Law and let us fight to get you the benefits you deserve.

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Listing vs. Residual Functional Capacity (RFC): How Does the Social Security Administration Determine Whether I Qualify for Disability Benefits for Chronic Heart Failure?

Social Security disability benefits may be available for people who suffer from chronic heart failure. The Social Security Administration must first determine whether your chronic heart failure is severe enough to meet or equal a listing at Step 3 of the Sequential Evaluation Process. The Social Security Administration will conclude that you are disabled and eligible for disability benefits if it determines that you meet or equal a listing because of your chronic heart failure.

If the Social Security Administration decides that your chronic heart failure is not severe enough to equal or meet a listing, it must assess the work that you are still capable of doing, in spite of your illness or disease. The work that you are able to do in spite of your illness or disease is called residual functional capacity (RFC). You may qualify for benefits at Step 4 and Step 5 of the Sequential Evaluation Process if you are able to do in spite of your illness or disease.

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How Can I Meet a Listing and Win Social Security Disability Benefits for Chronic Heart Failure?

The Social Security Administration will determine whether you are disabled at Step 3 of the Sequential Evaluation Process by evaluating whether your chronic heart failure is severe enough to equal a listing.

The term "listing" refers to a compiled list of common impairments. The Social Security Administration created a set of guidelines called the Listing of Impairments that contains the most common impairments. For each listing of a particular impairment, there is an explanation regarding the degree of severity that the Social Security Administration presumes would prevent a person from performing substantial work.

The Social Security Administration will consider you disabled if your chronic heart failure is severe enough to meet or equal a listing.

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What is Your Residual Functional Capacity Assessment for Chronic Heart Failure?

If the Social Security Administration decides that your chronic heart failure is not severe enough to equal or meet a listing, it must assess the work that you are still capable of doing, in spite of your illness or disease. The work that you are able to do in spite of your illness or disease is called residual functional capacity (RFC). You may qualify for benefits at Step 4 and Step 5 of the Sequential Evaluation Process if you are able to do in spite of your illness or disease.

The Social Security Administration expresses an RFC for physical impairments in terms of whether the Social Security Administration believes you are able to do heavy, medium, light, or sedentary work in spite of your impairments. The lower your RFC, the less the Social Security Administration believes you can do.

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Can Your Doctor's Medical Opinion Help You Qualify for Social Security Disability Benefits for Chronic Heart Failure?

The role of the Social Security Administration is to conclusively establish whether you are disabled based on your education, work experience, medical evidence, and your age.

The role of your doctor is to provide the Social Security Administration with information concerning the degree of your medical impairment by providing the Social Security Administration medical source statement that describes your capacity for work which is part of your residual functional capacity assessment. Your residual functional capacity is what you can still do despite your limitations.

The Social Security Administration must consider your treating physician's opinion because the Social Security Administration considers it to be controlling when making its decision.

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What is the 5 Step Sequential Evaluation Process?

The Social Security Administration has created a five (5) step sequential process to determine whether an adult claimant is entitled to receive disability benefits. Children have a different test to determine eligibility.

Step 1: Substantial Gainful Activity

The Social Security Administration presumes that if you are working and that you make a certain amount of money that you are engaging in what it determines to be a substantial gainful activity (SGA). The Social Security Administration considers a person to be engaged in a SGA if that person is earning more than a certain amount of money each month (i.e. net of impairment - related work related expenses).

In 2013, the Social Security Administration has determined that a statutorily blind individual is engaged in a SGA if they earn more than $1740.00 per month while a non-blind individual must earn more than $1040.00 per month. Changes in the national average wage index usually affect the aforementioned SGA amounts.

Step 2: Severe Impairment

The Social Security Administration has determined that each claimant must either have a severe impairment or a combination of impairments. The impairment or combination of impairments must drastically limit the claimant's physical or mental ability to do basic work activities without regard to age, work history, or education. For many claimants, the level of proof at this level is minimal; therefore, they usually satisfy the Step 2 requirements and proceed to Step 3.

Step 3: Listing of Impairments

The Listing of Impairments details specific impairments that the Social Security Administration considers severe enough to prevent an adult claimant from engaging in a substantial gainful activity and in the case of a minor, the impairment has to be severe enough to cause functional limitations. There is also a durational requirement. The Social Security Administration has determined that the impairment must last for 12 months or long or result in the death of the claimant. If the claimant fails Step 3 because they do not meet or equal a listing then the case will proceed to Step 4.

Step 4: Past Relevant Work

At Step 4, if your condition is severe enough to meet the requirements of Step 2 (Severe Impairment); however, your severe impairment does not meet or equal a listed impairment that is the subject of Step 3 (Listing of Impairments), then the Social Security Administration must decide whether your severe impairment interferes with your ability to do any of the work you previously performed. The Social Security Administration likes to look at the work you performed over the past 15 years prior to the onset of your disability. If the Social Security Administration determines that your impairment does not interfere with work you previously did then you must proceed to Step 5.

Step 5: Ability to Perform Other Work

A majority of disability claims are decided at this level. If you cannot perform work you did in your past, then a determination must be made as to whether you can adjust to different types of work. The determination at this level takes into consideration your education, age, and prior work and is better known as your residual functional capacity.

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