Suffering an Unfair Job Loss is Tough, our california employment attorneys can help.

Coronary Artery Disease

How Do I Get Social Security Disability Benefits for Coronary Artery Disease?Coronary Artery Disease and Disability?

Ischemic Heart Disease refers to a disease of the heart that deprives the heart muscle of blood flow and oxygen. Most ischemic heart disease is caused by coronary artery disease (a hardening of the arteries) but may also be caused by narrowed heart valves.

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

To qualify for Social Security Disability benefits due to coronary artery disease, you must have ischemic heart disease with symptoms due to myocardial ischemia, while on a regimen of prescribed treatment, with one of the following:

  1. Sign-or-symptom limited exercise test demonstrating at least one of the following manifestations at a workload equivalent to 5 METs or less:
    1. Horizontal or down-sloping depression, in the absence of digitalis glycoside treatment or hypokalemia, of the ST segment of at least -0.10 millivolts (-1.0 mm) in at least 3 consecutive complexes that are on a level baseline in any lead other than aVR, and depression of at least -0.10 millivolts lasting for at least 1 minute of recovery; or
    2. At least 0.1 millivolt (1 mm) ST elevation above resting baseline in non-infarct leads during both exercise and 1 or more minutes of recovery; or
    3. Decrease of 10 mm Hg or more in systolic pressure below the baseline blood pressure or the preceding systolic pressure measured during exercise due to left ventricular dysfunction, despite an increase in workload; or
    4. Documented ischemia at an exercise level equivalent to 5 METs or less on appropriate medically acceptable imaging, such as radionuclide perfusion scans or stress echocardiography.
  2. Or

  3. Three separate ischemic episodes, each requiring revascularization or not amenable to revascularization, within a consecutive 12-month period.
  4. Or

  5. Coronary artery disease, demonstrated by angiography (obtained independent of Social Security disability evaluation) or other appropriate medically acceptable imaging, and in the absence of a timely exercise tolerance test or a timely normal drug-induced stress test, an MC, preferably one experienced in the care of patients with cardiovascular disease, has concluded that performance of exercise tolerance testing would present a significant risk to the individual, with both 1 and 2:
    1. Angiographic evidence revealing:
      1. 50 percent or more narrowing of a non-bypassed left main coronary artery; or
      2. 70 percent or more narrowing of another non-bypassed coronary artery; or
      3. 50 percent or more narrowing involving a long (greater than 1 cm) segment of a non-bypassed coronary artery; or
      4. 50 percent or more narrowing of at least 2 non-bypassed coronary arteries; or
      5. 70 percent or more narrowing of a bypass graft vessel; and
    2. Resulting in very serious limitations in the ability to independently initiate, sustain, or complete activities of daily living.

[Back to Top]

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

Social Security disability benefits may be available for people who suffer from Coronary Artery Disease. The Social Security Administration must first determine whether your Coronary Artery Disease 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 Coronary Artery Disease.

If the Social Security Administration decides that your Coronary Artery Disease 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.

[Back to Top]

How Can I Meet a Listing and Win Social Security Disability Benefits for Coronary Artery Disease?

The Social Security Administration will determine whether you are disabled at Step 3 of the Sequential Evaluation Process by evaluating whether your Coronary Artery Disease 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 Coronary Artery Disease is severe enough to meet or equal a listing.

[Back to Top]

What is Your Residual Functional Capacity Assessment for Coronary Artery Disease?

If the Social Security Administration decides that your Coronary Artery Disease 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 expressesan 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.

[Back to Top]

Can Your Doctor’s Medical Opinion Help You Qualify for Social Security Disability Benefits for Coronary Artery Disease?

The role of the Social Security Administration is to conclusivelyestablish 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 informationconcerning 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.

[Back to Top]

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.

[Back to Top]