Heart failure (CHF) is a condition that effects the heart’s ability to pump enough blood to body tissues, and may effect a person’s ability to work and entitle that person to receive disability benefits.

July 15, 2013

          Heart failure (CHF) is a condition that effects the heart’s ability to pump enough blood to body tissues, and may effect a person’s ability to work and entitle that person to receive disability benefits. There can be multiple causes of CHF, including hypertension, cardiomyopathy rheumatic, congenital, or other heart disease. To qualify as disabled for chronic heart failure, the Social Security Administration analyzes it under Listing 4.02.  In order to meet the severity level under listing 4.02, an individual must meet the criteria of both parts A and B of that listing. Both of the two main types of heart failure (predominant systolic dysfunction and predominant diastolic dysfunction) are reviewed under this regulation.

             Meeting the criteria in part A of Listing 4.02 requires a showing of either systolic or diastolic failure. Systolic failure requires evidence of left ventricular end diastolic dimensions greater than 6.0 cm or ejection fraction of 30 percent or less during a period of stability. Diastolic failure requires evidence of left ventricular posterior wall plus septal thickness totaling 2.5 cm or greater with an enlarged left atrium greater than or equal to 4.5 cm, with normal or elevated ejection fraction during a period of stability.

             Meeting the criteria in part B of Listing 4.02 requires that an individual’s CHF results in at least one of several specific symptoms which are outlined in parts B(1)-(3) of that listing. To satisfy part B(1), an individual must show that the symptoms of CHF result in a significant inability to independently initiate, sustain and complete activities of daily living. To satisfy part B(2), an individual must show that they have had three or more episodes of congestive heart failure within a consecutive twelve month period. Finally, satisfying part B(3) of listing 4.02 requires that an individual demonstrate an inability to perform an exercise tolerance test at a workload equivalent to 5 METs or less. 

             As with any claim for disability benefits, it is important that you receive proper treatment for your conditions. This is particularly important for heart conditions, as most of the evidence considered by SSA in these types of claims will be objective test results. Even if your conditions do not meet the severity outlined in listing 4.02, you may still be eligible to receive benefits if your conditions result in your inability to function or maintain work skills. Our attorneys deal with these complicated issues on a frequent basis and with a high success rate.  Feel free to call if you want to discuss these issues further.

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