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Social Security Disability Benefits For Coronary Artery Disease

I have been diagnosed with coronary artery disease (CAD). Can I get Social Security Disability benefits (SSI/SSDI), Disability Insurance Benefits (DIB), or Supplemental Security Income benefits (SSI)?

Receiving a diagnosis of coronary artery disease is just the start. Typically, your Social Security disability claim will focus on the symptoms you experience from coronary artery disease and how those symptoms affect your ability to engage in full-time physical and mental work-related activities – that is, eight (8) hours per day, five (5) days per week.

Is coronary artery disease considered a disability?

When the arteries are diseased or damaged, it can reduce the blood and oxygen supply that these arteries bring to the heart. This is coronary artery disease (CAD). Two common types of CAD are atherosclerosis, where fat and calcium build up in the arteries, and arteriosclerosis, where plaque deposits harden the arterial walls. Either type typically occurs among people with unhealthy, sedentary lifestyles.

If you are just starting to have this disease, you may not notice symptoms yet. But as CAD progresses, it may cause chest pain, shortness of breath, and even a heart attack if an artery is completely blocked.

To check if this condition disables you, the Social Security Administration (SSA) will evaluate your case using a five-step process.

Step 1. Do you have gainful work?

At the first step, the SSA considers your work activity. If you are engaged in Substantial Gainful Activity (SGA) you will not be found as disabled. The amount you must earn to be working at SGA changes each year. For 2018 it is $1,180 per month if you are not blind and $1,970 per month if you are blind. If you are working, and your earnings average more than the SGA limit, then you will not be found disabled. If you are not working, or your earnings are less than SGA, the process proceeds to Step 2 where your coronary artery disease is more closely examined.

Step 2. Does your medical condition qualify as “severe”?

Disability means that your medical condition significantly limits your ability to do basic work activities such as sitting; standing; walking; lifting; carrying; understanding, remembering, and carrying out simple instructions; making simple work-related decisions; responding appropriately to supervision, co-workers, and work stress; and dealing with changes in a routine work setting.

For the SSA to find you disabled, you must have a medically determinable physical or mental impairment (or a combination of impairments) that is severe and has lasted or is expected last one (1) year or end in death. If your medical condition is not that severe, you will not be found to meet the requirements for Social Security disability benefits.  If your condition is that severe, the SSA goes to Step 3.

Step 3. Does your disease match a “listing”?

The Social Security Administration maintains a listing of medical criteria that are considered to be so severe that you will be found disabled if your medically determinable physical or mental impairment(s) matches them. The Adult Listing for coronary artery disease can be found here.

If you do not have an impairment that meets or equals one of the listings, or if the duration requirement is not met, the SSA determines what you’re capable of doing despite your impairments (your Residual Functional Capacity or RFC) and will proceed to Step 4.

RFC is a function-by-function assessment of your maximum ability to do sustained work-related physical and mental activities on a regular and continuing basis (8 hours a day, for 5 days a week) despite the limitations and restrictions resulting from your medically determinable impairments. In short, it is an evaluation of your capacity for full-time work.

Step 4. Are you still capable of doing any of the work you’ve done in the last fifteen (15) years?

At this step, the SSA decides if your medical condition prevents you from being able to work full-time at jobs you have done in the past fifteen (15) years. If the SSA decides you can perform any of your past relevant work (PRW), you will be found not disabled. To be PRW, the work must have been substantial gainful activity (SGA); performed in the fifteen (15) year relevant period; and performed long enough to learn the job. If the SSA decides you cannot perform your past relevant work, or you have not worked in the past fifteen (15) years, the SSA goes on to Step 5.

You have the burden of proof at Step 4 – that is, you are required to present evidence. Two of the strongest types of evidence at this stage are medical records and the opinions of the doctors who are treating you for the conditions that are affecting your ability to work. The strongest medical evidence is what is known as objective medical evidence, or evidence that does not rely upon what you tell your doctors. The strongest opinions are opinions that are offered by doctors who specialize in the condition that is keeping you from working and which are supported by objective medical evidence.

Can you get Social Security disability for coronary artery disease?

Some types of objective medical evidence that can support a claim for disability based upon coronary artery disease include:

  • Cardiovascular test results – May include electrocardiograph or electrocardiogram (ECG), exercise tests, magnetic resonance imaging (MRI), angiography, and ultrasound.
  • Detailed reports of history
  • Physical examinations
  • Laboratory studies
  • Any prescribed treatment and response
  • Longitudinal clinical record – This must cover not less than three (3) months of observations and treatment.

Doctors who specialize in treating coronary artery disease include:

  • Cardiologists – Their specialty is on the heart and blood vessels.
  • Vascular specialists – They further specialize in blood vessel problems.
  • Cardiac surgeons – They perform various types of heart surgery.

If you are only treating with your family doctor or primary care doctor for your coronary artery disease, the SSA may interpret this as meaning that your condition is not that serious (otherwise you would be treating with a specialist). An experienced Social Security disability lawyer can help you locate sources of treatment (even if you don’t have health insurance).

Step 5. Is there any other type of work you can do?

At Step 5, the “burden of proof” shifts to SSA. If you cannot do your past relevant work, the SSA looks to see if you would be able to do other work. It evaluates your medical condition, your age, education, past work experience, and any skills you may have that could be used to do other work. If you can do other work, the SSA will determine you are not disabled. If you cannot do other work, the SSA will find you disabled.

Are you over 50? There are special rules that may apply to your claim that can result in a finding of disability even if there is some other work you could perform on a full-time basis. An experienced Social Security disability lawyer will be familiar with these rules and can ensure that they are considered in the evaluation of your case.

Specialized medical care is crucial in treating your coronary artery disease, but the medical bills can likely take a toll on your finances. This, combined with your disrupted ability to earn, can create a great burden for which you may need assistance.

Contact Gillette Law Group

You may truly deserve disability benefits from the SSA. Don’t be discouraged by the strict evaluation process. With our help at the Gillette Law Group, you can pursue a highly effective disability claim that is more likely to get approved. With our years of in-depth experience, we have helped numerous claimants succeed, and we can do this for you, too.

Whether this is your first time applying or you are appealing a denied claim, talk to us. Your consultation is free. Call us today at (855) 873-2604.

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