In the United States, heart disease is one of the primary causes of disability. The Social Security Administration employs Section 4 of the Blue Book to determine whether a claimant’s cardiac or circulatory disease is serious enough to qualify for disability benefits.
The Blue Book’s Section 4 is further subdivided into eight subsections. Each of the subsections gives a detailed explanation about a specific type of ailment, disease, or disorder and provides the SSA with recommendations on how to evaluate each. The following are the eight subsections and the criteria for each for eligibility for Social Security disability benefits:
- Aneurysm of aorta or major branches – Regardless of how the injury occured (e.g., atherosclerosis, cystic medial necrosis, Marfan syndrome, or trauma), providing a confirmation of the disability via medical imaging, with dissection not controlled by prescribed medication, you will be considered disabled.
- Chronic heart failure – In addition to abnormal findings on appropriate medically acceptable imaging, the history and physical should describe typical symptoms and signs of pulmonary or systemic congestion. When an arrhythmia, dietary sodium overload, or high altitude trigger an acute episode of heart failure, cardiac function may be restored and no chronic impairment may exist. Other requirements include failing an exercise tolerance test, having two or more episodes of heart failure in a year (requiring fluid retention and hospitalization), or having symptoms that limit your ability to work and make an exercise test unsafe.
- Chronic venous insufficiency – The following will classify you as disabled if one or more of the conditions fits you or if you have an obstruction: Extensive brawny edema encompassing at least two-thirds of the leg from ankle to knee or the distal one-third of the lower extremity from ankle to hip OR Varicosities on the skin’s surface, stasis dermatitis, and recurring or persistent ulceration that has not healed after at least three months of prescribed treatment. Varicosities on the skin’s surface, stasis dermatitis, and recurring or persistent ulceration that has not healed after at least three months of prescribed treatment.
- Heart transplant – Someone is classified as disabled the first year after having undergone a heart transplant.
- Ischemic heart disease – If you meet one of the following, you will be considered disabled: Meeting the four guidelines that the SSA provides via their bluebook, after performing an exercise test. Within a 12-month period, three distinct ischemia episodes occurred, each needing revascularization or being unrevascularizable. Coronary Artery Disease, which an angiography or other medically acceptable imaging demonstrates this or taking an exercise test (or medical documentation showing why taking an exercise test proposes health risks to you).
- Peripheral arterial disease – To qualify for disability for peripheral arterial disease, someone has prove they have it which is established by medically adequate imaging, and intermittent claudication. As well as meeting the SSA guidelines regarding blood pressure.
- Recurrent arrhythmias – To be eligible for disability payments based on recurrent arrhythmias, medical evidence must establish that the condition is irreversible and results in near syncope or syncope.
- Symptomatic congenital heart disease – The SSA recognizes medical imaging or a cardiac catheter as proof of symptomatic congenital heart disease. They will check to determine if your hematocrit and oxygen saturation levels fulfill their guidelines. Additionally, if you have right to left shunting or if your systolic blood pressure is sufficiently increased, you may qualify (70 percent of systemic or higher)
Below is other medical conditions that is brought up or mentioned in section 4 of the bluebook:
- Venous Insufficiency
- Sinus Bradycardia
- Mitral Valve Prolapse
- Marfan Syndrome
- Left Ventricular Assist Device
- High Cholesterol
- High Blood Pressure
- Heart Valve Disorder
- Heart Failure
- Heart Attack
- Cor Pulmonale Secondary Chronic Pulmonary Hypertension
- Chronic Pulmonary Hypertension
- Chest Pain
- Budd-Chiari Syndrome
- Blood Clots