Social Security Disability for Peripheral Artery Disease
If your recently diagnosed peripheral arterial disease is preventing you from completing the necessary tasks of your job, you could qualify to receive Social Security disability benefits. PAD is a medical condition that causes narrowing of the arteries of the extremities, typically the legs. As a result, victims have limited blood flow to the tissues around the affected area.
The heart is responsible for pumping blood to the tissues in the body which contains the necessary nutrients and oxygen, but PAD prevents this from functioning properly. The arteries are too narrow, so blood is unable to reach the extremities at a sufficient volume. The decreased blood flow is exacerbated by exercise and motion due to the increased strain causing muscles and tissues to require more oxygen to complete a task.
The muscles do not receive sufficient oxygen if there is constricted blood flow in an artery. The most common symptom that PAD sufferers experience is pain in the extremities, specifically the calves, known as intermittent claudication. It can differ in severity from mild to excruciating. Rest often reduces the pain.
Local numbness, weakness, one extremities being colder than the other, chronic sores, and a weak or absent pulse in the leg are all common symptoms sufferers experience. Some symptoms could also be signs of an oncoming heart attack or stroke, in which case require emergency medical assistance. There is also the possibility of limb amputation being necessary due to ischemia or absence of blood flow.
The Cost of Treating PAD
Peripheral Arterial Disease is a severe, chronic disorder. The National Centers for Biotechnology Information estimates the average person diagnosed with PAD collects medical expenses that vary from $2,000 to $20,000 during their lifetime. Naturally, if they underwent amputation or experienced a stroke from PAD, their bills are substantially higher.
Those with insurance pay copays and coinsurance that range from 5 percent to 50 percent of the total medical bills. Those without insurance can expect to pay more. It is a prevalent disease that creates seriously problematic health issues to those diagnosed with the condition.
Getting Medical Approval for Disability
The Social Security Administration acknowledges Peripheral Artery Disease as a disabling condition under certain situations. The SSA follows procedures from a medical guide to evaluate your disability. This is known as the Blue Book, which lists PAD under the cardiovascular system due to it being a cardiovascular condition. The SSA requires serious disability or impairment preventing you from completing any form of work even despite receiving disease treatment. The exact requirements for those with PAD are listed in Section 4.0, Cardiovascular – Adult.
You need to prove that you have been accurately diagnosed with PAD by a licensed medical professional. There also needs to be evidence of concurrent treatment for the disease, not just diagnosis. Evidence of your response to treatments is also necessary. You need to have undergone at least 3 months of recorded treatment before applying for disability.
Typically, the SSA needs more extended treatment to see if you are going to respond to before your claim is reviewed. If your PAD is not stable, or if you have changed treatments without recorded results, you could be seeing a waiting period before SSA looks at your case.
To qualify for disability benefits with PAD, you need to have imaging documentation from a Doppler or angiography, suffer pain in the legs, and have one of the following:
- A resting ABI of less than 0.5.
- A 50% decrease in systolic blood pressure at the ankles with exercise that needs at least 10 minutes or longer for recovery.
- A resting toe systolic blood pressure of less than 30 mm HG.
- Resting toe or brachial index of less than 0.4
Gaining Disability Benefits Using an RFC
RFC stands for residual functional capacity; it’s a form that your doctor fills out which can help increase your likelihood of approval for disability benefits if you do not meet the conditions listed in the Blue Book. The form should be filled completely listing any limitations or restrictions that your condition has caused. This would look like a note stating you need to be repositioned every 45 minutes due to the reduced blood flow and accompanying leg cramps, which will prevent you from completing necessary work tasks.
You could suffer from blood clots in your extremities due to PAD, which will prevent you from long periods of sitting due to the raised likeliness of another thrombosis event. If PAD forces you to elevate your legs and feet often to alleviate excruciating pain, that needs to be obviously noted. It should also state how much weight you’re able to lift, if you cannot bend, and how PAD affects your mobility, such as the requirement of crutches to walk or inability to walk long distances.
An RFC is considered as a component of the medical-vocational allowance, which takes into account your job history, transferable skills, education, and age. If your condition prevents you from returning to your occupation, Disability Determination Services will look to see if you are able to complete other work such as occupations that have fewer duties like a sedentary job. Once you’ve been determined to be unable to work at all full-time, you will be approved to receive monthly disability benefits.
Applying for Disability Benefits
The Social Security disability benefits process is complex and simply frustrating. The SSA needs detailed medical documentation, accurate tests reflecting your blood pressure in your extremities, advanced scans proving the accuracy of your diagnosis of PAD, records that depict how PAD affects your mobility and pain experience, in addition to documented responses of treatment. You could potentially be denied several times and need to file appeals. The last step in that situation would be a hearing with an administrative law judge.
You may start the process online at www.ssa.gov, over the phone at 1-800-772-1213 or in person at your nearest Social Security office. A disability attorney can significantly increase your chances of being approved for benefits.