Heart failure why would the SSA say I can do other work?
Unfortunately, its not unusual for many claimants who apply for benefits to be found not disabled by the Social Security Administration (SSA). Some claimants who are very disabled may be denied simply because they did not understand the SSA disability process and what they needed to win benefits. Recently on our disability forum a user asked, I have been diagnosed with severe heart failure. I can barely walk from my bed to my chair each morning. Why would the SSA claim I can retrain for a new job and work 40 hours per week? Can you help me?
Denied for other work with heart failure
Using what the SSA terms the 5 step sequential evaluation process the SSA will evaluate whether a claimant with heart failure is disabled or whether they have the residual functional capacity to work. The questions the SSA will review include the following:
If the SSA determines you do not meet the requirements of any step you can be denied Social Security Disability Insurance (SSDI). The trick is finding out why you were denied and providing additional evidence to prove your case. Remember, you have 60 days from the date of the denial letter to file your appeal so you need to act fast.
5 Step Sequential Evaluation Process for Heart Failure
Lets take a closer look at the questions.
Given the description of your heart failure it seems likely that we can assume you meet the requirements of the first step. You are clearly not working too much or making too much money.
Lets move to the second question, Is your condition severe? Under this question you need to prove that your heart failure will last at least 12 continuous months. If you have severe heart failure with no expectation of recovery, you will meet this requirement and we can move to step 3.
Next, the SSA will evaluate whether your heart failure meets or exceeds a listing. This question is a bit tougher and will require understanding the SSA Listing of Impairments (a listing of the most common conditions and their symptoms which the SSA considers automatically disabling).
Heart Failure and Meeting a Listing
All coronary conditions and their corresponding symptoms that the SSA considers disabling can be found under Listing 4.00 Cardiovascular System. Review this listing with your doctor. Some claimants have heart failure and their condition meets a listing, but they do not have enough medical evidence in their medical file to prove it to the SSA.
If this is the case you simply need to work with your doctor to gather the appropriate medical information about your heart failure. Consider asking them to complete a RFC (Residual Functional Capacity form) to provide more medical information about your ability to work.
Heart Failure and proving you cannot do other work
If you cannot ever convince the SSA that your condition meets or equals a listing, information from your doctor which clearly states your limitations to do other work due to your heart failure becomes critical to your case (i.e., getting an RFC form which limits you to less than sedentary work).
If all else fails it may be time to talk a lawyer and find out what else you can do to increase your chance of winning at the appeal level.
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