Coronary artery disease applied 3 times and denied?

Recently on our disability forum a user asked, “I have severe coronary artery disease. I cannot work. My condition is not expected to improve. I have worked as a construction worker for 25 years and paid into the disability benefits system. Why would the Social Security Administration (SSA) deny my Social Security Disability Insurance (SSDI) claim three times?”

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Coronary artery disease is caused by a build-up of plaque in the coronary arteries. Also referred to as ischemic heart disease, if left untreated, this condition can eventually lead to hardening of the arteries, slowing of blood flow, and eventually a heart attack.

Unfortunately, millions of disability applicants submit disability claims each year with an estimated 70% of those claims being denied. Some claimants are denied for a variety of conditions, many of them quite severe.

Why are claimants denied? Denials are common for a variety of reasons: claimants do not have enough work credits to qualify for SSDI benefits, claimants apply for benefits while they are working and making too much money, the SSA decides the claimant’s condition is not long-term or severe, or the claimant fails to provide sufficient evidence that their claim does not allow them to work.

Coronary Artery Disease and winning SSDI benefits

Now, you mentioned that you had worked and paid into the Social Security disability system. You also mentioned that you are not currently working. Your denial is therefore based on another reason. There are several possibilities.

For instance, some claimants wait too long to file their disability application and their SSDI benefits expire. If this is the case, you will need to talk to the SSA to determine your date last insured (DLI) and whether you filed your claim prior to this date.

Although most claimants will not qualify for benefits if they file after this date, you might if you can prove that your disability started prior to this date and you did not do any substantial gainful activity after this date. Talk to the SSA if you have questions about your options.

Proving your coronary artery disease is serious and disabling

Most likely, however, your case was denied because the SSA did not believe that your coronary artery disease was so severe that you cannot work.

How do you prove that you are disabled?

The SSA will award benefits if they believe one of the following:

  • Your condition meets or exceeds a listing on the SSA Listing of Impairments (a list of conditions and their corresponding systems that automatically disqualify a claimant from work).

The SSA does have a listing in their SSA Listing of Impairments for coronary heart disease under 4.00 Cardiovascular System, Section 4.04. Under this listing the SSA has documented specific symptoms you will have to have to prove you are disabled. This SSA will make this determination by reviewing your medical records.

  • Your condition is so severe it has reduced your functional capacity to work

To prove your condition does not allow you to work you will need to prove that you cannot work your current job, past job, or based on your age, education, and work experience, you cannot retrain for new work.

Bottom Line:

Winning benefits for coronary artery disease is possible, but you will need sufficient evidence to prove your claim.

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