Coronary Artery Disease and SSA Disability Insurance

Coronary Artery Disease and SSA Disability Insurance
By Kimberly BishopOctober 29, 2023

If you have been assessed with Coronary Artery Disease (CAD) and are unable to work, read on for information on how the Social Security Administration will evaluate your claim for SSA Disability Insurance.

The Bishop Law Firm has represented Social Security Disability clients since 2009 in North Carolina. We have represented clients in front of Raleigh, Charlotte, Fayetteville and Greensboro SSA Administrative Law Judges. We do not get paid unless we win and we offer free case reviews. Call us today, 919-615-3095 or start online now.

Types of Social Security Disability Benefits

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Social Security Disability Insurance (SSDI)

SSDI (Social Security Disability Insurance) is based on the credits from the work you have done in your life. You must be found disabled before your date last insured (DLI) to be found eligible for SSDI. Your DLI is calculated by counting your “quarters of coverage” from your earnings record. You must have 20 “quarters of coverage” of the last 40 quarters. Simply put, you must have worked 5 years of the last ten years (in general). In addition, Adult Disabled Children can be eligible for benefits off their parent’s account.

Supplemental Security Income (SSI)

SSI (Supplemental Security Income) is a need-based program and you must meet income/asset standards in addition to being found disabled under the five steps above. In 2023, SSI is $914.00 per month for an individual and $1,371 for an eligible couple. SSI will be reduced by 1/3 if you are receiving financial help from others. In NC, SSI recipients are also entitled to Medicaid.

You must be found disabled under SSA’s Five Step Sequential Evaluation before you are entitled to either type of benefit. (Read more at SSA’s Five Step Sequential Evaluation). 

What is Coronary Artery Disease (CAD)?

Coronary Artery Disease develops when your coronary arteries — the major blood vessels that supply your heart with blood, oxygen and nutrients — become damaged or diseased. – Via the Mayo Clinic. Plaque buildup in arteries can cause your heart to receive less blood flow. If the flow of blood is cut off to the heart, you may have a heart attack or you can develop chronic congestive heart failure via CDC.

A heart attack (cardiac ischemia or myocardial infarction) can result in long term damage to the area of the heart that did not receive appropriate oxygen and blood flow (via AHA). The amount of damage depends on the size of the blood deprived area and how long the area was deprived.

Chronic Heart Failure is broken into four stages per the New York Heart Association. Symptoms increase in severity by the classifications. Also read Heart Failure and Social Security Disability.

Symptoms frequently described by clients from CAD are chest pain, shortness of breath and unexplainable fatigue. Doctors usually test for CAD using an electrocardiogram, echocardiogram, catheterization or stress test. Medications can be used to help with your CAD and symptoms. If more aggressive treatment is needed, angioplasty with/without stent placement or bypass surgery may be done.

Unfortunately, treatment in certain circumstances can further weaken the heart muscle and have long term effects on the patient’s ability to work.

Can you get Social Security Disability for Coronary Artery Disease?

As with all impairments with the Social Security Administration, the name of your impairment is not as important as the severity of your symptoms. The real question is if your medical evidence demonstrates that your heart disease and accompanying symptoms (chest pain, shortness of breath, fatigue) are severe enough to prevent you from working.

The Social Security Administration can evaluate your claim for disability insurance under 4.04 Ischemic Heart Disease. This listing specifically addresses Coronary Artery Disease in part C:

4.04 Ischemic heart disease, with symptoms due to myocardial ischemia, as described in 4.00E34.00E7, while on a regimen of prescribed treatment (see 4.00B3 if there is no regimen of prescribed treatment), with one of the following:

C. Coronary artery disease, demonstrated by angiography (obtained independent of Social Security disability evaluation) or other appropriate medically acceptable imaging, and in the absence of a timely exercise tolerance test or a timely normal drug-induced stress test, an MC, preferably one experienced in the care of patients with cardiovascular disease, has concluded that performance of exercise tolerance testing would present a significant risk to the individual, with both 1 and 2:

1. Angiographic evidence showing:

a. 50 percent or more narrowing of a nonbypassed left main coronary artery; or

b. 70 percent or more narrowing of another nonbypassed coronary artery; or

c. 50 percent or more narrowing involving a long (greater than 1 cm) segment of a nonbypassed coronary artery; or

d. 50 percent or more narrowing of at least two nonbypassed coronary arteries; or

e. 70 percent or more narrowing of a bypass graft vessel; and

2. Resulting in very serious limitations in the ability to independently initiate, sustain, or complete activities of daily living.

You must have objective evidence (angiography or other testing) demonstrating that you have significant narrowing in your arteries or bypass graft vessel AND “very serious limitations in the ability to independently initiate, sustain, or complete activities of daily living.”

If you meet this listing, you are in bad shape. Many people receive stents or bypass before they meet this listing. The surgery may reduce your narrowing to less than what is required by the listing, but you still may be unable to work due to your symptoms.

If you are unable to work due to your Coronary Artery Disease, do not worry about meeting this or any other listing. If your symptoms from your Coronary Artery Disease prevent you from working, file a claim for SSA Disability Insurance as soon as possible and call the Bishop Law Firm. Delay may cause you to lose benefits!

The Bishop Law Firm represents Social Security Disability clients in RaleighDurhamFayettevilleCary, Rocky MountWilsonSmithfieldLouisburgChapel HillRoanoke Rapids , Winston SalemGarner, GreensboroGreenville and surrounding areas in North Carolina. Call us today for a free case review, (919) 615-3095 or start online now.

Also read NC Social Security Disability Lawyer

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