Will Medical Evidence of Heart Failure Prove I Am Disabled?

 Posted on October 21, 2016 in Social Security Disability Medical Conditions

Heart failure is one of the leading causes of death in the United States. According to the Centers for Disease Control and Prevention, approximately 5.7 million American adults currently suffer from some degree of heart failure. About 50 percent of these people will die within five years of diagnosis.

The term “heart failure” itself is somewhat misleading. It does not mean a person’s heart has stopped working, or even that there is irreversible damage to the heart tissue itself. Medical professionals use a classification scale developed by the New York Heart Association (NYHA) to assess degrees of heart failure. The NYHA scale helps determine what limits a person’s heart failure may have on his or her daily activities—including the ability to work. Even at lower classification levels, heart failure may render a person unable to work and qualify him or her for Social Security Disability insurance benefits.

Court Orders Social Security to Reconsider Applicant With Class II Heart Failure

As with many common medical impairments, however, Social Security officials are often quick to dismiss or minimize the impact of heart failure. A recent disability benefits case in Illinois illustrates the challenge many applicants face in this regard.

In this case, an applicant for disability benefits presented medical evidence that he suffered from heart failure. Specifically, the applicant’s treating physician of over more than three years diagnosed him with Class II heart failure under the NYHA scale. Class II failure indicates the need for “slight limitation of physical activity.” While the diagnosis may not sound that bad, the physician said the applicant could not “sit, stand, or walk” for more than two out of eight hours in a typical workday. The applicant would also need to take “unscheduled” breaks at least once per hour and “elevate his legs to waist level about 15 percent” of the time during the workday.

A Social Security administrative law judge (ALJ) dismissed the doctor’s diagnosis as “too accommodating” and held the applicant’s heart failure did not rise to the level of a disability. The applicant appealed and a federal magistrate ordered Social Security to reconsider the case. The magistrate said the ALJ simply ignored the regulations regarding the assessment of medical evidence—i.e., the treating physician’s diagnosis—and failed to properly identify any evidence supporting his own, contrary conclusions about the applicant’s ability to work.

Additionally, the ALJ improperly declared the applicant lacked credibility due to his “infrequent treatment” for his heart failure. The magistrate said the ALJ failed to consider any possible reason for the applicant’s purported non-treatment, as is required by Social Security regulations.

Contact an Illinois Social Security Disability Attorney

Heart failure is just one of many serious medical impairments that may qualify you for Social Security disability benefits. But as the above case demonstrates, Social Security may not always take medical evidence of your disability seriously, at least not at first. If you need help from an experienced Chicago disability benefits lawyer in making your case, contact Pearson Disability Law, LLC, today.

Sources:

http://www.cdc.gov/DHDSP/data_statistics/fact_sheets/fs_heart_failure.htm

http://www.heart.org/HEARTORG/Conditions/HeartFailure/AboutHeartFailure/Classes-of-Heart-Failure_UCM_306328_Article.jsp#.V9lyBE1TFv4

https://scholar.google.com/scholar_case?case=12277811501578661939&hl=en&as_sdt=6,47