Does Cardiomyopathy Qualify as a Disability?

You might wonder whether cardiomyopathy is considered to be a disability. Many elderly people have cardiomyopathy (diseased heart muscle), but not all are considered disabled. Qualifying for disability is determined according to how well the condition can be treated.

Cardiomyopathies have many causes, including drug or alcohol abuse, viruses, coronary artery disease, kidney disease, high blood pressure and many other conditions. Cardiomyopathies are not considered disabling if symptoms can be managed. Medications are effective, as are corrections by surgery. For example, coronary artery bypass surgery usually restores blood supply to the heart, so symptoms improve and the cardiomyopathy is no longer considered as disabling.

There are several common forms that characterize cardiomyopathies:

• Restrictive Cardiomyopathy is defined as “the least common form, in which the heart muscles stiffen and the heart chambers cannot properly fill with blood, leading to congestive heart failure.”
• Hypertrophic Cardiomyopathy: “a genetic thickening of the heart muscle that shrinks the left ventricle, making it more difficult for the heart to pump blood to the rest of the body. This form often leads to cardiac arrhythmias (abnormal heart rhythms), and in severe cases can lead to chronic heart failure.”
• Ischemic Cardiomyopathy is “caused by coronary artery disease (hardening of the arteries). Doctors sometimes classify this as ischemic heart disease rather than cardiomyopathy.”
• Dilated Cardiomyopathy is “a true cardiomyopathy involving enlargement of the left heart ventricle, meaning poor pumping function which can lead to congestive heart failure.”

The SSA does not have a separate listing for cardiomyopathies. Instead, you apply under one of the other three categories: congestive heart failure (4.02), ischemic (coronary) heart disease (4.04), or arrhythmia (4.05).

4.02: Many patients with cardiomyopathy also suffer from congestive heart failure, or ineffective blood flow. If you’ve had to quit work or reduce your work hours because of your heart condition, you may qualify. Since these cardiomyopathies are caused by diseased heart muscle, you might suffer from symptoms like dizziness, fainting, chest pain (angina), shortness of breath, irregular heartbeat, severe fatigue, and swelling of the legs and feet. You must provide medically documented evidence of heart failure and show evidence of persistent symptoms that drastically limit your daily living.

4.04: You must produce evidence of an abnormal exercise test, evidence of surgery or other attempts to repair the ischemia, or evidence of any arterial disease and functional loss.

4.05: you must show evidence of a recurring arrhythmia and uncontrolled cardiac episodes.

Qualifying under one of these three conditions is very complex, so hiring a social security disability representative is advised.

You might still qualify for benefits even if your cardiomyopathy does not meet one of the above criteria. It is possible to show medical equivalency, meaning an overall effect it has had on you. In these cases, an overall assessment of both your physical and mental states is performed. You must show that you are not working because your condition prevents it. SSA will determine how the cardiomyopathy affects your daily living, and will also take into account your age, work experience, and education.

If you’re not sure whether you qualify, give us a call. You’ll get one of our social security disability representative to talk with you about whether you qualify.