Social Security Claims
HEART DISEASE AND SOCIAL
SECURITY DISABILITY CLAIMS
By: Pitt
Dickey - Attorney
Social Security Disability and
heart claims - This column will take a look at
how the Social Security Administration evaluates disability claims
from people who suffer heart disease. The SSA has a set of
Listings covering the various types of heart disease.
As readers
of this column may recall, the SSA uses a set of criteria to
determine if a person’s health problems with a particular
disease meet the requirements to be granted monthly Disability
Insurance Benefits from the SSA. To understand the Listings for
heart disease it is useful to look the mechanics of the heart.
The heart is a muscle about the
size of your fist. The heart pumps blood throughout the body. The
heart itself has four chambers. The top two chambers are called
the atria and the lower two chambers are called the ventricles.
The heart is designed to receive
oxygen depleted blood after it has circulated through the body and
to pump that oxygen poor blood through the lungs where it receives
oxygen and then back out into the body to carry the oxygen to the
body’s cells. Arteries are blood vessels that take blood
away from the heart. Veins are blood vessels that bring
blood back towards the heart.
The oxygen depleted blood enters
the heart through two large veins call the superior vena cava
which receives blood from the upper portion of the body and the inferior
vena cava which receives blood from the lower portion of the
body. These two veins enter the upper right chamber of the heart
which is called the right atrium. The right atrium then
pumps the blood through the tricuspid valve into the lower
right chamber of the heart which is called the right ventricle.
The right ventricle pumps
the blood into the pulmonary valve which leads into the pulmonary
artery. The word pulmonary means lung which means the pulmonary
valve leads into the artery that leads into the lungs.
The blood pumped into the lungs
is filled with carbon dioxide which is expelled by the lungs in
breathing out. The inhalation portion of breathing loads oxygen
back into the blood that is circulating in the lungs. Blood filled
with oxygen returns from the lungs to the heart in the pulmonary
veins which enter the upper left chamber of the heart which is
called the left atrium.
The left atrium pumps the
blood with the oxygen in it through the mitral valve into
the left ventricle which is the lower left chamber of the
heart. The left ventricle is the strongest part of the
heart in that it must pump the blood out of the heart with enough
pressure to circulate the blood into the rest of the body. The
blood leaves the left ventricle through the aortic valve
into the aorta. The aorta is the artery that splits
into the other arteries that carry the blood with oxygen into the
rest of the body.
The heart has two stages in its
pumping of blood. The diastole stage is when the heart is
relaxed and the systole stage is when the heart is
contracting and pumping blood.
In the diastole stage the
ventricle relaxes and blood enters the heart from the venae
cavae and pulmonary veins. The mitral valve and
the tricuspid valves open and blood flows from the right
and left atria into the ventricles. The next stage systole occurs
and the right and left ventricles contract and pump blood into the
aorta and pulmonary artery.
Unfortunately the heart does not
always work as perfectly as it was designed to do. The heart can
suffer a variety of ailments which interfere with its ability to
perform its functions. The SSA Listing for Chronic Heart failure
directs that disability benefits will be awarded if the worker is
diagnosed with chronic heart failure with either of the following:
A. Enlargement of the
heart to certain standards ( documented by a chest x-ray or a
echocardiogram of the heart) , which result in the inability to
carry on physical activity and with symptoms of inadequate cardiac
output, lung congestion, systemic congestion or anginal
syndrome at rest. Anginal syndrome is recurrent or
persistent fatigue, anginal discomfort (chest pain due to
not enough oxygen being available to meet the needs of the heart)
, dyspnea (shortness of breath), orthopnea (
Breathing is easier in the upright position, commonly in
congestive heart failure the person has difficulty in breathing
while lying down because their lungs fill with fluid). Or;
B. Enlargement of the
heart or ventricle dysfunction, abnormal ventricle wall motion, or
left ventricular ejection fraction of 30% of less of
normal. Ventricular ejection fraction is amount of blood that
passes through the ventricle. In addition the worker must have the
inability to perform at a certain level on an exercise test due to
symptoms of chronic heart failure due to 3 or more consecutive
premature ventricular heart beats, or failure to increase his
systolic blood pressure by certain amount or to decrease his
systolic blood pressure below the usual resting level. ; or signs
of inadequate cerebral perfusion (circulation) such as ataxic
gait (unsteadiness on the feet) or mental confusion. And;
The person has marked limitation
of physical activity with such symptoms as fatigue, palpitation (
irregular heart beats), dyspnea, or anginal discomfort on ordinary
activity, even though the person is comfortable while resting.
Readers should be aware that
these listings are guidelines for the SSA and are not the only
factors that the SSA uses in evaluating chronic heart failure. If
a claimant meets these listings then his claim should be approved
without the necessity of having a hearing before an Administrative
Law Judge.
Preface: Since Social
Security Disability is directed under Federal law, the information
in this column will apply anywhere in the United States.
However each Office of Hearings and Appeals and District Office
have their own ways of doing things as does the various Federal
District and Circuit Courts. I have kept this column
primarily dealing the the mechanics of how the Social Security
District Offices and Office of Hearings and Appeals evaluates
disability claims.
- Pitt Dickey
Pitt Dickey has practiced law
in Fayetteville since 1978. He has handled SSA disability claims
for over twenty years. He practices with the firm of Smith,
Dickey, Smith, Hasty & Dempster, P.A. at 555 Executive Place
and can be reached at 910-485-8020 or at pitt@smithdickey.com
. Or at the firm web site of www.smithdickey.com
.
Copyright © 2002 Pitt Dickey -
Used with permission
