Disability Benefits for Coronary Artery Disease

Coronary Artery Disease is one of the most common illnesses among elderly patient. Coronary artery supplies oxygenated blood and nourishment to heart muscles and heart valves. Narrowing of the coronary artery results in less blood flow to heart and this condition is known as coronary artery disease. Coronary artery disease causes severe functional impairment because of chest pain and shortness of breath with minimum exertion. The impairment like chest pain and shortness of breath restricts daily activities, which results in disability. This article will give comprehensive information about whether Coronary Artery Disease qualifies for Social Security Disability Benefits, what are the chances of an individual getting SSD Benefits for Coronary Artery Disease, and why an SSD attorney is important in order to win the disability claim for Coronary Artery Disease.

Disability Benefits for Coronary Artery Disease

Coronary Artery Disease And Disability

Coronary Artery Disease is a pathological condition, which follows narrowing of the coronary artery. The narrowing of the artery affects blood flow and reduces oxygen supply as well as nutrients to the cardiac tissue. Lack of adequate supply of oxygen causes cardiac muscle death known as infarction. Myocardial infarction is caused by severe blood restriction to heart muscle. Coronary artery disease eventually causes myocardial infarction. Myocardial infarction reduces function of the heart also known as decreased cardiac output. Heart pumps the oxygenated blood to all the parts of the body. Blood also carries nutrients. The myocardial infarction decreases cardiac output. The cardiac output is an amount of blood (in milliliters) pumped out during each heart's beat.

The main cause of Coronary Artery Disease is cholesterol deposits in the arteries or inflammation of arterial wall, which results in scarring and narrowing. Narrowing of the coronary artery depends on the amount of cholesterol deposits on inner surface of the artery. The cholesterol deposits start building up slowly and during the slow building of cholesterol plaque on the surface of the artery patient is often asymptomatic until artery is significantly narrowed. The cholesterol deposits over the inner surface of the coronary artery causes significant narrowing of the lumen resulting in reduced blood flow to heart muscles known as myocardial ischemia. Myocardial ischemia causes a variety of symptoms like chest pain and shortness of breath. If there is complete blockage of the artery then it can also cause a heart attack. The significant cholesterol deposits over inner surface of coronary artery resulting in coronary artery disease takes several years to fully develop. The initial phase of building up cholesterol plaque is often unrecognized for several years.

Middle age patients suffering with coronary artery disease often fear for rejection of the disability benefits. The answer is yes to the question as to whether Coronary Artery Disease qualifies for disability benefits. Symptomatic coronary artery disease does qualify for Social Security Disability benefits since Coronary Artery Disease tends to cause symptoms like chest pain, dyspnea with exertion or rest, or even a heart attack which can prohibit an individual from carrying out work related activities in a normal fashion without causing symptoms. Thus, an individual with severe Coronary Artery Disease can apply for Social Security Disability.

What Are The Causes Of Coronary Artery Disease?

Coronary Artery Disease is believed to develop as a result of damage to the inner layer of the coronary artery. This can begin at times as early as in the childhood years of an individual.

Some of the risk factors for Coronary Artery Disease are:

Causes Of Coronary Artery Disease

  • Smoking
  • Hypertension
  • Hypercholesterolemia
  • Diabetes mellitus
  • Sedentary lifestyle.

What Are Symptoms Of Coronary Artery Disease?

Some of the symptoms of Coronary Artery Disease are:

Chest Pain: There will be a sensation of pressure or tightness in the chest. The pain also called as angina is generally started off by some sort of stress either physical or emotional. This pain resolves as soon as the stress resolves.

Shortness of Breath: This is caused since the heart is not able to pump enough blood to meet the demands of the body resulting in shortness of breath with activities or even at rest.

Heart Attack: If the artery gets completely blocked then it results in a heart attack. Some of the characteristic features of a heart attack are severe pressure feeling in the chest along with pain in the left arm along with shortness of breath and sweating.

Symptoms Of Coronary Artery Disease

Does Coronary Artery Disease Qualify For Disability Benefits?

The Social Security Administration (SSA) makes use of a manual which has a detailed list of pathological conditions qualifying for Social Security Disability benefits. This manual is also known as Blue Book. This manual has a comprehensive list of pathological conditions which according to SSA qualify for Social Security Disability benefits provided the claimant meets the criteria specified in the Blue Book.

Based on the Blue Book, Coronary Artery Disease qualifies for Social Security Disability benefits provided the claimant meets the specifications mentioned below:

The Blue Book states that the claimant should be experiencing symptoms due to Myocardial Ischemia caused by Coronary Artery Disease like any one of the following:

Anginal Pain

  • Angina Pectoris: This is a type of chest discomfort which is brought on by any type of stress either activity related or stress related and this pain or pressure rapidly ceases with rest or by taking nitroglycerin
  • Atypical Angina: This is a type of discomfort which is present at other areas of the body apart from the chest like the inner part of the left arm, jaws, neck, back and upper part of the abdomen
  • Anginal Equivalent: By anginal equivalent, it is meant that the individual experiences shortness of breath with exertion but does not have any complaints of chest pain or pressure
  • Variant Angina: These are episodes of angina ar rest as a result of spasm of the coronary artery.

Under SSA specifications for disability due to coronary artery disease, there is also Silent Ischemia, which is the term given to an individual having myocardial infarction without any presenting pain or symptom.

Additionally, the specifics for disability due to coronary artery disease also describe that the claimant should have any one of the following:

  • Abnormal stress test
  • Ischemic episodes
  • Abnormal imaging.

Abnormal Stress Test: A stress test is said to be abnormal when the claimant is made to exercise at a load which is equal to or less than 5 METs and it causes the following:

  • Downsloping ST segment depression of at least -0.10 mV lasting at least a minute into the recovery phase
  • A minimum of 0.1 mV of ST segment elevation with exercise lasting a minute into the recovery phase
  • A reduction of systolic blood pressure by 10 mmHG or more below the baseline pressure
  • Documentation of ischemia at exercise level of 5 METs or less on imaging study like an EKG.

Ischemic Episodes: The claimant should have had at least three ischemic episodes in a one year time frame, and with every episode, there should have been a revascularization procedure done or it should be documented that the revascularization procedure was unsuccessful

Abnormal Imaging: If it is documented that the stress test may be significantly risky for the patient then imaging studies like angiography can also be done showing coronary artery disease. There should be documented evidence on imaging that there is narrowing of the coronary artery by at least 70% and it should be mentioned that the disease is significant enough to impair the claimant's workability either at home or in a work environment.

Cardiospecific Troponins: According to recent guidelines, the diagnosis of acute myocardial infarction (AMI) is based on increased or decreased value of cardiospecific troponins.1 Troponin immunoassay is periodically used with electrocardiogram and cardiac enzyme test to diagnose coronary artery disease.

Eligibility For Disability Benefits For Coronary Artery Disease

Patients who had angioplasty, coronary artery stent placement and coronary artery bypass surgery are often considered for disability benefits.2 Few patients suffer with hearing loss following coronary artery stent placement and bypass surgery. Patient suffering with bilateral hearing loss too are considered for social security disability.3

Role Of SSD Attorney In Improving The Chances Of Winning The Disability Claim For Coronary Artery Disease

Statistics show that majority of the claimants applying for SSD benefits for coronary artery disease are denied of any SSD benefits during the initial hearing. Most of the patient either postpone or avoid applying for disability benefits because of fear of denial and lengthy application. The process of application is lengthy and tedious. Lack of experience and knowledge of filling the long application forms combined with administrative obstacles often discourages applicants. This is where an experienced SSD attorney is helpful. An experienced SSD attorney has significant experience in handling disability cases and is the best person to present the case in front of the judge in the most appropriate manner and is quite familiar with rules of Social Security Administration thus helping the claimant get disability benefits. The attorney also has significant knowledge as to what to present to the judge in support of the claim for social security disability benefits for coronary artery disease at the time of the hearing and what the judge may be looking for in the documentation provided. An SSD attorney gets paid only after the claimant has been granted disability benefit thus the attorney goes all out to make sure that his or her client wins the disability claim.

One thing to understand here is that even if the claimant does not meet the criteria specified above for qualifying for disability benefits due to Coronary Artery Disease, even then under some circumstances a claimant becomes eligible for qualifying for Social Security Disability benefits due to Coronary Artery Disease. For this, it has to be proved that the claimant is not in a position to be gainfully employed due to the disease. If the Social Security Administration considers that the disease has impaired the life of the claimant such that he or she is unable to perform any sort of work then in that case the claimant can be considered as disabled.

Towards this, the SSA takes into consideration all the relevant evidence put forth in the case and determines the Residual Functional capacity of the claimant. RFC of an individual is the sort of work that individual can do be it sedentary, light duty work, or medium capacity work on a regular and continuous basis at least six to eight hours a day, five days a week irrespective of the impairment caused by the disease. While assessing the RFC of the claimant, the SSA assesses the ability of the claimant to sit, stand, walk, lift, push, pull, and carry items. As an example, if there is medical evidence stating that an individual cannot lift more than 10 pounds on a frequent basis due to dyspnea but the individual can stand or walk for at least six hours a day five days a week then the RFC of the individual will be for light duty work

Once the RFC of the claimant is determined, the SSA uses this information to finally decide whether the claimant is capable of performing the prior job with limitations. In case if restrictions are not able to be accommodated in the prior job setting then the SSA decides if any vocational retraining is required based on the age, educational qualification, work experience, and RFC of the claimant.

If an individual is significantly impaired and is not able to be gainfully employed due to Coronary Artery Disease then the individual is eligible to receive Social Security Disability benefits. By providing detailed medical records by the treating physician pertaining to the disease and the impairments caused due to it along with laboratory evidence, and other documented proof that the individual is significantly impaired due to Coronary Artery Disease and is not in a position to be gainfully employed then there should be no issues with getting disability benefits for CAD. It is advisable that the claimant work in coordination with the treating physician along with an experienced SSD attorney to gather the required information and develop the case supporting the claim in front of the honorable judge at the time of hearing so that the chances of getting disability benefits due to Coronary Artery Disease becomes extremely bright.

Conclusion:

In summary, an individual suffering with Coronary Artery Disease having significant impairment of function due its symptoms and is not in a position to work under any capacity should work in coordination with his or her treating physician and should hire an experienced disability attorney to prepare and develop the case in order to get Disability Benefits for Coronary Artery Disease.

References:

1. Diagnosis and management of ischemic heart disease.

Lippi G1, Franchini M, Cervellin G.

Semin Thromb Hemost. 2013 Mar;39(2):202-13.

2. Symptoms of angina pectoris increase the probability of disability pension and premature exit from the workforce even in the absence of obstructive coronary artery disease.

Jespersen L1, Abildstrøm SZ, Hvelplund A, Galatius S, Madsen JK, Pedersen F, Højberg S, Prescott E.

Eur Heart J. 2013 Nov;34(42):3294-303.

3. New potential determinants of disability in aged persons with myocardial infarction: results from the KORINNA-study.

Quinones PA1, Seidl H, Holle R, Kuch B, Meisinger C, Hunger M, Kirchberger I.

BMC Geriatr. 2014 Mar 19;14:34.

Written, Edited or Reviewed By:

, MD, FFARCSI

Last Modified On: May 3, 2016

Pain Assist Inc.

Pramod Kerkar
  Note: Information provided is not a substitute for physician, hospital or any form of medical care. Examination and Investigation is necessary for correct diagnosis.

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