Always Accessible & Available for You Schedule a Free Consultation

SSA Listing 4.04- Coronary Heart Disease

Known as Ischemic Heart Disease in the medical field, does it qualify for Social Security Disability? June 13, 2023

Ischemic heart disease (IHD), commonly known as coronary artery disease, is a prevalent medical condition characterized by reduced blood flow to the heart muscle. The Social Security Administration (SSA) provides disability benefits to individuals who are unable to work due to severe impairments, including ischemic heart disease. To determine eligibility for benefits, the SSA has specific criteria outlined in the Listing of Impairments. In this blog post, we will explore how the SSA evaluates ischemic heart disease based on the provided information in the Listing of Impairments.

Meeting the Criteria:

To meet the SSA's requirements for ischemic heart disease, an individual must satisfy the criteria in at least one of the following sections: A, B, or C of the Listing of Impairments. Let's examine each section in detail.

Section A: Exercise Tolerance Test

This section focuses on the results of an exercise tolerance test (ETT), which evaluates the heart's response to physical exertion. To meet the requirements, the individual must demonstrate at least one of the following manifestations at a workload equivalent to 5 METs or less:

  1. ST Segment Depression: Horizontal or downsloping depression of the ST segment of at least -0.10 millivolts in at least 3 consecutive complexes that are on a level baseline in any lead other than a VR. The depression should last for at least 1 minute of recovery.

  2. ST Segment Elevation: At least 0.1 millivolt ST elevation above resting baseline in non-infarct leads during both exercise and 1 or more minutes of recovery.

  3. Decrease in Systolic Pressure: A decrease of 10 mm Hg or more in systolic pressure below the baseline blood pressure or the preceding systolic pressure measured during exercise due to left ventricular dysfunction, despite an increase in workload.

  4. Documented Ischemia: Documented ischemia on appropriate medically acceptable imaging, such as radionuclide perfusion scans or stress echocardiography, at an exercise level equivalent to 5 METs or less.

Section B: Revascularization or Unamenable to Revascularization

This section focuses on the occurrence of three separate ischemic episodes, each requiring revascularization or not amenable to revascularization, within a consecutive 12-month period.

Section C: Coronary Artery Disease with Serious Limitations

This section requires angiographic evidence or other appropriate imaging demonstrating coronary artery disease. Additionally, an MC (preferably experienced in cardiovascular disease) must conclude that performing an exercise tolerance test would present a significant risk to the individual. The criteria include:

  1. Angiographic Evidence: The angiography should show specific levels of narrowing in nonbypassed coronary arteries or bypass graft vessels.

  2. Very Serious Limitations: The individual must experience very serious limitations in the ability to independently initiate, sustain, or complete activities of daily living as a result of their coronary artery disease.

The evaluation of ischemic heart disease by the Social Security Administration involves assessing the results of exercise tolerance tests, occurrence of ischemic episodes, and angiographic evidence of coronary artery disease. Meeting the criteria outlined in the Listing of Impairments is crucial to establish eligibility for disability benefits. If you or someone you know has ischemic heart disease and is considering applying for disability benefits, it is advisable to consult with a knowledgeable professional or seek legal assistance to navigate the application process effectively. Remember, this blog post is a general overview, and individual circumstances may vary.