SSA Listing 4.06-Symptomatic Congenital Heart Disease

Symptomatic congenital heart disease refers to heart abnormalities that are present at birth and result in noticeable symptoms. These conditions can significantly impact an individual's health and functioning. The Social Security Administration (SSA) provides disability benefits to individuals with severe impairments, including symptomatic congenital 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 symptomatic congenital heart disease based on the provided information in the Listing of Impairments.

Meeting the Criteria:

To meet the SSA's requirements for symptomatic congenital 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: Cyanosis at Rest

This section focuses on individuals with cyanosis (bluish discoloration of the skin) at rest. To meet the requirements, the individual must have one of the following:

1. Hematocrit of 55 percent or greater.

2. Arterial O2 saturation of less than 90 percent in room air or resting arterial PO2 of 60 Torr or less.

Section B: Intermittent Cyanosis on Exertion

This section addresses individuals with intermittent right-to-left shunting resulting in cyanosis (bluish discoloration of the skin) upon exertion. The criteria include:

1. Cyanosis on exertion (Eisenmenger's physiology).

2. Arterial PO2 of 60 Torr or less at a workload equivalent to 5 METs or less.

Section C: Secondary Pulmonary Vascular Obstructive Disease

This section focuses on individuals with secondary pulmonary vascular obstructive disease, which is characterized by elevated pulmonary arterial systolic pressure. To meet the requirements, the pulmonary arterial systolic pressure must be elevated to at least 70 percent of the systemic arterial systolic pressure.

The evaluation of symptomatic congenital heart disease by the Social Security Administration involves assessing the presence of specific symptoms, medical imaging, and physiological measurements as outlined in the Listing of Impairments. Meeting the criteria is crucial to establish eligibility for disability benefits. If you or someone you know has symptomatic congenital 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.