If you are a recent recipient of a heart transplant, or you have the procedure scheduled for the near future, you may qualify for disability benefits from the Social Security Administration (SSA).
The SSA maintains a master list of medical conditions that it considers disabling. Its listing for heart transplants is very clear and unambiguous: If you received a heart transplant, the SSA considers you fully disabled for one year. Thus, you qualify to receive disability.
That said, it is important to make sure you go about applying for disability benefits the proper way. Your application must be complete. It cannot contain errors or omissions. Otherwise, you may face a denial from the SSA. If this happens, you will have to undertake a long, arduous appeals process to qualify for benefits. It pays to get it right the first time you apply.
At the Law Offices of Ogle, Elrod & Baril, PLLC, our skilled and accomplished attorneys can help you understand how to get disability for a heart transplant. We have a strong, successful track record of helping our clients win disability benefits. We want to put our resources to work for you and make you our next happy client.
We offer free consultations and do not get paid until you do. Call our office today at 866-628-8179 to set up your appointment.
What Are the SSA’s Guidelines for Getting Disability Benefits for a Heart Transplant?
The SSA’s master list of approved conditions for disability—known as its “Blue Book”—features an entire section relating to heart disease and other cardiovascular disorders. For each disorder listed, the SSA explains the diagnostic criteria the patient must meet in order to receive benefits for that condition.
The section on heart transplants, section 4.09, is very cut and dry. It states that the SSA will consider you disabled for a period of one year following a heart transplant. That means you qualify to receive disability benefits for that period of time.
It is a good idea to meet with one of our disability lawyers and start the application process as soon as you know you will be having this surgery. The approval process can be long.
What Happens After One Calendar Year?
The SSA considers you disabled for one year after your transplant. After that, the organization will reevaluate your condition and make a new determination on whether you qualify for continuing benefits.
To qualify for continuing benefits, you must meet the Blue Book requirements for the condition that prompted your heart transplant to begin with. You may also demonstrate to the SSA that your condition impacts you in a way that is functionally equivalent to a Blue Book condition.
The other heart conditions that qualify for benefits include:
- Ischemic heart disease;
- Chronic heart failure;
- Peripheral artery disease;
- Chronic venous insufficiency;
- Aneurysm of aorta or major branches;
- Recurrent arrhythmias; and
- Symptomatic congenital heart disease.
Each of these conditions has its own set of criteria, clearly defined in its respective Blue Book listing, that you must meet to receive continuous benefits. We can work with you to gather the evidence necessary to build a case that you deserve disability benefits for residual effects after your one-year period comes to a close.
What If I Do Not Meet the Blue Book Criteria for a Listed Condition?
If you do not meet the Blue Book criteria for a listed condition once your one-year period ends, we can use another method to seek continuing benefits. We do this by demonstrating that the effects of your condition are functionally equivalent to those of a Blue Book condition.
Our method of doing this involves completing a Residual Functional Capacity (RFC) test. This test, which your doctor completes, establishes objective data that your condition impacts your functionality. If your RFC test shows you cannot work or carry out activities of daily living, the SSA may consider you disabled and approve your application for benefits.
Our attorneys have helped many clients win benefits through the use of an RFC test. While not a foolproof process, it offers the best chances of making our case to the SSA if your condition does not meet all criteria for a Blue Book listing.
Income and Work Requirements for Disability
Meeting the SSA’s medical criteria is only one requirement for receiving disability benefits for a heart transplant. You must also meet the income or work requirements for one or both of the two disability programs. These programs are Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI).
Both programs offer monthly compensation and other ancillary benefits to the disabled. However, SSDI is a government-run disability insurance program, while SSI is a means-tested benefit program for the needy.
SSDI operates like a disability insurance program. To qualify for benefits, workers must pay “premiums” through their payroll taxes. Accordingly, you cannot draw SSDI benefits unless you have a sufficient work history and have paid a certain amount of premiums into the program. You must also have a certain number of work credits based on your age.
Though SSDI is not an income-based program, the SSA will need to see proof that your condition leaves you unable to earn a livable wage. That is why you cannot qualify if your monthly income surpasses the substantial gainful activity limit. For 2017, this limit is $1,170.
SSI is a welfare program. The government put it in place to help disabled people who have little to no income and limited assets. If you make too much money or your net worth is too high, you do not qualify.
In 2017, you must earn less than $735 per month and have less than $2,000 in personal assets to qualify for SSI. These amounts may vary based on your family size.
We can examine your financial records and work history to determine which program is a better fit before you apply. In rare cases, you might qualify for both.
Call 866-628-8179 Today to Set up a Free Attorney Consultation.
Are you ready to get started? Contact the Law Offices of Ogle, Elrod & Baril, PLLC, today to schedule a free consultation with one of our skilled disability attorneys. Call us at 866-628-8179.