I have CHF, bradycardia, hypertension, diabetes, high cholesterol, acid reflux, and sleep apnea; can I get disability?

Question: I had a heart attack in November 2012 and I went back to work after being told I needed a pacemaker. In March of 2013, my heart rate went to 40 and I was hospitalized for a few days and then sent home. It did it again in June and […] they took me to surgery and gave me a pacemaker. The cardiologist says my bottom chamber was blocked. I was diagnosed with CHF, bradycardia, hypertension, diabetes, high cholesterol, acid reflux, and sleep apnea. My blood pressure will not stay stable – it’s been like that for years — my doctor says my blood pressure was controlling my heart. I am taking Carvedilol 2×day, Lisinopril-Hctz, Potassium, Norvas, and Nexium. I can’t work anymore; can I file for disability?

Answer: If your pacemaker implant was successful, it may not help you much in getting disability. (See my earlier blog post on pacemakers and disability for more information.) In general, Social Security is less interested in diagnoses and more interested in how and your day-to-day functioning is limited. You didn’t mention how you are actually limited in functioning, and the only way to get disability for heart failure without proving that your limitations prevent you from doing any job is to meet Social Security’s disability listing for CHF. If you’ve had three (or more) episodes of acute congestive heart failure over the past year that required extended emergency room treatment or hospitalization, Social Security should grant you disability benefits for meeting the CHF listing without even needing to look at whether your daily functioning is limited. Having failed an exercise stress test can help you meet this listing as well.

But, assuming you haven’t been hospitalized for CHF since your pacemaker implant, you’re more likely to get disability benefits by proving to Social Security that your activities are so limited that there isn’t any work you can do. Ask your doctor what New York Heart Association (NYHA) Functional Classification you fall under: Class I, II, III, or IV. (Class I patients have few symptoms and no limitation in ordinary physical activity while Class IV patients have severe limitations and experience symptoms even while resting). This will give you an idea where you stand, as far as the severity of your limitations. Social Security is more likely to find Class III and IV patients as unable to work due to the severity of their symptoms.

But the way to prove to Social Security that your limitations are too severe for you to work a full-time job is not with your NYHA class but by getting your cardiologist to fill out a functional capacity form saying what you are not able or allowed to do (such as not being able to walk for more than one hour per day or not being able to lift more than 25 pounds) as well as what you are capable of doing (such as being able to sit upright for six hours to eight hours per day).

If your doctor’s form or medical records do prove that you have severe limitations or restrictions, this limits the number of jobs Social Security can say you are able to do, making it harder for Social Security to find you “not disabled.” But if Social Security finds you can do sedentary work (a desk job), you won’t be found disabled unless you don’t have the skills to do sedentary work and you’re over 50 (and you can’t return to your previous work because of your limitations or doctor’s restrictions). Social Security also has to consider how the combined effect of all of your conditions limit your abilities, so make sure you have documentation of all of your conditions when you apply.

Social Security has rejected plenty of applicants who have pacemakers, CHF, high blood pressure, diabetes, and other conditions, so you may want to consult a Social Security disability attorney for help in getting disability benefits.