Can You Get Disability Benefits for Cardiomyopathy?

Cardiomyopathy is a medical term for an enlarged, hardened, or weakened heart muscle. Most types of cardiomyopathy (kar-dee-oh-my-AH-pah-thee) make it difficult for your heart to pump blood properly, causing symptoms such as fatigue, dizziness, and trouble breathing.

Mild symptoms of cardiomyopathy are often treated successfully with medication. But people with more intense symptoms can have trouble with basic daily tasks and can eventually become unable to work. When cardiomyopathy is severe enough to prevent you from working full-time, you might qualify for Social Security disability benefits.

What Types of Cardiomyopathy Qualify for Disability?

When the Social Security Administration (SSA) reviews an application for disability benefits due to cardiomyopathy, the agency looks at the medical records to see what kind of cardiomyopathy is present. Some types can qualify an applicant for automatic disability under the SSA's "Blue Book" of listed impairments for heart disease.

The various types of cardiomyopathy fall under two major categories: ischemic and non-ischemic. The SSA evaluates disability applications ("claims") based on how the cardiomyopathy is classified.

Ischemic Cardiomyopathy

Ischemic (eh-SKEE-mik) cardiomyopathy is a heart condition that occurs after you've had a heart attack or as a result of coronary artery disease, which causes your arteries to harden and restrict blood flow to your heart. If your medical records contain specific results from diagnostics such as a heart ultrasound, cardiac catheterization, or stress test, Social Security can find you disabled under Listing 4.04 for ischemic heart disease.

Non-Ischemic Cardiomyopathy

Non-ischemic cardiomyopathy is the general term for all types of decreased heart function that aren't caused by a heart attack or coronary artery disease. Cardiomyopathies that fall in this category include:

• Dilated cardiomyopathy causes the chambers of the heart (ventricles) to become enlarged. Myocarditis (inflammation of the heart) can develop into dilated cardiomyopathy over time. The SSA reviews the condition under its disability listing for chronic heart failure.
• Hypertrophic cardiomyopathy causes thickening of the heart muscle in one ventricle, preventing the heart from resting properly between beats. Severe cases of hypertrophic cardiomyopathy are evaluated under the listing for chronic arrhythmias.
• Restrictive cardiomyopathy causes the heart muscle to stiffen, making the heart unable to fill with enough blood. Advanced cases can result in biatrial enlargement (enlargement of both the left and right upper chambers), which can lead to congestive heart failure.
• Alcoholic cardiomyopathy causes the heart to change shape because of long-term, heavy alcohol use. Social Security can evaluate this condition as chronic heart failure, unless the agency thinks your condition could be reversed if you quit drinking.

Some types of cardiomyopathy are acute—meaning they're temporary, or expected to be temporary—unlike the cardiomyopathies above, which are chronic (permanent or long-lasting).

Stress-induced, chemotherapy-induced, or pregnancy-induced cardiomyopathies likely won't qualify for disability because they can often improve within weeks or months.

What Cardiomyopathy Symptoms Are Disabling?

Few disability applicants ("claimants") have the exact medical documentation needed to meet the requirements of Social Security's listings for heart disease. But the SSA can still find you disabled if you can show that your cardiomyopathy symptoms prevent you from doing any job.

Common Symptoms of Cardiomyopathy

Not everybody with cardiomyopathy will have the same symptoms, and the mildest cases might not have any at all. (Claimants with a diagnosis of cardiomyopathy, but no symptoms, will likely have a hard time getting disability without an additional impairment.)

Social Security will review your medical records for evidence of:

• shortness of breath
• fatigue
• dizziness, lightheadedness, or fainting ("syncope")
• chest pain, and
• swelling in the legs, feet, abdomen, or veins in the neck.

If you're experiencing these symptoms, make sure that you report them to your doctor. Your medical history is the foundation of your disability claim. The SSA will look for evidence of cardiomyopathy symptoms by asking your permission to obtain copies of any medical treatment you've received and looking at what your doctors have said about your condition.

Medical Evidence You Should Have for Cardiomyopathy

Ideally, your medical records will contain the following:

• progress notes from your regular doctors that include their observations of your symptoms
• results of physical examinations and exercise stress tests that show any abnormalities in how your heart pumps blood
• a list of medications you've been taking for cardiomyopathy or related conditions, including the date they were prescribed, the amount prescribed, and any side effects
• admission and discharge notes for any hospital visits or surgical procedures, and
• imaging such as angiography (a special kind of X-ray), echocardiogram (ECG), ultrasound, or MRI.

Any functional limitations you have that can be backed up by evidence in your medical records will factor into Social Security's assessment of your residual functional capacity (RFC). Your RFC is a set of restrictions that reflect the most you're capable of doing, physically and mentally, in a work environment.

Disabling RFCs for Claimants With Cardiomyopathy

Because cardiomyopathy symptoms can often cause physical limitations, a typical RFC for claimants with cardiomyopathy will likely include restrictions on how long they can sit, stand, and walk, as well as how much weight they can lift and carry. Social Security calls any restrictions you have with these basic fundamental activities your exertional level. (For example, if you can never lift over 20 pounds, your exertional level could be for light work.)

Restrictions in your RFC that aren't about the heaviest object you can lift or how long you can be on your feet are called non-exertional limitations. For example, if you experience dizziness as a result of your cardiomyopathy, your RFC might prohibit you from working at heights or around dangerous machinery.

Social Security will take your RFC and compare your current restrictions with the physical and mental demands of your previous work to see whether you could perform any of your past jobs now. If the SSA finds that you can't return to work that you've done before, the agency will then determine whether any other jobs exist that you can do.

The more limitations that are in your RFC, the less likely it is that Social Security will determine that you can do any jobs. You can help the agency understand what your restrictions are by thoroughly completing the function report form with your disability application. The SSA doesn't know what you can and can't do unless you tell them, so be specific and detailed when filling out this important form.

For more information, see our article on how to accurately describe your activities of daily living.

_{Updated November 29, 2022}