Having a pacemaker or implanted cardiac defibrillator (ICD) doesn't automatically qualify you for Social Security disability, especially if the device is controlling your symptoms well. Social Security will assess your condition and limitations in the same way as anyone else with a heart condition (except that the agency will wait for your condition to stabilize for at least three months after your pacemaker is installed to make a decision).
Social Security approves disability benefits for those whose activities are so limited by their condition that there is no job they can safely do. Social Security has two ways of assessing whether a disability applicant can work: determining if the applicant's symptoms and limitations meet the requirements of a disability listing in Social Security's Blue Book and measuring the applicant's limitations against the requirements of various jobs to see if there is work the applicant can do.
If you don't have active symptoms after having the pacemaker or defibrillator implanted, you aren't likely to meet a disability listing. But if your doctor has limited you to light or sedentary work, and you are 50 years old or older, you have a chance of getting an approval under the grid rules, which we'll discuss below.
The two main listings that would apply to someone with a pacemaker or implanted cardiac defibrillator are for arrhythmias and chronic heart failure.
Arrhythmias. If you have arrhythmias (irregular heartbeats) that aren't controlled by your pacemaker or defibrillator, you can check to see if you meet listing for recurrent arrhythmias. If you still have a slow or irregular heartbeat after implantation, and you have experienced three episodes of fainting or near fainting with altered consciousness in the past year, you should meet the requirements of the arrhythmias listing.
Heart failure. If you have congestive heart failure (diastolic or systolic), you could qualify under Social Security's listing for chronic heart failure. If, after implantation of a pacemaker, you still symptoms such weakness, shortness of breath, fatigue, and/or dizziness, you may qualify for benefits under this listing. To show that these symptoms are still severe enough to interfere with your ability to work, you need to prove one of the following:
These listings are not easy to meet, so most people with pacemakers or ICDs who qualify for disability benefits qualify because of their limitations.
If you can prove to Social Security that you can no longer work any type of full-time job due to your doctor's restrictions or self-reported limitations, you have a good chance of getting disability benefits. For example, if you experience such severe fatigue during the day that you must take breaks to lie down and rest, and Social Security believes this to be true, the agency would agree you are disabled.
But if your limitations aren't so extreme, Social Security may say there are jobs you can do that aren't that physically demanding. For instance, if your doctor has restricted you from working on hazardous equipment, or from walking or standing more than four hours per day, the number of jobs you are able to do is limited, but there are plenty of sit-down jobs you could do. If your past work was sedentary, you won't be found disabled.
If your past work did require a good amount of standing and walking, and you can no longer do it, you may be able to get disability under the "grid rules" if you're over 50 or 55. The grid rules lay out certain scenarios in which you must be found disabled. For instance, a 55-year-old who is limited to sedentary work (can't stand or walk for more than two hours per day) will be found disabled if he or she has a history of either unskilled work or work that didn't teach skills that can be used in sedentary work. See our section on the disability grid rules for more information.
Ask your cardiologist to fill out a residual functional capacity (RFC) form saying what you are not able or allowed to do (such as not being able to stand for more than one hour per day or not being able to lift more than 20 pounds). Social Security is required to rely on your doctor's opinion when it is backed up by objective evidence and consistent with the rest of the evidence in your file.
If you have an ICD, be sure to include information in your disability file about how often the ICD shocks you, whether these shocks are painful, how the shocks affect your ability to carry out your daily activities, and whether the shocks cause you psychological distress. Even if the ICD prevents you from experiencing cardiac symptoms, frequent shocks in response to benign arrhythmias or electrical malfunction may lower your RFC so much that there are no jobs you can do.
Consider hiring a disability lawyer to help prove that your limitations are too great for you to sustain any type of full-time work. Disability lawyers are not allowed to charge you if you don't win, and are limited to a small percentage of your disability backpay (up to $6,000) if you do win.