Can I Quit Work and Get Disability After a Heart Attack?

In the medical field, a heart attack is called a myocardial infarction (MI). A heart attack happens when the heart doesn't get enough blood flow because of a blockage in the arteries. The arteries supply oxygen to the heart, so without blood flow, heart tissue loses oxygen and dies. The longer it takes to restore blood flow to the heart, the more damage to the heart muscle can occur.

Having a heart attack doesn't mean that you'll automatically qualify for Social Security disability benefits. In many instances, the Social Security Administration (SSA) won't consider a single heart attack and a single bypass graft as particularly disabling. Many people who've had heart attacks go on to live healthy lives with little to no residual symptoms from the heart attack, which can make getting Social Security disability for a heart attack difficult. But if you're experiencing serious limitations with your ability to work and perform day-to-day tasks, you may be able to get Social Security disability benefits.

What Causes a Heart Attack?

The most common cause of a heart attack is coronary artery disease (CAD). CAD is caused by a buildup of plaque in the arteries that supply blood to the heart (called the coronary arteries). Over time, plaque, which is made up of deposits of cholesterol, causes the arteries to narrow. This plaque buildup can lead to partial or complete blockage of blood flow. When this happens, it's called atherosclerosis.

Heart attacks sometimes come on suddenly without warning, but many people will have warning signs for hours or days in advance. Often, the most common warning sign is chest pain that is worse with activity and better with rest.

A family history of heart disease at an early age (50 or younger), smoking, alcohol use, diabetes, obesity, and autoimmune disorders, such as rheumatoid arthritis or lupus can all increase the chances of having a heart attack.

How Is a Heart Attack Treated?

Treatments while you're having a heart attack include aspirin, antiplatelet drugs (medication to prevent blood clots), and thrombolytic therapy (medication to dissolve blood clots). You may also receive other medication to help widen the blocked arteries and decrease pain.

Treatments following a heart attack may include:

• cardiac catheterization, which is a procedure where a thin tube (a catheter) is guided through the blood vessel to the heart to find where the blockage
• balloon angioplasty, which is a procedure where a balloon is attached to a catheter and is inserted into an artery to widen the artery and allow for more blood flow
• stent placement, which is a minimally invasive procedure where a metal or plastic tube (a stent) is placed inside a blood vessel to relieve a blockage, and
• bypass grafting, which is a surgical procedure where a cardiac surgeon will "re-route" blood flow around your blocked artery, usually by using a blood vessel from your leg or chest.

Can You Get Social Security Disability Because of a Heart Attack?

If you're experiencing severe limitations in what you can do because you've suffered a heart attack, you might be able to get Social Security disability benefits if you're prevented from working for 12 months or more. Social Security has two ways you can qualify for Social Security disability benefits:

• Meeting a "listing." Social Security has a disability evaluation handbook that outlines the criteria for disability for various medical conditions. Social Security calls these rules "listings."
• Being unable to work. Even if you don't meet a listing, you may still be eligible for disability benefits if you can prove that you have a severe medical impairment that makes you unable to do much physical activity.

Meeting a Listing for a Heart Attack

After a heart attack, Social Security might evaluate your condition under listing 4.04 for "ischemic heart disease." Listing 4.04 states that you must have coronary artery disease due to obstructed blood flow to the heart. To meet this listing, Social Security normally expects you to have angina (chest pain that's caused by activity or emotion and is relieved by rest or fast-acting medication like Nitroglycerin). You could also have atypical angina (pain occurring in places other than the chest, like the left arm, neck, jaw, or back) or the equivalent of angina (shortness of breath without chest pain when you are active). Instead of having pain on activity, some people have angina occurring at rest (especially at night). In this case, Social Security will want to see an electrocardiograph (ECG) showing "transitory ST-segment elevation." If you don't have angina at all, you might have "silent ischemia," which Social Security might accept if you have evidence of abnormalities on an ECG, Holter monitor, or medical imaging.

Your symptoms must occur even though you're following your doctor's recommended treatment plan. And in addition to these symptoms, listing 4.04 states you must also have one of the following:

• an abnormal stress test, which is a test that measures the heart's ability to respond to exercise in a controlled environment
• abnormal imaging results, or
• three ischemic episodes requiring bypass surgery or angioplasty.

For the detailed test results that Social Security wants to see to meet this listing, see our article on the disability listing for ischemic heart disease.

As you've probably figured out, the criteria required to meet the cardiac listings are very specific and can be hard to understand if you're not a doctor.

Being Unable to Work Due to a Heart Attack

Meeting the criteria explained in the listings can be difficult. In fact, most disability claims that are approved for benefits don't meet the criteria of one of the listings contained in Social Security's evaluation handbook. Instead, Social Security approves them because a disability applicant's symptoms and limitations make them unable to perform their previous jobs, and they're unable to transition into another type of work.

To decide if you're unable to work at any job, Social Security will look at your medical records to see whether you have enough evidence that your heart-related problems limit your ability to do many work-related activities. This means you must have a diagnosis of CAD and it must be backed up by medical findings, like ECGs, lab tests, or imaging, not just your reports about shortness of breath or chest pain.

If Social Security agrees that your diagnosis is serious and your condition is severe, a claims examiner will determine your Residual Functional Capacity (RFC). Your RFC is the most intensive work you can still do (medium, light, or sedentary), despite the limitations caused by your medical condition. For example, if you've suffered a heart attack, your doctor might limit you to standing a certain number of hours per day due to fatigue or shortness of breath.

A full RFC for someone who has experienced a serious heart attack might include the following limitations:

• walk and stand no more than two hours of an eight-hour workday
• sit no more than four hours of an eight-hour workday
• lift and carry no more than twenty pounds occasionally (defined as 1/3 of an eight-hour workday) and ten pounds frequently (defined as occurring from 1/3 to 2/3 of an eight-hour workday)
• occasionally stoop, crouch, crawl, kneel, or bend
• never climb ladders, ropes, or scaffolds, and
• occasionally climb ramps or stairs.

Social Security would probably find that someone with these limitations would be unable to complete a full work shift and so would be unable to perform most jobs.

What Medical Evidence Will Social Security Need to Decide Your Claim?

Social Security requires a "longitudinal clinical record," meaning that you must have had at least three months of treatment, unless Social Security already has enough evidence for Social Security to make a decision. But Social Security requires that your cardiovascular problems have been, or are expected to be, disabling for a year or more, so continuing to receive see your doctor for your condition is very important.

At a minimum, your medical records should include:

• reports of any tests you've had, like an ECG or an exercise stress test
• a summary of any hospitalizations or surgeries you've had
• a description of the ongoing medical care you're receiving
• documentation of medications you've tried and your response to them, and
• doctor's notes reflecting the frequency and severity of your symptoms.

How Do You Apply for Social Security Disability Benefits?

A convenient way to apply for Social Security disability benefits is to file your claim online at www.ssa.gov/applyfordisability. You can also file a claim over the phone by contacting Social Security at 800-772-1213, but be prepared for long wait times. For more information, please see our article about applying for Social Security disability benefits

If you have questions or you'd like help with your application, click for a free case evaluation with a legal professional, who can help you determine if the symptoms and limitations following your heart attack qualify for benefits.

_{Updated March 9, 2022}