In the medical field, a heart attack is called a myocardial infarction (MI). A heart attack, or MI, happens when the heart doesn't get enough blood flow because of a blockage in the coronary arteries. These 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 or have had to quit work, you may be able to get Social Security disability benefits.
A heart attack is the end result of "arterial stenosis" (narrowing of the arteries) and "ischemia" (inadequate supply of oxygen to the heart).
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 ("angina") 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.
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 might also receive other medication to help widen the blocked arteries and decrease pain.
Treatments following a heart attack may include:
Open heart surgery is often used when someone who has had a heart attack needs bypass grafting, a surgical procedure where a cardiac surgeon will "re-route" blood flow around the blocked artery, usually by using a blood vessel from the patient's leg or chest. In some cases, a surgeon may be able to bypass the arteries through a less invasive procedure than traditional open heart surgery.
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:
After a heart attack, Social Security might evaluate your condition under listing 4.04 for "ischemic heart disease." Listing 4.04 is for people who have coronary artery disease with obstructed blood flow to the heart.
To meet this listing, Social Security normally expects you to have symptoms of "myocardial ischemia" and your symptoms must occur even though you're following your doctor's recommended treatment plan.
The most typical symptom of ischemia is 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're active).
Some people have angina occurring at rest (especially at night), instead of having pain on activity. 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.
In addition to documentation of these ischemic symptoms, listing 4.04 states you must also have one of the following:
For the detailed stress test and imaging 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 guessed, the criteria required to meet the cardiac listings are very specific and can be hard to understand if you're not a doctor. You could show your doctor listing 4.04 and ask if you might meet its requirements.
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 Blue Book. Instead, Social Security approves the claims when disability applicants' limitations make them unable to perform their previous jobs, and they're unable to transition into other types of work.
To decide if you're unable to work at any job, Social Security will look at your medical records to see whether your heart-related problems limit your ability to do many work-related activities. You aren't expected to do a job that's beyond your capabilities, physically or mentally.
To prove that there are no jobs within your capabilities, first, 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, next 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 only two hours a day due to fatigue or shortness of breath (sedentary work).
A full RFC for someone who has experienced a serious heart attack might include the following limitations:
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. Let's look at how the SSA uses your RFC.
Social Security will look at each job you've done in the last 15 years to see if you could do any of them now, with your current RFC and cardiac limitations. If you can't be expected to do the work safely, the agency will determine whether any other easier jobs exist that you can do.
Most younger disability applicants need to show that they can't do even the least physically demanding jobs before Social Security will award them benefits. But if you're 50 years of age or older, you might be able to use the medical-vocational grid rules to qualify for benefits if you can physically perform light or sedentary work, but you've never done it before (and can't learn the skills to do it).
Social Security requires a "longitudinal clinical record," meaning that you must have had at least three months of treatment with a cardiologist, unless the agency already has enough evidence for Social Security to make a decision. But Social Security also requires that your cardiovascular problems have been, or are expected to be, disabling for a year or more, so continuing to see your doctor for your condition is very important.
At a minimum, your medical records should include:
If you've had a heart attack, you will probably require a coronary artery bypass graft (CABG, pronounced as "cabbage"). Will having a CABG get you disability benefits? It depends on the extent of the damage caused by a heart attack and your prognosis. If just one of your coronary arteries required a bypass, the SSA isn't likely to consider you disabled.
But a person with a CABG x 2 (two arteries bypassed and grafted—a double bypass) will have less of a chance of re-entering the workforce than an individual with a CABG x 1 (a single artery bypassed), and Social Security recognizes that.
Patients who've had a triple bypass (three arteries grafted or bypassed) or a quadruple bypass (four arteries grafted or bypassed) are even less likely to be able to work again. The medical reasoning behind this is clear: more extensive grafting implies more damage to the heart and less likelihood of full recovery. While having a triple bypass or quadruple bypass doesn't automatically qualify for disability, the more serious the damage to your heart, the higher your chances of getting approved.
But whether you can get disability benefits after a CABG will depend on:
For more detailed information, see our article on when you can get disability for coronary artery disease.
A convenient way to apply for Social Security disability benefits is to file your claim online at www.ssa.gov/applyfordisability. Here are three other ways to apply:
For more information, please see our article about applying for Social Security disability benefits
Updated September 15, 2023