Disability Benefits for Deep Vein Thrombosis (DVT) or Chronic Venous Insufficiency (CVI)

Deep vein thrombosis (DVT), also known as venous thromboembolism, is a common but serious medical condition where a blood clot forms in a deep vein, usually in the leg. The clot can become dangerous and potentially life-threatening if it breaks loose and travels to the lungs or heart. Complications from DVT may qualify as automatically disabling, particularly chronic venous insufficiency (CVI).

Getting Social Security disability for DVT by itself can be an uphill battle, since the condition often clears up with blood thinners and other treatment. However, serious cases of DVT or complications like CVI can be disabling if they keep you from working full-time for at least one year. Before you file your application for benefits, it’s a good idea to learn a little about the basics of these medical conditions and when Social Security will consider them disabling.

Can I Get Disability for Deep Vein Thrombosis (DVT?)

You may qualify for disability benefits if your DVT symptoms prevent you from earning money at the level of substantial gainful activity for at least 12 months. You’ll also need to meet the financial eligibility requirements for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI).

Because uncomplicated DVT symptoms are usually resolved effectively with treatment, it can be difficult to qualify for disability based on DVT alone. But if you have a heart disorder or other medical condition that also causes functional limitations, Social Security will assess how your combined impairments affect your ability to work.

How Do I Get Disability Benefits for DVT?

You can get disability for DVT if you can show that you’re unable to work at any job as a result of your medical condition (or conditions). The process by which Social Security decides whether you can work is called assessing your residual functional capacity (RFC). Your RFC is a set of limitations describing what activities you’re still able to do at work and what you should avoid. Social Security reviews your medical records and your daily routine to determine your RFC.

For example, DVT can cause significant pain in your affected leg, making it difficult for you to walk, climb, crawl, or stoop. Your RFC would then contain restrictions on performing jobs that involve using ladders or being on your feet all day. Or, because sitting for a long time can increase the risk of an embolism, your RFC might state that you’ll need to change positions frequently throughout the day, elevate your legs to relieve swelling, or take unscheduled breaks.

Social Security will review your work history and compare your current RFC with the demands of your past jobs to see if you could do any of those jobs today. If not, the agency will take your RFC—along with your age, education level, and job skills—into account to determine if you can do another job. For people under the age of 50, Social Security generally needs to see that you can’t perform the easiest sit-down jobs before you can get disability benefits. Applicants over 50 may be able to get benefits even if they can do less demanding jobs using a special set of rules called the medical-vocational grid. (You can learn more in our article on how Social Security decides if you can work.)

Can I Get Disability Automatically If I Develop CVI?

Chronic venous insufficiency is included in Social Security’s Blue Book of listed impairments, meaning that if your symptoms are severe enough, you may qualify for benefits without having to show that you can’t work at all. CVI is a complication from DVT that happens when the veins in your legs are damaged, preventing proper blood flow to your lower extremities that can cause pain, swelling, and ulcers in your legs that make it hard to sit, stand, or walk.

You can meet the requirements of listing 4.11 for chronic venous insufficiency if you’ve been diagnosed with CVI and your medical record contains evidence of the following:

• a type of severe swelling known as “brawny edema” that is extensive, meaning it covers one-third to two-thirds of a lower extremity, or
• cramping, burning, or itching of the legs (“varicosities”), scaling of the skin on the lower legs (“dermatitis”), or sores that are recurring or non-healing (“ulcerations”), despite being treated for at least three months.

If you don’t meet the requirements of listing 4.11, you might still get benefits automatically if your symptoms are “equal” to the listing. Equalling a listing means that the severity, frequency, and duration of your symptoms are functionally the same as those explicitly stated in the listing, even if they’re not an exact match.

What Medical Records Do I Need to Show That My DVT or CVI is Disabling?

Whether you’re applying for benefits due to DVT or CVI, Social Security can’t approve your claim without objective medical evidence. Doctors diagnose DVT by looking at medical imaging like X-rays, CT scans, and ultrasound (“Doppler”) reports, running blood tests, and measuring blood flow through the legs, so you should have documentation of these diagnostic tools in your medical records.

Your medical records should also include progress notes made by your doctor during your appointments and any treatment methods you’ve been prescribed. Treatment for DVT usually involves blood thinners (“anticoagulants” or “thrombolytics”), vein filters, and compression stockings. More serious cases of DVT can require surgery, so if you’ve had surgical treatment for your DVT, your records should include the intake and discharge documents for the procedure.

If you have a doctor (such as a cardiologist) that you’ve been seeing regularly for DVT treatment, you should consider asking your doctor to write a medical source statement in support of your disability application. Social Security values the opinions of doctors (specialists in particular) who are directly responsible for your care and can provide unique insight into your limitations.

How Much Is the Disability Payment for DVT or CVI?

Social Security doesn’t pay benefits based on the type of disability you have, so there’s no specific award amount for individual medical conditions. Rather, the amount of money you’ll receive depends on whether you’re eligible for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI).

SSDI eligibility is based on your earnings history and how many work credits you’ve acquired before you became disabled. Employment doesn’t matter for SSI eligibility, but it is a needs-based benefit subject to low income and asset limits. You can learn more (and calculate your estimated benefit amount) in our article on SSDI and SSI monthly check amounts.

How Do I File for SSDI or SSI?

Starting an application for SSDI or SSI is a fairly straightforward process. You can choose from one of the methods below to begin your claim.

• One easy way is to file online. You don’t have to complete the application in one sitting, and you’ll get a tracking number so you can check the status of your claim.
• You can also apply over the phone by calling Social Security at 800-772-1213 (TTY 800-325-0778) 8 a.m. to 7 p.m., Monday through Friday.
• If you prefer to file in person, you can schedule an appointment with a representative at your local Social Security field office.

When completing the application, you’ll need the contact information and treatment dates for all of your medical providers and the names, addresses, and dates of employment for all of your employers in the last five years. For more information, check out our step-by-step guide on applying for SSDI or SSI.

What if My Disability Claim Is Denied?

If a disability adjudicator reviewed your application and thought that you were able to return to your past work or that other jobs exist that you could do, you’ll receive a denial letter. (You’ll also receive a denial letter if you didn’t meet the non-medical eligibility requirements for SSDI or SSI, although those types of denials are harder to challenge.)

Don’t get too discouraged if your initial application for disability benefits was denied. You always have the option to appeal the denial, and can eventually request a hearing in front of an administrative law judge. (Most disability applicants who are ultimately granted benefits don’t get approved until after they’ve been in front of a judge.) You may also want to consider contacting a disability attorney to help increase your chances of a successful appeal. Disability attorneys work on contingency—meaning they get paid only if you win—and many offer free consultations, so it doesn’t hurt to ask around to find a lawyer you like.