Facts about Congenital Heart Defects and Filing for DisabilityThese selected pages answer some of the most basic, but also some of the most important, questions for individuals who are considering filing a claim for disability benefits. Facts about the condition 1. Congenital heart disease is actually a defect of the heart muscle and is present at birth. There are a variety of abnormalities that can fall under the broad spectrum of congenital heart defects. 2. Some heart defects are obvious soon after birth. Other heart defects may not show symptoms until the age of three or later. The more serious types of defects show up earlier in a child's life. 3. Signs that a newborn may have a serious heart defect include pale, gray or blue skin color, swelling (especially in the legs, abdomen or around the eyes), shortness of breath and poor weight gain. 4. Signs that an older child may have a heart defect are experiencing shortness of breath or tiring easily during activity, fluid in the heart or lungs, and swelling of extremities (hands and feet). 5. Of all birth defects, heart defects are both the most common and the main cause of death. However, medical advancements have resulted in a higher survival rate and now more adults are living with congenital heart disease. 6. It is unknown exactly what causes some children to experience problems with heart development that results in a defect. There are, however, some risk factors that have been determined, including conditions like rubella and diabetes, medications like lithium (for bipolar disorder), and alcohol use during pregnancy. It is also apparent that genes play a role, since some genes have been identified for heart development. Genetic conditions such as Down syndrome also increase the likelihood of a congenital heart defect. 7. Some heart defects require minimal treatment or no treatment at all. Others may require significant medical procedures such as open heart surgery or even a heart transplant. Some children may have to have multiple procedures throughout their lives to treat their heart defect. 8. Regardless of successful treatment for a congenital heart defect, adults with the condition should be aware of increased risk for heart problems later in life. Qualifying for disability benefits with this condition Whether or not you qualify for disability and, as a result, are approved for disability benefits will depend entirely on the information obtained from your medical records. This includes whatever statements and treatment notes that may have been obtained from your treating physician (a doctor who has a history of treating your condition and is, therefore, qualified to comment as to your condition and prognosis). It also includes discharge summaries from hospital stays, reports of imaging studies (such as xrays, MRIs, and CT scans) and lab panels (i.e. bloodwork) as well as reports from physical therapy. In many disability claims, it may also include the results of a report issued by an independent physician who examines you at the request of the Social Security Administration.
Qualifying for SSD or SSI benefits will also depend on the information obtained from your vocational, or work, history if you are an adult, or academic records if you are a minor-age child. In the case of adults, your work history information will allow a disability examiner (examiners make decisions at the initial claim and reconsideration appeal levels, but not at the hearing level where a judges decides the outcome of the case) to A) classify your past work, B) determine the physical and mental demands of your past work, C) decide if you can go back to a past job, and D) whether or not you have the ability to switch to some type of other work. The important thing to keep in mind is that the social security administration does not award benefits based on simply having a condition, but, instead, will base an approval or denial on the extent to which a condition causes functional limitations. Functional limitations can be great enough to make work activity not possible (or, for a child, make it impossible to engage in age-appropriate activities).
Why are so many disability cases lost at the disability application and reconsideration appeal levels? There are several reasons but here are just two: 1) Social Security makes no attempt to obtain a statement from a claimant's treating physician. By contrast, at the hearing level, a claimant's disability attorney or disability representative will generally obtain and present this type of statement to a judge. Note: it is not enough for a doctor to simply state that their patient is disabled. To satisy Social Security's requirements, the physician must list in what ways and to what extent the individual is functionally limited. For this reason, many representatives and attorneys request that the physician fill out and sign a specialized medical source statement that captures the correct information. Solid Supporting statements from physicians easily make the difference between winning or losing a disability case at the hearing level. 2) Prior to the hearing level, a claimant will not have the opportunity to explain how their condition limits them, nor will their attorney or representative have the opportunity to make a presentation based on the evidence of the case. This is because at the initial levels of the disability system, a disability examiner decides the case without meeting the claimant. The examiner may contact the claimant to gather information on activities of daily living and with regard to medical treatment or past jobs, but usually nothing more. At the hearing level, however, presenting an argument for approval based on medical evidence that has been obtained and submitted is exactly what happens. About the Author: Tim Moore is a former Social Security Disability Examiner in North Carolina, has been interviewed by the NY Times and the LA Times on the disability system, and is an Accredited Disability Representative (ADR) in North Carolina. For assistance on a disability application or Appeal in NC, click here. Most popular topics on SSDRC.com Social Security Disability in North Carolina Common Mistakes to avoid after being denied for Disability Tips to Prepare for Filing for Social Security Disability or SSI Advice to Win SSD and SSI Benefit Claims Social Security Disability SSI Questions What is the difference between Social Security Disability and SSI? How to get disability for depression Getting disability for fibromyalgia SSI disability for children with ADHD What is the Application Process for Social Security Disability and SSI? Social Security Disability SSI Exam tips More Social Security Disability SSI Questions What makes you eligible for Social Security Disability or SSI? Related Body System Impairments: If you have had a heart attack will you qualify for Social Security Disability? Angina and Filing for Disability Arrhythmia and Filing for Disability Brain Aneurysm and Filing for Disability Cardiomyopathy and Filing for Disability If you have had a heart attack will you qualify for Social Security Disability? Angina and Filing for Disability Arrhythmia and Filing for Disability Brain Aneurysm and Filing for Disability Cardiomyopathy and Filing for Disability Cardiovascular Heart Stenosis and Filing for Disability Congenital Heart Defects and Filing for Disability Congestive Heart Failure and Filing for Disability DVT Deep Venous Thrombosis and Filing for Disability Heart Attack and Filing for Disability Heart Murmur and Filing for Disability High Cholesterol and Filing for Disability Lymphedema and Filing for Disability Mitral Valve Prolapse and Filing for Disability Peripheral Arterial Disease and Filing for Disability Triple Bypass Surgery and Filing for Disability Thrombosis and Filing for Disability Tachycardia and Filing for Disability Wolff-Parkinson-White and Filing for Disability Congestive Heart Failure, Social Security Disability, and Applying for Benefits Heart Attack, Social Security Disability, and Applying for Benefits Will I qualify for Social Security Disability SSI in California Getting a Social Security Disability SSI Attorney in California How long do disability claims take in California and why |
