30,000 organ transplants occur in the United States each year, and approximately 2,000 of those are heart transplants. While it typically takes 3-6 months to fully recover from this complicated surgery, some patients need a full year to recover.
Survival rates for heart transplants have improved significantly, with nearly 90% of patients surviving after one year and 75% of patients remaining alive after five years.
If you require a heart transplant and are unable to work due to your condition, there could be financial help available to you. The Social Security Disability Insurance (SSDI) program was created to assist those who have become disabled due to a life-limiting illness such as heart failure.
What Can I Expect From My Heart Transplant?
A heart transplant is a surgery done to remove a person’s diseased heart and replace with a healthy heart from a deceased person. A heart transplant is considered when all other options have been exhausted, and the person has developed end-stage heart failure.
A heart transplant is recommended for someone who is sick enough to need a new heart, yet well enough to handle the surgery and recovery. Heart transplants are most often performed on patients with coronary heart disease, viral infections of the heart, damaged heart valves and muscles, or hereditary conditions.
There are many risks associated with a heart transplant, such as infection, bleeding, cancer, and blood clots. However, the biggest risk is a rejection of the heart. Patients who receive a heart transplant must take medications to prevent their immune systems from attacking their new heart.
What Symptoms Do I Need to Qualify for Social Security for My Heart Transplant?
There is a range of symptoms that can be expected when you have a heart transplant, and they all could affect your ability to work (albeit a bit differently depending on the symptom). Here are some relevant facts about your application for benefits related to your heart transplant from the Social Security Administration (SSA):
- A heart transplant is one of the few conditions listed in the SSA’s impairment listing manual, or “Blue Book,” that meets approval for financial benefits with no additional criteria needed.
- A heart transplant is listed in Section 4.09 of the Cardiovascular System in the “Blue Book.” It states that all heart transplant recipients will be eligible for disability for at least one full year from their transplant.
- After the one-year anniversary of your heart transplant, the SSA will reevaluate you to determine if your illness continues to be disabling enough to keep you from working. You will be evaluated on what is called your “residual impairments.” This means that you will be responsible for providing evidence of your health and your work capabilities as related to your health. The SSA will consider the following:
- How well you are functioning since your transplant, including a full assessment of your cardiovascular system.
- Health complications that may have developed in other parts of your body since your heart transplant, such as newly developed health issues.
- If you have had any rejection episodes and how often or severe they were.
- Any negative reactions that you may have had to treatments, such as adverse reactions to your immunosuppressant medications.
- Anyone requiring a heart transplant will have had health problems before they undergo transplantation. It is likely that you will qualify for financial assistance through another section of the Cardiovascular System. For example, you will likely already qualify for benefits under Section 4.02, Chronic Heart Failure.
Do I Qualify for Benefits?
To be eligible for Social Security benefits, your medical records will need to show that your symptoms are severe enough to prevent you from working at a level that would support you. As discussed earlier, a heart transplant is a serious surgery that will allow you to qualify for benefits for at least one year from your transplant.
What Information Will I Need to Provide?
When applying for Social Security, you may be asked to provide the following:
- Confirmation of your diagnosis from a cardiologist, including progress notes and prognosis
- Cardiac tests related to your heart condition, such as echocardiogram, EKG, or stress test
- Blood tests to examine the extent to which your heart failure is affecting other organs, such as the liver or kidneys
- Chest x-rays, CT scans, or other imaging results that may help to evaluate the extent of your heart disease
- Any procedural test results, such as a coronary angiogram
- Surgical or pathology reports from myocardial biopsy
- Inpatient hospital notes
- Progress notes from any other health care providers directly involved in your care such as rehabilitation specialists or psychologist.
What’s Next?
If you have end stage heart disease and require a heart transplant, you should contact a disability advocate or lawyer in your area. When your health is suffering, it can be difficult to know where to turn or what to do next.
A qualified attorney can help you navigate the Social Security application process, leaving you time to focus on what’s most important: your health.
