Blood clots can form in any blood vessel in the body. Formation of small clots in the tiny vessels nearest the surface of the skin rarely cause any serious health concerns and typically require little to no medical intervention; however, those that form in the larger and deeper veins in the body can be associated with, or result in, very serious health concerns. Many of the medical conditions associated with larger blood clot formation can qualify for Social Security Disability (SSD) benefits. Just a few of the most common conditions associated with the formation of blood clots include strokes, heart arrhythmias, and arteriosclerosis or atherosclerosis.
Applying for SSD with Blood Clots
Your application for SSD benefits must be based on the medical condition that is associated with, or causes, your blood clots to form, rather than on simply the occurrence of the blood clots themselves. This is because there is no dedicated listing for blood clots among the Social Security Administration’s (SSA’s) Blue Book, which is the manual of potentially disabling medical conditions that Disability Determination Services (DDS) staff uses to review applications under the SSA’s eligibility criteria for disability benefits.
As there are many condition associate with, or caused by, blood clots, there are also many sections of the SSA’s Blue Book which could apply to your application for SSD benefits. For example, if your blood clots are the result of an underlying heart condition, then section 4.00: Cardiovascular System, would be the appropriate section for you to review in consultation with your medical doctor and your disability advocate or Social Security disability attorney.
This section of the Blue Book contains a number of listings of specific cardiovascular conditions, several of which can be associated with the formation of blood clots. Your application for SSD should meet the listed criteria for the condition from which you suffer in order for you to be found eligible for disability benefits, including:
- Section 4.05 – Recurrent arrhythmias
- Section 4.06 – Symptomatic congenital heart disease
- Section 4.10 – Aneurysm of aorta or major branch, from any cause
Formation of blood clots in the lungs, or in other areas of the body which then move to the lungs, is also a very serious and quite common affliction. Again, there are several medical conditions in which these kinds of blood clot incidents can occur. If your blood clots involve your respiratory system, then you’ll want to review the SSA’s Blue Book Section 3: Respiratory System, again, in coordination with your treating physician and your Social Security advocate or disability attorney.
Listings that appear under this section that can be pertinent to an application for SSD benefits involving blood clots can include:
- Section 3.02 - Chronic pulmonary insufficiency
- Section 3.09 – Cor pulmonale secondary to chronic pulmonary vascular hypertension
If your medical records and other documentation do not meet the listing for any specific condition, you may still qualify for benefits, if your condition is severe enough to prevent you from maintaining gainful employment. In such a case, you can either:
- have documentation that proves your condition is equivalent in severity to another listed condition in the Blue Book
- meet the criteria for a “medical vocational allowance”, which essentially means that while your ailment doesn’t meet or match any listed condition with the SSA, it is nonetheless disabling and prevents you from earning a gainful living as a result
Medical Documentation Needed to Prove Blood Clots
Regardless of which underlying medical condition applies in your case, your application for disability benefits must include extensive medical documentation substantiating your claim. Medical evidence included in your application should encompass:
- Diagnostic test results documenting the cause of your blood clots and the effect they have on you
- Notes from your visits to the doctor, including details of physical examinations performed
- Records of any and all treatments you’ve undergone, including prescription drugs and other therapies
- Detailed statements from your primary care physician that include your symptoms, their frequency and duration, and how severe their affect is on you and your everyday physical and/or mental and emotional functions
- Documentation that your blood clots and your other medical conditions have not improved despite following the treatments you’ve been prescribed
Getting Help with Your Blood Clot SSD Application
When submitting an application for SSD benefits with any diagnosis, you must work in conjunction with your doctor to make sure your records are detailed and that they accurately reflect the affects your medical condition have on your everyday life and ability to work. As blood clots can result from many different medical conditions, you will also want to consider seeking assistance with your application from a Social Security advocate or disability attorney to ensure your documentation meets or matches the criteria for a listed medical condition, or substantiates acclaim for disability benefits under a medical vocational allowance.