Is A Heart Transplant A Disability?

What Is A Heart Transplant?

A heart transplant, also known as a cardiac transplant, is a surgical procedure in which one’s damaged, failing, and diseased heart is removed from their body and replaced with a healthier heart. The healthy heart that is transplanted into the patient undergoing surgery is taken from an organ donor who has recently passed away. Heart transplant surgery is reserved only for people who are considered to be too sick to survive without said transplant. In addition to this, people must meet a strict set of criteria in order to receive a heart transplant. 

The heart transplant procedure is an intricate procedure that typically takesheart-surgery-operating-room around 4 to 6 hours to complete. Generally speaking, heart transplant surgeries tend to have a high success rate. However, given the gravity of what is being done in the heart transplant procedure, a recipient’s recovery process is typically slower (a.k.a., more gradual) and can be quite painful, especially in the beginning of this process. Usually, it takes heart transplant recipients around 3 to 6 months to recover in full from the procedure. Because the recovery from heart transplant surgery is pretty standard in terms of taking up a significant period of time and potentially causing pain, the chances of heart transplant recipients returning to work immediately after their procedure are quite low. As such, people who have received a heart transplant can qualify for and become approved to get Social Security disability benefits through the Social Security Administration (SSA). 

Heart Transplant – Condition and Symptoms

Despite the fact that medical technology has made monumental advances since the turn of the last century, there are still times when a badly damaged or excessively diseased organ simply can no longer be helped by modern medicine. Fortunately, there are still options. While it would have been inconceivable a generation ago, a healthy human heart can be removed from an individual with a life-ending injury and placed in the chest of another person whose heart is no longer healthy enough to keep them alive.

Heart transplants are performed when all other medical interventions have failed and the patient’s heart is no longer capable of sufficiently pumping enough blood to meet the body’s needs. This disabling condition is known as heart failure, and can be caused by a number of conditions. Some of them are:

  • Cardiomyopathy (Weakening of the heart muscle)
  • Congenital Heart Defect
  • Arterial Disease
  • Valvular Heart Disease
  • Failure of a previous heart transplant
  • Viral infection of the heart muscle

Because the number of people who need a heart transplant dramatically exceeds the number of viable donor hearts available, most transplant centers have a waiting list. If a suitable donor heart becomes available for the next person on the list, that person is called. Once called, the patient must act quickly because the donor heart can only stay viable for transplant for a few hours. During the operation, the blood is circulated throughout the body by a mechanical pump. (At this point, a mechanical heart which is suitable for long-term use has not been successfully developed.)

After the operation is complete, the recipient of the heart will spend 1 to 2 weeks in the hospital, followed by extensive cardiac rehabilitation. Also, the patient will have to be monitored for signs of rejection. Rejection is a serious potential complication of a heart transplant. It happens when the patient’s body sees the new heart as a foreign substance that must be removed, so the immune system attacks it. The patient will be put on drugs to suppress their immune system for the remainder of their lives, making them highly susceptible to infections.

Is A Heart Transplant A Disability?

In order for people to qualify for Social Security disability benefits, they must have a disability. Disabilities generally refers to people having a medical condition that incapacitates and/or debilitates them to a certain, severe degree. The SSA defines “disability” as someone being unable to participate in substantial gainful activity (SGA) of any kind as a result of having a medically-heart-doctordeterminable mental or physical impairment that has lasted and can be (1) expected to last for a sustained period of time (at least 12 months long) or (2) expected to result in death. 

In order to be eligible for disability benefits, you have to meet the medical criteria listed in the SSA’s Blue Book as well as provide the SSA with evidence that proves you have had a heart transplant and it has prevented—or will prevent—you from participating in any SGA for a sustained period of time. This evidence should include all of your medical records and documentation, notes from your physicians and surgeons, and any other documentation you have that can prove you are disabled due to your heart transplant. 

So, is a heart transplant a disability? Yes, a heart transplant is a disability, according to the Social Security Administration (SSA). Organ transplantation—including heart transplants—will automatically make you eligible for disability benefits.

Filing for Social Security Disability with a Heart Transplant Diagnosis

Once again, being able to file, and actually filing, for Social Security disability benefits for a heart transplant centers around the question: is a heart transplant a disability?

A heart transplant is identified by the Social Security Administration (SSA) impairment listing manual (more commonly called the “Blue Book”) as one of the many transplants that qualify for disability. While most condition listings in this manual detail very specific diagnostic criteria that must be met in order to qualify for benefits, heart transplant is a rare exception - it is simply listed as a qualifying condition. The implication is that the health of a person who needs a heart transplant is already compromised to the point that disability benefits are warranted.

Under the guidelines detailed in the Blue Book, the recipient of a heart transplant is to be considered disabled for a period of 12 months following the date of the surgery. After that point, the case is to be evaluated based on any residual impact from the surgery. For example, if the immunosuppressant medication prescribed to prevent rejection of the donor heart were to cause kidney damage (which is a potential side-effect of some of these medications), the disability case would then be evaluated on the basis of the kidney problem beginning at the 1 year post-surgical date.

As already mentioned, the recipient of a heart transplant (or any other organ, for that matter) will, as a result of the anti-rejection medication, be extremely vulnerable to infections. While most of these infections would present little challenge to a fully-functioning immune system, they could be potentially life-threatening to someone whose natural immunity is compromised. As a result, such infections need to be monitored closely and treated aggressively.

Your Disability Case after a Heart Transplant

If your health has been impacted to the point that you need a heart transplant, chances are very good that you already qualify for Social Security Disability benefits. While your condition makes you a likely candidate for approval, it would be very wise of you to trust your case to a Social Security Disability attorney.

Less than one third of all disability cases are approved when they are firstuplifting-heart-support submitted. The rest have little choice but to appeal the initial decision if they choose to pursue the case further. Because of the sheer volume of cases handled by the SSA and state-run Disability Determination Service (DDS), the appeal process can drag on for months, sometimes years, before it is finally resolved.

To make matters even more frustrating, many of these denials are based on paperwork errors or omissions instead of the lack of a qualifying condition. Working in close collaboration with you and your medical team, an experienced Social Security Disability lawyer can make sure your application and its accompanying documents are in order before the paperwork is submitted, reducing the chance that your case will be denied for procedural reasons.

If you or someone you love is the recipient of a heart transplant, you already have an ally in your corner as you begin the disability application process. Having your case evaluated by a qualified Social Security Disability attorney will maximize the chances that your case will have a favorable outcome.

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