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Hypertension and Social Security Disability

Applying for Social Security Disability Benefits with Hypertension

The Centers for Disease Control and Prevention (CDC) report that one in three adult Americans have high blood pressure or hypertension. That’s about 70 million people, or nearly 30 percent of the adult population of the United States.

Hypertension carries an increased risk of developing heart disease, stroke, or other cardiovascular complications, but can severely affect other organs and body systems as well. The Social Security Administration (SSA) understands that uncontrolled high blood pressure can cause disability.

If your hypertension prevents you from working as you once did or has put an end to your ability to earn income from employment entirely, then you may be entitled to Social Security Disability Insurance (SSDI) and/or Supplemental Security Income (SSI) benefits. These programs pay benefits on a monthly basis and can help you cover the costs of everyday living expenses, medical care, and other bills.

The Costs of Hypertension

Hypertension that is uncontrolled by medications and other therapies takes its toll in many ways. It leads to higher medical bills, lower earnings, and increases the likelihood that you’ll miss work more often or that you’ll eventually be unable to work at all. It additionally compromises your everyday abilities, often slowly eroding your participation in social events, personal interests, and even family and home life activities.

The CDC reports hypertension’s total costs to the American public at more than 46 billion dollars annually. This figure includes lost days of work as well as medication and other healthcare costs. But what does that translate to for each person for whom hypertension is an ongoing health issue?

For the treatment of high blood pressure alone, the average annual expense was about $733.00 in 2010, according to the Agency for Healthcare Research and Quality (AHRQ). But that doesn’t account for the cost of hypertension health complications, especially for patients that have more serious high blood pressure-related impairments, like heart or kidney disease, stroke, macular degeneration, or glaucoma, to name just a few.

Because high blood pressure can have far-reaching consequences, your medical costs likely far exceed AHRQ-reported average. For each area of the body affected, you may have additional prescription and other treatment expenses. If your hypertension causes sleep apnea, for example, you may require a sleep study and a CPAP machine. National Public Radio reported the average cost of a sleep study at nearly $2,000.00 in 2012, and a CPAP costs about $850.00, according to the Sleep Association.

Over time, the affects of hypertension continue to accumulate, often adding up to significant financial costs, not to mention the personal losses you experience. Disability benefits can help cover your financial obligations and provide income on a consistent schedule. Approval for Social Security Disability also provides access to health coverage through Medicare and/or Medicaid.

Medically Qualifying for Benefits for Hypertension

The SSA uses “disability listings” in its Blue Book to review claims for benefits. These listings outline the severity level of a medical condition must achieve in order for it to be considered disabling. The Blue Book also describes the medical evidence necessary to support a claim for benefits.

It’s important to understand that there is no listing for hypertension, but the SSA still has standard methods for reviewing applications filed for this condition. Because hypertension can affect many areas of the body and can seriously compromise organ function, the SSA reviews high blood pressure claims under the listing for the organ or body system that is most severely affected.

Heart disease (4.00) and stroke (11.04) are among the most common complications, but the lungs (3.00), bones (1.00), kidneys (6.00), eyes (2.00), and brain function (12.00) can also be affected by high blood pressure.

The kinds of complications you experience from your hypertension determine how your claim is reviewed and the types of medical evidence you need in order to support your application. This can be confusing, but your doctor can help. Your treating physician can assist with understanding the disability listing under which you’re most likely to qualify. Your doctor can also help translate the medical terminology that appears so frequently in the Blue Book. When it comes to applying for benefits, your doctor is additionally your most powerful ally and can help ensure that your medical records are complete and available to the disability examiner that reviews your claim.

Qualifying for Disability without Meeting a Listing in the Blue Book

If your hypertension doesn’t meet or closely match any single listing in the Blue Book, the SSA will look at all of your medical conditions, including every complication you experience from your hypertension. They will examine your daily challenges and physical, mental, or emotional limitations. This process is known as a “residual functional capacity” or RFC analysis.

Through an RFC, the SSA looks examines how limited you are by your high blood pressure and other medical conditions. They take into account your age, education level, work history, and job-related skills. If all of these things combined show that you’re unable to find and maintain a job, then you can receive benefits even without meeting a Blue Book listing.

The RFC process requires you, your doctor, and perhaps others (like friends, family, or social workers) to complete “functional report” questionnaires. These forms are combined with your application, medical records, and other documentation, giving the SSA a clearer picture of your functional limitations.

RFC forms have a short window for completion and submission. Typically, it’s just ten days from the date that they are mailed. When you apply for benefits, you’ll provide contact information to the SSA for your doctor and others who know about your daily challenges. Make sure these people know they may receive forms in the mail and that your eligibility for benefits may hinge on them filling out and returning those forms on time.

How to Apply for Disability Benefits with Hypertension

Disability applications require extensive medical evidence. This is true whether you’re able to qualify through a disability listing or an RFC evaluation. Either way, the SSA needs to see specific tests and other medical documentation that supports your claim for benefits.

Your doctor can help you understand what records are required, based on the organs or areas of the body that are affected most profoundly by your high blood pressure. That being said, most hypertension claims must at least have the following evidence in the applicant’s medical history:

  • Frequent blood pressure results, preferably recorded by a doctor or nurse (Many doctors will let you stop by any time to have your blood pressure taken. Just make sure you have them record your results in your medical file each time you drop by the office.)
  • Treatment records, documenting medications and other therapies as well as their affects
  • Physical exam and clinical observation notes, recording changes in your physical, mental, and emotional abilities over time

Disability applications for hypertension must typically include “longitudinal reports.” These document your medical history over a period of three months or longer, and show how your high blood pressure symptoms and complications affect your ongoing health, everyday abilities, and ultimately, your employability.

Consult with your doctor before you apply, and if you’re concerned about proving your disability, seek assistance from a Social Security advocate or an attorney familiar with hypertension claims. You can even have someone go with you to apply in person at your local SSA office (for SSDI and/or SSI) or help you fill out your SSDI application online.