CHRONIC PULMONARY HYPERTENSION & DISABILITY
WHAT IS CHRONIC PULMONARY HYPERTENSION ?
Chronic pulmonary hypertension (CPH) is a serious condition that can affect every part of your life. It can make walking across a room or carrying groceries tiring. For many people, it leads to shortness of breath, fatigue, and even chest pain. These symptoms can make it nearly impossible to continue working. When a medical condition prevents you from working for at least 12 months, you may qualify for Social Security Disability benefits or SSI benefits.
However, winning a disability case for chronic pulmonary hypertension is not easy. The Social Security Administration (SSA) applies strict rules when deciding who qualifies for SSDI and SSI benefits. You must present medical evidence that meets their requirements.
In some cases, you may qualify by meeting a specific medical listing for CPH. In other cases, you will have to show that your symptoms prevent you from working at any job. Understanding SSA’s rules and gathering the right medical evidence are the first steps in winning SSD benefits. If you can’t work, then you need to replace your income. Hiring the best SSD lawyer can make the difference between winning and losing benefits.
UNDERSTANDING CHRONIC PULMONARY HYPERTENSION
Chronic pulmonary hypertension is high blood pressure in the arteries that carry blood from your heart to your lungs. This high pressure forces the right side of your heart to work harder to push blood through your lungs. Over time, the added strain can cause the heart muscle to weaken or enlarge. Additionally, your lungs may have difficulty exchanging oxygen. This leads to a wide range of symptoms. These symptoms include shortness of breath, fatigue, chest pain, and swelling in the legs, ankles, or abdomen.
The condition can be caused by many different underlying health problems. Chronic lung diseases, such as COPD, can lead to CPH. Heart problems, including left heart failure or valve disease, may also be a cause. Blood clots in the lungs, lupus, or even unknown causes can also lead to the condition. Because it is chronic, the condition does not go away with short term treatment. Also, it may get worse over time.
HOW CHRONIC PULMONARY HYPERTENSION AFFECTS DAILY LIFE
For those living with CPH, daily activities can become a struggle. Simple tasks, like walking to the bathroom, bending over to tie shoes, or carrying a small bag, can cause severe fatigue. Even talking for long periods can become tiring. Over time, the physical limits brought on by CPH can lead to emotional challenges, including anxiety and depression. Many people with CPH find themselves unable to keep up with the demands of a job.
The unpredictable symptoms from chronic pulmonary hypertension can make holding a steady job difficult. Some days may be better than others, but flares of chest pain, or fatigue can require rest and recovery time. This can result in frequent absences from work and difficulty completing a full workday.
The SSA will take these limits into account when evaluating your claim for benefits. But you will need strong medical evidence to support your claim for SSD benefits.
FILING APPLICATION FOR TWO FORMS OF SSD BENEFITS
If you have chronic pulmonary hypertension that keeps you from working, then there are two benefits for which you can file an application: Social Security Disability benefits and Supplemental Security Income benefits. You can file an application on the Social Security’s website. Below, you can find an explanation as to each type of benefit:
Social Security Disability Insurance (SSDI):
SSDI benefits are for those who can no longer work at any job due to a medical condition. The amount of money you will receive from SSDI benefits is based on your earnings during your work history.
To qualify for SSDI, you must have enough “work credits.” A work credit is an amount of taxable income. You can earn up to 4 work credits per year. The amount of work credits you need will depend on how old you are when you apply. If you haven’t earned enough work credits for your age at the time you apply, then you can only file for Supplemental Security Income benefits.
Supplemental Security Income (SSI):
SSI is a needs based benefit. It is for those people with little to no income, such as children and the elderly. Anyone who makes greater than a certain income per month cannot receive SSI benefits. The SSA counts the income of those in your house, not just your income and assets. The same applies if you have significant assets. If you have a boat, a cabin, and a motorcycle, you don’t qualify for SSI.
If you have a spouse who earns $5000 a month, then that income will prevent you from getting SSI benefits. You cannot be paid SSI benefits, no matter how severe your medical condition, if you do not meet the income and asset rules for SSI.
HOW THE SSA REVIEWS CHRONIC PULMONARY HYPERTENSION
When you apply for SSD benefits, the SSA will not approve your case simply because you have CPH. They will want to know how severe your condition is and when your CPH began. The SSA will also want to know how it limits your ability to work. Therefore, they will carefully review your medical records to find this information. This includes reading your test results, hospital records, and progress notes from your doctors.
One of the most important tests in CPH cases is a cardiac catheterization. This test measures the pressure inside your pulmonary arteries. This test is critical because it can determine whether you meet the SSA’s Listing 3.09 for Chronic Pulmonary Hypertension. Even if you do not meet the listing, the SSA will use your medical evidence to determine whether your symptoms prevent you from doing your past work or other work.
HOW TO MEET THE LISTING FOR CHRONIC PULMONARY HYPERTENSION
Listing 3.09 is the SSA’s medical standard for chronic pulmonary hypertension. You meet listing 3.09 if you have chronic pulmonary hypertension due to any cause, documented by a mean pulmonary artery pressure equal to or greater than 40 mm Hg as determined by cardiac catheterization while you are medically stable. The words “medically stable” mean that the test cannot be done during a sudden medical crisis, such as being in the hospital for acute heart or lung failure.
If your cardiac catheterization shows a mean pulmonary artery pressure of 40 mm Hg or higher under stable conditions, then you can win benefits. Meeting a listing is the most direct path to approval. However, it requires exact test results that match the SSA’s rules. If your reading is even slightly below 40 mm Hg, or if there is no record of your medical stability at the time of the test, then you will not meet the listing. Therefore, you will need to win benefits and prove disability another way.
UNDERSTANDING THE KEY RULES OF LISTING 3.09
SSA uses specific rules to guide how they interpret listing 3.09. Two key rules you should know are 3.00L and 3.00E2a, because they explain the listing terms.
3.00L explains what chronic pulmonary hypertension means under SSA rules. It clarifies that this condition involves increased blood pressure in the lung blood vessels. Over time, if not treated, it can lead to right side heart failure. It also confirms that SSA evaluates it under Listing 3.09, which applies regardless of what caused your pulmonary hypertension.
3.00E2a defines what SSA means by “medically stable” for cardiac catheterization results. In simple terms, your test must be not be done during an acute flare. SSA wants to make sure that your pulmonary pressure reading reflects your usual baseline. They do not grant benefits because of a temporary spike in hypertension. Spike occur due to illness, hospital stays, or emergency room treatment.
Together, these two rules help shape the application of Listing 3.09. Section 3.00L confirms the proper diagnosis category. It also states that the SSA will not order the test themselves. Instead, they expect you to already have a cardiac catheterization. Section 3.00E2a ensures the sample in your report is valid and taken under stable health conditions.
HOW TO PROVE YOU MEET LISTING 3.09
To prove that you meet Listing 3.09, you must have the actual cardiac catheterization report in your file. A summary from your doctor that simply says you have high pulmonary artery pressure will not be enough. The SSA needs the precise number from the test. Additionally, they will need to know if you were medically stable at the time of the test. Without both, your claim can be denied, even if you have severe symptoms.
Your medical records should also include a clear diagnosis of chronic pulmonary hypertension. You will need notes from your treating doctor about your ongoing symptoms. You will also need evidence of ongoing treatment.
Additional tests, such as echocardiograms or CT scans, can help support your case. However, they will not replace the need for a cardiac catheterization when trying to meet the listing. Having these records ready before you apply can shorten the process and reduce the risk of denial.
WHAT HAPPENS WHEN YOU DO NOT MEET THE LISTING?
Even if your condition does not meet the exact requirements of Listing 3.09, you can still win benefits. You can do so by proving that your symptoms prevent you from working. This is done through an evaluation of your residual functional capacity (RFC). The RFC is a measure of what you can still do despite your condition. The SSA will consider your ability to walk, stand, lift, carry, and concentrate. They will also determine how often you need breaks and whether you require oxygen.
For example, if you can’t walk 50 feet or you cannot stand for longer than a few minutes at a time, then you might not be able to work. Even if you could physically handle a seated job, the need for frequent breaks or absences could prevent you from regular employment.
Detailed medical evidence and honest testimony about your daily challenges are essential in these cases. You can provide your testimony about how CPH impacts you at a hearing. Learn about how to prepare for an SSA hearing.
BUILDING A STRONG DISABILITY CLAIM
A successful disability claim for CPH requires consistent medical records. This means seeing your doctor regularly and following their treatment plan. Each visit should note your symptoms, any changes in your condition, and how well treatments are working. If you use oxygen, this should be recorded in your medical records. Make sure your records also include how often you need oxygen and at what flow rate.
It is also important to make sure the SSA receives all relevant records. Missing medical evidence is one of the most common reasons claims are denied. This includes the original test results, hospital records, and notes from experts, such as a cardiologist. Working closely with your doctors to make sure your records are complete. It can make a major difference in the outcome of your case.
HOW THE BEST SSD ATTORNEY CAN HELP
Disability cases that involve chronic pulmonary hypertension can be complex. An attorney who is an expert in Social Security Disability law knows exactly what evidence you need. They also know how to present it effectively. They can request and review all medical records. Additionally, they can ensure the SSA has the correct test results and obtain statements from your doctors.
If your case goes to a hearing, then hire an attorney with experience to prepare you to testify. Your attorney can also question the SSA’s vocational expert and the medical expert at the hearing. They will argue your CPH meets or equals Listing 3.09. Additionally, they will show why your RFC prevents you from working.
Hiring the top SSD law firm triples your chances of approval. Especially if your case depends on showing that you cannot perform any type of work.
HOW WILL YOU PAY THE ATTORNEY FEE?
We will use our legal skills to help you through the Social Security appeal process. It is our goal to win your case. But, it also our goal to make the appeal process easier for you.
We offer a free review of your case. If you call, there is no pressure to become our client. Even if we don’t accept your case, we will still try to help you.
It also doesn’t cost you any upfront money to hire us. Why? Because you only pay us an attorney fee if we win your case. If we win, then the SSA pays us out of your back benefits. Learn about past due benefits. If you do not win, then you do not pay an attorney fee.
How much is the attorney fee? The attorney fee is whatever is less between 25% of your back benefit and the fee cap. This is best understood through an example. If your back benefit is $10,000, then your attorney fee would be $2500. However, if your back benefit is $100,000, you would not pay 25% or $25,000 in attorney fees. Instead, you would pay the amount of the fee cap, which is $9200.
Regardless, you pay whatever is less between 25% of your back benefit and the fee cap. Additionally, you only owe an attorney fee if we win your case. Find out what it will cost to hire an SSD attorney.
HIRE THE BEST SSD LAW FIRM TO WIN YOUR BENEFITS
Chronic pulmonary hypertension is a serious medical condition that can make it impossible to work. It isn’t easy to get Social Security benefits and the application process can be frustrating for most people. But, having an attorney throughout the appeal process can make it easier. When you have a law firm with experience handling your Social Security case, the SSA makes sure to follow their own procedures.
Additionally, when you have an attorney with legal experience, they will have access to Social Security’s decisions throughout the process. They can also submit medical evidence that may be missing from your case. Your attorney can also give you advice about what you need to do to win your benefits.
The most important factors in winning are strong medical evidence and a clear argument as to how your chronic pulmonary hypertension affects your daily life. With the right preparation—and the help of an experienced attorney—you can give yourself the best possible chance of getting the benefits you need.
