HEART TRANSPLANT & SSD BENEFITS
HEART TRANSPLANT & SOCIAL SECURITY DISABILITY BENEFITS
A heart transplant is an operation where surgeons replace a failing or damaged heart with a healthy heart from a deceased donor. This procedure is usually performed on individuals with end stage heart failure or severe heart conditions. It is an option only after your heart disease cannot be managed with medications, lifestyle changes, or less invasive surgeries.
In 2022, the United States performed a record number of heart transplants, 4,111 procedures. This marked the 11th consecutive year of increasing numbers of heart transplants. Adult heart transplants have increased by 85.8% since 2011. The trend has gone up because of efforts to reach donors nationwide. However, as of December 2024, there are still 3,571 people in the US waiting for a heart transplant.
A heart transplant comes with many challenges, both physically and emotionally. Recovering from the procedure can make it impossible to return to work for months or even years. Social Security Disability Insurance (SSDI) benefits provide financial support for those facing such circumstances. Understanding how heart transplant patients qualify for SSD benefits can help ensure a smoother claims process.
WHAT IS A HEART TRANSPLANT?
A heart transplant begins with the recipient of the donor heart being put under with anesthesia. Next, the heart surgeon makes an incision in the chest to reach the damaged heart. The patient is then connected to a heart-lung bypass machine. The machine takes over the functions of the heart and lungs during the operation. The diseased heart is then removed.
The surgeon leaves a portion of the recipient’s own heart tissue, such as the back walls of the atria, to connect the new heart. The donor heart is sewn into place. Next, the blood vessels are reattached to the donor heart. Once the new heart begins beating, the bypass machine is removed. Then, the chest is closed.
WHY DO PEOPLE NEED A HEART TRANSPLANT?
Heart transplants are performed when other treatments for heart problems haven’t worked, leading to heart failure. In adults, heart failure can be caused by:
- A weakening of the heart muscle (cardiomyopathy)
- Coronary artery disease
- Heart valve disease
- Congenital heart defect
- Dangerous abnormal heart rhythms (ventricular arrhythmias)
- Failure of a previous heart transplant
In children, heart failure most often occurs due to either a congenital heart defect or cardiomyopathy.
WHEN WAS THE FIRST HEART TRANSPLANT?
On December 3, 1967, the first human heart transplant was done on by South African surgeon Dr. Christiaan Barnard in Cape Town, South Africa. The recipient was 53 year old Louis Washkansky, who was suffering from severe heart failure. Denise Darvall was the person who gave the donor heart. She died in a car accident.
Although the transplant was an incredible medical achievement, Washkansky only survived 18 days after the surgery. He died from complications from pneumonia caused by the drugs he was taking to prevent organ rejection. Despite his short survival, the operation was the beginning of saving lives through the new treatment.
The first person to receive a human heart transplant in the US was Norm Shumway. The surgery occurred on January 6, 1968, at Stanford University School of Medicine. Mr. Shumway was 54 years old and he received the heart of a 43 year old man.
THE ARTIFICIAL HEART
In 1982, surgeons at the University of Utah, transplanted the first permanent artificial heart into Barney Clark, who was 61 years old. Dr. Willem Kolff led the team that developed this artificial heart. After leaving the Cleveland Clinic in 1967, Dr. Kolff went to the University of Utah. There he met and hired Robert Jarvik onto his study steam, which was working to develop artificial organs.
Dr. Kolff had a tradition of naming artificial hearts after the people who were working on them. Robert Jarvik was working on the artificial heart. Dr. Jarvik was only 35 years old when we became famous for and received credit for this invention. But, Dr. Kolff is the inventor.
Before its first successful transplant the Jarvik 7 was tested in clinical trials. Barney Clark lived for 112 days after the transplant. The second recipient went on to live for 620 days. Patients who received the artificial heart died from complications such as organ failure, stroke, and infection. The main problem with the Jarvik 7 was that it needed a “large pneumatic console” to function. Therefore, the patient could not leave the hospital.
WHO IS ELIGIBLE FOR A HEART TRANSPLANT?
When medications and lifestyle changes don’t work, then those with end stage heart failure or severe heart disease may be eligible for a heart transplant. Common conditions that qualify you for a heart transplant include dilated cardiomyopathy and ischemic heart disease. Additionally, you may qualify if you have congenital heart defects or severe valve disease.
You won’t receive a heart transplant unless you have less than one to two years to live without the transplant. You must also be otherwise healthy to physically survive the surgery. Doctors will require you to commit to medical care for the rest of your life. This includes taking medications to prevent organ rejection.
Additionally, you cannot have other serious conditions, such as advanced cancer or severe infections. Finally, you should not have damage to other organs like your liver or kidneys. Because those problems will delay your recovery.
Doctors also evaluate your mental health and your ability to adhere to the medication regimen after the transplant. A support system of family and caregivers is important for success. A transplant team reviews each case to ensure that you qualify for the surgery.
RISKS OF A HEART TRANSPLANT
Besides the risks of open heart surgery, which include bleeding, infection and blood clots, the risks of a heart transplant include:
- REJECTION OF THE DONOR HEART: After a heart transplant, your immune system may see your donor heart as a foreign object and try to reject the new heart. Every heart transplant recipient receives medications to prevent rejection. However, sometimes the medications don’t help. Doctors can change your medications if you start to reject your new heart. You must always take your medications and keep your doctor appointments.
- FREQUENT BIOPSIES: Rejection often occurs without symptoms. To determine whether your body is rejecting the new heart, you’ll have frequent heart biopsies in the first year after your transplant. After that, you won’t need them as often.
- PRIMARY GRAFT FAILURE: The most frequent cause of death in the first few months after a heart transplant is that the donor heart doesn’t function.
- ARTERY PROBLEMS: After your heart transplant, it is possible for the walls of the heart arteries to thicken and harden. This can lead to cardiac allograft vasculopathy. Hardened arteries can make it difficult for blood to circulate through your heart. Therefore you could have a heart attack, heart failure, heart arrhythmias or sudden cardiac death.
OTHER MEDICAL RISKS AFTER A HEART TRANSPLANT
- ISSUES FROM MEDICATION: After your heart transplant, you will need to take medication for the rest of your life. Unfortunately, the medication can cause kidney damage and other serious problems.
- CANCER RISK: The medications can also increase your risk of developing cancer. For example, the medications can put you at a greater risk of skin cancer and non-Hodgkin’s lymphoma.
- INFECTION. Because you need to suppress your immune system with medications, it can decrease your ability to fight infection. Many people with heart transplants have infections that require them to stay in the hospital after their transplant.
APPLYING FOR SSD BENEFITS AFTER A HEART TRANSPLANT
Recovering from a heart transplant requires patience and significant support. For those unable to work during this period, SSD benefits can provide critical financial relief. Understanding the SSA’s requirements and preparing a proper application can improve your chances of winning benefits.
If you need SSD benefits, then hire a disability attorney to guide you through the process. Your attorney can make sure you submit all of the necessary evidence.
Applying for SSD benefits after a heart transplant requires you to document the procedure and its impact on your overall health. Medical records play a critical role in this process. You will need to submit the medical records from the heart transplant. Additionally, you will need to submit echocardiograms, blood tests, and progress notes from your cardiologist.
Additionally, detailed information about your medications and symptoms can help explain your physical limits. Statements from your doctors about your ability to work can also strengthen your application.
Filing an SSD application early is crucial, as processing times can take months. Providing complete and accurate information about your medical condition and treatments is essential for a strong claim. Working closely with your doctor to document your symptoms and recovery can significantly increase your chances of approval. Submitting additional medical evidence and having a hearing before an Administrative Law Judge (ALJ) are steps you may need to take to continue benefits.
SSA LISTING 4.09 FOR HEART TRANSPLANT
The Social Security Administration (SSA) includes heart transplants under Listing 4.09 in its Blue Book. The Blue Book is simply a list of medical conditions that the SSA finds meet their conditions for benefits. If you have a heart transplant then you meet the listing under the step three criteria of the SSD review process. Listing 4.09 is below:
LISTING 4.09 – HEART TRANSPLANT: Consider under a disability for 1 year following surgery. Thereafter, the SSA will evaluate your residual impairment under the appropriate listing.
The one year period provides recovery time for you to adjust to your new heart and manage any medical problems. After this period, the SSA evaluates your condition to determine if you still cannot perform substantial gainful activity (SGA). For example, fatigue, pain, or other symptoms from the transplant may continue to qualify you for benefits.
RESIDUAL FUNCTIONAL CAPACITY & HEART TRANSPLANT
After the one year approval period, the SSA will evaluate your residual functional capacity (RFC) to see if your benefits should continue. They will review your physical and mental limitations. For example, they will define your ability to walk, stand, and lift. They will look at your ability to use your hands to type, write, and use small objects. Likewise, the SSA will include your ability to carry, pull, and push.
In essence, they are looking at your physical abilities to see if you can return to work. Learn how the SSA defines work.
They will also review your mental health.
Mental conditions are part of your RFC. If you have a treating psychologist or counselor, they can complete an RFC form. Likewise, they can write a letter about your mental limits. Your mental RFC includes how many minutes you can concentrate on a task, like reading or following instructions.
If you have memory problems on a daily basis, then your counselor can document it. Also, if you have trouble getting alone with other people, then this is part of your RFC. Almost all jobs require the ability to get along with other workers, bosses, and even the public. Make sure your doctor documents these symptoms to help your case.
RFC FINDINGS COME FROM YOUR MEDICAL RECORDS
In order to figure out your physical RFC, the SSA will examine your medical records. They will take into account what your doctor states in your medical records. Also, the SSA will review any statements from your doctors about your ability to work.
Additionally, they will their own doctors review your medical records. These doctors never meet or examine you. These doctors are supposed to offer an objective opinion, but they work for the state agency who reviews all cases. Their medical opinion is almost always that you can do some sort of work. The SSA takes the medical opinion of these doctors into account too.
Likewise, if they need more information, they may send you to an exam with one of their doctors. Learn what to expect at the SSA’s doctor exam.
The SSA will also consider descriptions about your fatigue and symptoms from your family and friends. Find out what types of evidence the SSA must consider. For example, your family could write statements about your mental and physical symptoms. Find out how RFC, along with age, can keep you from working. Also, learn about SSA’s Medical Vocational Guidelines.
If your RFC proves you cannot work, then you may continue to receive SSD benefits.
HOW WILL YOU PAY THE ATTORNEY FEE?
One of the main reasons people do not hire an attorney to help them win their SSD benefits is they are afraid of the cost. Most people think that hiring an attorney will cost too much money. However, in Social Security cases, the attorney fee is set by law.
The attorney fee in all Social Security benefit cases is “capped.” This means that the law firm you hire cannot charge you more than 25% of your past due benefit. Your past due benefit is money the SSA owes you since the time you could no longer work due to your heart transplant.
Currently, the SSA caps the attorney fee at $9200. The cap goes up according to the cost of living every year. However, the attorney fee cannot be more than the fee cap. The attorney fee in your case will be the fee cap OR 25% of your past due benefit. You will pay whatever amount is LESS.
Most importantly, the attorney is only paid a fee if she wins the case. If an attorney is trying to charge you an upfront fee for legal services, then the attorney is breaking the law. Do not hire that attorney, because they do not understand how the fee process works in SSD cases.
Additionally, hiring an attorney triples your chance of winning SSD benefits. The SSA denies 40% of all initial applications. On appeal, they deny 85% of all claims. Finally, at the hearing level the judges deny over 50% of the cases that come before them. Learn information about SSA’s denial rates. With these denial rates, you need an attorney with years of legal experience on your side.
TO WIN SSD BENEFITS HIRE OUR LEGAL TEAM
We have won millions of dollars in ongoing and past due SSD benefits for our clients. If you want to win benefits for a heart transplant, then you should hire an attorney with the experience to win your benefits. If the SSA doesn’t grant your case, then hire our law firm to prove to win your SSD benefits. Contact us for free.
If you want to learn about our lawyers and staff, then review our About Us page. For instance, Andria Summers can help you with your Medicare plan. She has also won thousands of SSD cases. Dianna Cannon has been helping clients win SSD benefits for thirty years. Brett Bunkall also has years of experience helping people obtain their benefits. We are experts. You can trust us to help you win SSDI and SSI benefits.
In the past 30 years, we have won over 20,000 SSDI and SSI cases for our clients. Also, we help our clients with their Medicare benefits. Our legal experts can help you file an application for SSDI and SSI benefits using the SSA’s website.
Likewise, if you need an appeal, we can help you do that too. There are also many forms you will need to fill out. But, don’t worry. If you have questions about the SSA forms, then we will answer them. You can learn how to complete SSA’s appeal forms. Call us for a free review of your benefits and heart transplant case.
