PERIPHERAL ARTERY DISEASE & DISABILITY
WHAT IS PERIPHERAL ARTERY DISEASE?
Peripheral artery disease (PAD), also called peripheral arterial disease, is a common circulatory condition in which fatty deposits build up in the artery walls and block blood flow. Your arteries supply blood flow to your arms and legs. If the blood flow is blocked, then you have PAD.
When your arms and legs don’t receive enough blood flow, you will experience pain in your leg and arm muscles. If left untreated, PAD can get worse. This causes severe problems such as critical limb ischemia, where blood flow to the limb is cut off. You may then have wounds that don’t heal, infections, and tissue death or gangrene. If you get gangrene, then your limb may require amputation.
The CDC estimates that almost 8 to 12 million people in the United States have peripheral artery disease. PAD is more common in older adults. For example, around 12-20% of people over the age of 60 have PAD. PAD affects both men and women, but it is slightly more common in men. Additionally, African Americans have a higher risk of getting PAD compared to other racial groups. PAD occurs more often in those who have risk factors such as smoking, diabetes, high blood pressure, and obesity.
SYMPTOMS OF PERIPHERAL ARTERY DISEASE
Peripheral artery disease has many symptoms, although some people with PAD may not experience any noticeable symptoms in the early stages of the disease. The most common symptoms of PAD include:
- Intermittent Claudication: This is the most common symptom of PAD. It refers to pain or fatigue that occurs in the leg muscles during physical activity such as walking or climbing stairs. The pain usually stops with rest and returns when the activity resumes.
- Leg Numbness or Weakness: Some people experience numbness, weakness, or a “pins and needles” feeling in their legs. This feeling is the result of reduced blood flow to the area.
- Coldness or Temperature Changes: Your leg or foot may feel colder than other parts of your body. If you have PAD, then your skin will feel cold and you will have little hair growth on your limbs.
- Skin Color Changes: The skin on your legs or feet may appear pale or have a bluish tint. This is due to reduced blood flow and a lack of oxygen to the limb.
- Slow Healing of Wounds: PAD can impact the healing of wounds on your body. For example, sores, cuts, or ulcers on your legs or feet may take longer to heal or they may not heal at all.
- Poor Nail and Hair Growth: The reduced blood flow to the limbs can affect the growth and health of toenails and leg hair.
- Erectile Dysfunction (in men): Reduced blood flow to the genital area can lead to problems achieving an erection.
- Weak Pulse: No pulse or a weak pulse in the legs or feet.
- Cramping in Arms: Pain when using your arms, such as aching and cramping when knitting, writing or doing other manual tasks.
RISK FACTORS FOR PERIPHERAL ARTERY DISEASE
There are many risk factors for getting peripheral artery disease that you have some control over. Obviously, we can’t control every type of risk for the disease. For example, some people have a genetic reason to have high blood pressure or high cholesterol. However, by reading below, you will see that you can help yourself avoid PAD by living a healthy life. Here are some common risk factors for peripheral artery disease:
- Smoking: Smoking is a major risk factor for PAD. It damages the blood vessels, reduces blood flow, and increases the risk of PAD.
- Diabetes: People with diabetes have a higher risk of developing PAD. Elevated blood sugar levels can damage blood vessels over time, leading to narrowed arteries.
- High Cholesterol: High levels of cholesterol in the blood can cause the buildup of plaque in the arteries, leading to PAD.
- High Blood Pressure: Uncontrolled high blood pressure can damage blood vessels and increase the risk of PAD.
- Obesity (BMI over 30): Being overweight or obese puts strain on your body systems and can add to the development of PAD.
- Age: The risk of PAD increases with age. As you age, your arteries naturally become stiffer and narrower, increasing the chances of PAD.
- Family History: Having a family history of PAD or other heart disease increases the risk of developing the condition.
- Sedentary Lifestyle: Lack of physical activity and a sedentary life can cause poor circulation and increase the risk of PAD.
- Other Medical Conditions: Certain medical conditions, such as kidney disease, autoimmune disorders, and chronic inflammation, can increase the risk of PAD.
TREATMENT OPTIONS FOR PAD
There are many treatments for peripheral artery disease. For example, making healthy changes in your life can help manage PAD. These include quitting smoking and eating a healthy diet with lots of fruits and vegetables. Also, you should exercise and keep your body at a healthy weight.
Doctors may give you certain medicines to help with PAD. These drugs prevent blood clots, lower cholesterol levels and control high blood pressure. They also relieve leg pain.
Additionally, your doctor may give you a special exercise programs that is helpful for people with PAD. These programs are designed by experts to improve your walking ability and overall fitness.
Finally, if you have wounds or ulcers on your legs or feet due to PAD, then proper care is important. This may involve cleaning the wound and applying dressings. You may need medical help to do this. If so, get the help you need, because you do not want a wound to become infected.
Remember, the best approach is to consult with a doctor who can determine if you have PAD and offer the best treatment options for you.
APPLY FOR SSDI & SSI BENEFITS FOR PERIPHERAL ARTERY DISEASE
If you have peripheral artery disease, then there are two types of benefits you can file for under the Social Security program: Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) benefits. In order to receive benefits, you must first file an application. You can do this online at Social Security’s website. Below, please find an explanation as to each type of benefit you can apply for if you have SBS:
SSDI benefits are for those who have worked in the recent past and can no longer work at any job due to a medical condition. The amount of money you will receive from SSDI benefits every month is based on how much Social Security tax you have paid during your work history. To qualify for SSDI, you must have earned enough “work credits” to qualify. 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 will 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, you will only qualify for Supplemental Security Income benefits.
SSI is a needs based benefit and it is for those people with little to no income, such as children and the elderly. Anyone who makes more than a certain amount of money per month cannot receive SSI benefits. The SSA counts the income of those in your house, not just your income. If you have a spouse who earns more than $4000 a month, for example, then that income will be the factor in whether you can receive SSI benefits. You cannot qualify for SSI benefits, no matter how severe your peripheral artery disease, if you do not meet the income and asset rules for SSI.
SSA’S LISTING 4.12 FOR PERIPHERAL ARTERY DISEASE
SSA listing 4.12 gives you an understanding of the elements you need to prove in order to be paid SSDI and SSI benefits. You will need to prove that you meet or equal the following listing by having the proper tests and a medical opinion from your doctor as to your PAD.
4.12 Peripheral arterial disease, as determined by appropriate medically acceptable imaging, causing intermittent claudication and one of the following:
A. Resting ankle/brachial systolic blood pressure ratio of less than 0.50.
B. Decrease in systolic blood pressure at the ankle on exercise of 50 percent or more of pre-exercise level and requiring 10 minutes or more to return to pre-exercise level.
C. Resting toe systolic pressure of less than 30 mm Hg.
D. Resting toe/brachial systolic blood pressure ratio of less than 0.40.
PERIPHERAL ARTERY DISEASE & YOUR RESIDUAL FUNCTIONAL CAPACITY (RFC)
If you don’t meet listing 4.12, you can still win SSDI and SSI benefits through the SSA’s vocational rules. This takes your PAD symptoms, other medical conditions, your age, work history, skills, and education into account.
When the SSA decides your residual functional capacity (RFC), they use your statements on the forms you fill out for them. For example, when you fill out forms about your past work, you state how much you had to lift on the job. You also tell them how much you stood or sat during a work day.
Your answers on these forms are often some of the most important statements you make. If you state on your Work History form that you lifted nothing on the job, then that is what the SSA assumes is correct. Frankly, there are no jobs where you lift “nothing.” But for some reason, many people write that down as an answer. Even desk jobs require some lifting. You might, for example, lift files, boxes of paper, books, or supplies. The SSA also wants to know how much weight you lifted on your job. What weighed the most? Also, what was the weight you lifted daily.
Think about it. Failing to tell the SSA about the lifting you had to do at your past jobs, makes it easier for them to return you to your past jobs. In other words, you are making it easier for them to deny your case.
THE MEDICAL EXPERT CAN TESTIFY ABOUT YOUR PAD
Medical Experts (ME) often testify at Social Security hearings. They are called by the ALJ to review your medical records for peripheral artery disease. Also, they explain your medical conditions to the judge. Additionally, they testify as to whether or not your medical condition meets or equals SSA listing 4.12. Similarly, an ME can be requested by your attorney. This is, however, mostly done in complex medical cases.
The medical expert who appears at the hearing is not your treating doctor. The doctor at the hearing must have never met you before. Because, the medical expert is there to give testimony about your medical records and should not be for either side of the case.
Medical experts are doctors who the SSA calls to testify about your PAD at the hearing. Usually, the medical expert comes to the hearing. However, they can also testify by video or by telephone.
It is also possible for an ME to answer written questions after the hearing. These written questions are sent to the expert. The ME’s answers require review and possibly filing objections. If you do not know how to do this, then hire an attorney. Do not make the mistake of not preparing for the medical expert.
THE VOCATIONAL EXPERT & YOUR SSD BENEFITS
The vocational expert (VE) is also an expert witness, just like the medical expert. Normally, the Social Security Judge calls a VE to testify at the hearing. The Judge will ask the VE about jobs that are available to you based upon your RFC. VEs have training in placing people in jobs. They also understand the numbers and types of jobs that exist in the nation. They are at the hearing in order to answer questions about jobs in the national economy.
Once the Judge asks you questions about your medical conditions, she will decide what you are capable of doing during an 8 hour work day. The SSA calls this your RFC. Your RFC what you can physically do throughout an 8 hour work day. Therefore, your answers to the questions at the hearing are very important. Just as the important as the medical records you submit.
The Judge listens to your hearing testimony and the takes the symptoms from your medical records to determine how your peripheral artery disease symptoms impact you on the job. At the end of your hearing, the Judge will ask the VE questions. Likewise, your attorney will also ask questions. Your attorney can also question the VE. It is often the VEs answers that determine whether you will win SSD benefits.
HYPOTHETICAL QUESTIONS FOR THE VOCATIONAL EXPERT
The Judge will ask questions to the VE about whether or not a person with your peripheral artery disease symptoms can work. Typically, the Judge will use three to four different questions. These questions can include many different symptoms from your PAD.
For example, the Judge may ask if a person cannot concentrate on the job due to limb pain, could they work. Or, the Judge may ask what kind of work would be available to a person who cannot lift more than 10 pounds. The Judge’s questions will include your RFC. Learn more here about your residual functional capacity here.
Once the Judge is done asking questions, your attorney has the right to question the VE. For those who do not hire an attorney, they are left to try to ask the VE questions on their own. Obviously, most people do not know what questions to ask because they have never been to a hearing. Nor do they have the training they need in order to understand what questions to ask.
VEs testify about what kinds of jobs are available to you. However, they also testify as to the number of jobs that exist in the national economy. For example, a VE may testify as to whether your work skills can be used in other work. They will also testify about the specific jobs in which they can be used.
A VE may also testify as to the effects of other medical conditions on the range of work you can do. Likewise, the VE can testify about the erosion of the job base caused by all of your medical conditions.
HIRE US TO HELP YOU WIN BENEFITS FOR PERIPHERAL ARTERY DISEASE
Unfortunately, if you do not hire an attorney with experience to help you, then you will probably lose your case for peripheral artery disease. Most cases turn on the VE’s testimony at the hearing. If you are not capable of questioning the VE, you will not win. The judge relies on the VE’s testimony. So, you need to be able to prove, using VE testimony and medical records, that you cannot work. An attorney can make sure that all of your symptoms are taken into account during the VE’s testimony.
Also, your attorney should be familiar with jobs in the national economy. If the attorney has legal experience before the SSA, then they also know what jobs the VE is likely to testify about. This part of the hearing is difficult. Trying to do it yourself will not work. If nothing else, you should hire an attorney to represent you if the Judge has called a VE to your hearing.
WHAT WE DO TO HELP YOU WIN SSDI AND SSI BENEFITS
If you have peripheral artery disease, then you need help to apply for Social Security benefits. You can always call our law firm and we will help you. We can help you file your application. Also, we can help you appeal every SSA denial. For example, our attorneys and staff can:
- Send you the paperwork you need to become our client
- Help you file your application for SSDI and SSI benefits
- Inform the SSA they should automatically pay your benefits under the Compassionate Allowance Rules
- Appeal if you receive an initial denial from Disability Determination Services
- Help you confirm your Consultative Examination
- Request a Hearing with an Administrative Law Judge (ALJ)
- Prepare you to testify at your SSA hearing
- Represent you at your hearing and question the witnesses
- Read more about vocational experts here
- Learn more about medical expert testimony here
- Request review of an SSA decision with the Appeals Council
- Request review of an Appeals Council denial in Federal Court
If you file your application for benefits online at Social Security’s website, then you have 6 months to complete the application. Once you submit your application online, the SSA sends you an application summary in the mail. You must sign the summary and mail it back. If you don’t send it back, the SSA will not process your application. Sign it and send it back as soon as you can.
LEGAL EXPERIENCE WINS PERIPHERAL ARTERY DISEASE BENEFITS
If you have peripheral artery disease, then you need to hire a law firm to help you win your benefits. Cannon Disability is one of the best Social Security law firms in the country. We are one of the best Social Security benefits firm in Las Vegas, Nevada. Also, we are one of the best Social Security law firms in Salt Lake City, Utah.
Learn more about Utah SSD benefits here. Nevada SSI Information is on this website. We also represent clients in Idaho. For Idaho benefits read here. Find out more about Colorado SSDI benefits here. Likewise, if you are from California, go here for California SSD & SSI information.
Over the last 30 years, we have won thousands of SSDI and SSI claims. Additionally, we have won over $100 million in SSD and SSI benefits for our clients. It has become more difficult to win Social Security cases. Also, SSA’s listing rules are harder to meet. That is why you need an attorney who will help you win your case.
We recommend you do not go to your hearing without an attorney. Why? Because a lawyer can prepare you for your hearing. She can explain the judge’s questions. Preparation, like medical records, will help you win your case.
Those who come to the hearing without counsel are usually not successful in winning benefits. In fact, if you hire an attorney who has legal experience, you are three times more likely to win your SSD and SSI benefits. Contact Cannon Disability Law today. We can help you win benefits for peripheral artery disease. Call us today and ask us for a free review of your case.