Disability Benefits & CHD

Applying for Social Security Disability Benefits with a
Congenital Heart Defect

by, Deanna Power

I was born with Ebstein’s anomaly VSD. It’s actually two congenital heart defects (CHDs) in one: Not only is my right ventricle a little wonky, but I also have a small hole connecting two chambers of my heart. I needed surgery when I was a baby, and again in March of 2015. Today I do not have any physical restrictions, and I might be able to even have children some day! I’m well aware of how lucky I am. Not every person with a CHD is as fortunate.

If you’re an adult with a CHD and you’re too ill to work, or if you’re the parents of a child who experiences serious complications due to a CHD, there may be resources available for you. The Social Security Administration (SSA) offers financial benefits for people with congenital heart defects in need.

Forms of Disability Benefits Available

There are two primary forms of Social Security disability benefits. Adults and children will qualify for different forms.

The first type of Social Security benefits is Social Security Disability Insurance, or SSDI. SSDI is only for adults aged 18-66 who have worked at least part-time for any 5 of the past 10 years, although this will of course be less for young adults. If you’ve held steady jobs throughout adulthood but your CHD complications eventually became too severe to continue working, you’ll likely qualify for SSDI.

The second type of disability benefits is Supplemental Security Income (SSI). These benefits are for adults and children, but you can only qualify if you have a financial need. This means that adults applying for SSI do not need to have worked, but must have very little saved cash or assets. When parents apply for SSI on behalf of a child, their own household income will be evaluated. Your total household income limit will vary depending on how many children you have or if you’re married, but if you earn less than $36,000 per year you’ll certainly financially qualify.

Medically Qualifying for Social Security With a CHD

Regardless of whether you’re an adult applying on behalf of yourself or your child, all applicants’ CHDs are compared to the SSA’s Blue Book, a medical guide listing exactly what test results or symptoms you need to be approved for Social Security benefits.

The childhood CHD listing is very complicated, so be sure to discuss the Blue Book listings with your child’s cardiologist. To briefly summarize, here are a few ways your son or daughter could qualify:

Your child has cyanotic heart disease, causing low red blood cell counts, low oxygen levels in the blood, or fainting spells.
Your child has vascular obstructive disease with high blood pressure
Your child has acyanotic heart disease, with heart problems seriously affecting his or her ability to complete activities.
Your infant (12 months or younger) has a life-threatening CHD that will require surgical treatment within the first year of life, and the CHD is considered to be disabling in the future. This will qualify until age 1, at which your child will be reevaluated.

The adulthood CHD listing is similar, but with less ways to qualify. You or your adult child will need to either:

A CHD that causes cyanosis at rest with low blood pressure or oxygen levels
Right-to-left shunting with a low ability for heart function
Vascular obstructive disease with high blood pressure

Applying for Social Security Disability Benefits

If you are applying for SSDI benefits for yourself or your child who’s aged 18 or older, you can apply entirely online on the SSA’s website. If you’re applying on behalf of your minor child, you can start the application online, but you will need to complete the application at your local SSA office.

Regardless of where you apply, be sure to be as thorough as possible. The more medical evidence you have on your side, the better your chances of your child being approved for Social Security benefits!

This article was provided by Disability Benefits Help. If you need any help applying on behalf of a child with a CHD, feel free to contact our staff at help@disability-benefits-help.org.