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Heart transplant and SSDI benefits

Is a heart transplant disabling?

If you have a severe heart condition you may eventually be in need of a heart transplant. We had a user on our disability forum ask if they would be eligible for Social Security Disability Insurance (SSDI) if they have had a heart transplant. First, let’s discuss who is eligible for SSDI benefits and when a heart transplant recipient can receive benefits.

Requirements for SSDI

SSDI is offered to disabled workers who have a severe health condition and who are unable to work due to this condition for at least 12 continuous months. What may confuse many SSDI applicants is that you not only have to have a severe condition, you also have to be “insured” for SSDI.

To reach an insured status a worker must have worked and paid employment taxes earning what the Social Security Administration (SSA) terms work credits. This is similar to what workers are doing for SSA retirement benefits. SSDI is not offered to workers who have not worked or who have worked but have not paid taxes. Unfortunately, even if you have a heart transplant and you are severely disabled, you will not be eligible for SSDI unless you have worked and paid taxes recently enough to be insured.

Schematic of a transplanted heart with native ...

Determining if you qualify for SSDI for a heart transplant

The SSA has two methods for determining if you are disabled. First the SSA will determine if you have a condition and symptoms which are listed in the SSA Listing of Impairments. If you do not, the SSA will determine if you lack the residual functional capacity to work through what they term a “medical vocational allowance.”

This sounds like a complicated term, but basically the SSA will review your health condition, your age, your work skills, and your education to determine if you can work your current job, an old job or retrain for new work. Under a medical vocational allowance it is much easier to win benefits if you are over the age of 55.

The good news is there is a listing for a heart transplant under the SSA Listing of Impairments. This means that if you are insured and have sufficient work credits for SSDI than you should be immediately approved for SSDI. But this is not the end of the story. The SSA will give you SSDI for 12 months, but after that time they will determine if you have the capacity to return to work.

What will this mean for you? There are many heart transplant recipients that can, after a specified time, return to some type of full-time work. If you are a young worker and you are working sedentary or light work you may have difficulty proving that you cannot do any type of full-time work 12 months after a heart transplant.

Older workers, with limited education who have performed only physical labor their entire lives, are likely to have an easier time proving that they cannot return to work they have done in the past and their education and age limitations may make it difficult to find new work. If after the evaluation the SSA determines you cannot return to work you will continue to receive SSDI; otherwise, your SSDI benefits will be terminated.

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