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Congestive heart failure and SSDI denial because income is too high?

Recently on our disability forum a user asked, “I have applied for Social Security Disability Insurance (SSDI) because I have been diagnosed with congestive heart failure. I just received a letter from the SSA stating that I am not disabled because I am making too much money. I am confused. I was going to quit working when I started receiving benefits. They never even reviewed my medical records. Can you tell me what’s going on? How can they say I am not disabled? I can barely walk.”

Overview of SSDI benefits for congestive heart failure 

SSDI benefits are offered to claimants who have a serious health condition which does not allow them to work for at least 12 continuous months. Claimants must also not be working and making too much money when they apply for SSDI and have sufficient work credits to be considered insured for benefits.

Now, you have asked about one of the most frustrating aspects of getting approved for SSDI benefits: working too much and making too much money when you apply.

With that in mine, let’s take a closer look at work and how it affects your ability to qualify for SSDI benefits.

Can I work and get SSDI benefits for congestive heart failure?

Claimants will only be considered disabled by the Social Security Administration if their condition is so severe that they are not able to work. Work can be both gainful and substantial and is referred to by the SSA as substantial gainful activity (SGA).

First, to determine whether work is gainful the SSA will evaluate whether the claimant is working and earning $1170 per month (in 2017). If the worker is earning this amount the SSA will consider them not disabled and will deny their claim without ever reviewing their medical records.

Next, the SSA will determine if the claimant’s work is substantial. This means that a claimant who is earning less than $1170 per month could still be considered not disabled if their physical or mental work effort is comparable to the work that could be required for a full-time job.

For example, if you are working 35 hours per work as a volunteer at a homeless shelter and this is comparable to other paid work then you would be considered not disabled even though your voluntary work does not generate pay or profit. Specifically, the SSA can decide that your capacity to perform voluntary work could be equal to your capacity to work a regular job.

What should you do now?

It’s important to note that while some SSDI denials can be appealed, the type of denial you have received is a technical denial and cannot be appealed unless something about your work situation changes (i.e. you start working less hours or making less money).

So, what should you do? You are going to have to decide how severe your heart condition really is and whether you have the capability to continue to work or whether you need to stop working and appeal your SSDI case.

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