First off the people reviewing your case are not medical professional and most cases are denied because the medical document isn’t clear to point out what the disability is. So that is where the letter from your cardiologist is essential. Now Social Security Disability determines if you are disabled by a thing that is called a blue book. Unfortunately however the congenital heart disease section is very out to date and really refers cyanotic patients. I have to say I am still cyanotic so the section does refer to my condition. There are two books one for adults and one for children so if you’re over 18 refer to adults
My advice is to pretty much print out the whole cardiovascular section and bring it with you to the doctors. Also any other conditions you might have like respiratory conditions (i.e. pulmonary hypertension) .Now this is the social security disability bible so to speak this is how the case workers first determine if you are even classified as disabled so this is extremely important
After gathering the blue book info sit with your doctor to compose your letter. This may take a while so I would let the doctor office know why you are coming and it will probably take an hour or so to compose the letter. I preferred to do this with my doctor so I knew that I got everything I needed in the letter so I didn’t have to bother him for rewrites. Also many doctors are not sure what to write.
• The first paragraph of the letter should state how long the doctor has known you and how long you have been treated for such a condition at that hospital. According to the blue book the last 5 years of medical information is the important determination on getting approved. So have doctors who know your medical condition and treated you the most in that time period write the letter.
• The second paragraph should be basic vital signs, age, work history diagnosis and severity of condition
• Third paragraph is where the blue book comes in handy Have doctor review each section then outline the listings that your condition meet. Have you doctor list each listing that your meet and explain how you meet them and the medical documentation to back them up. For example
Patient meets listing 4.06 of the blue book – Patient has cyanosis current at rest Oxygen saturation level is 85% which leads to a hematocrit of 60 measured on the latest blood work that was obtained 10/10/10 , 7/20/09 please see attached office notes in the lab work sections.
It is really important that your doctor not only says the listing that you meet but the evidence behind it so it is easy for the agent to review medical documents Also the blue book does state in it sections which tests they will take to back up the evidence you have such condition. Most are typical test people with CHD have had like ECO, EKG, and cardiac caths
If you don’t exactly meet the criteria of a listing have your doctor show evidence close to the listing and the severity of it and how it affects you.
• Last paragraph the doctor should close with how long your impairment shall last for example Patient’s current medical limitiaons, as outlined does not permit that he/she sits, stands or walks for 8 hours a day. This impairment will last for life, as he/.she does not have therapeutic options available.
Then have your doctor give you copies of the medical record they have especially the ones that are referred to in said letter. I gave all documents to my agent at the social security office when I applied, but if you apply online I advise mailing the information as soon as you apply.
Now Disability is decided by the state you live in some states are tougher than others for example Massachusetts really is determined by the severity even if the listing are not meet exactly but in California they seem to base approval on the listing being met. Getting approved is very hard and getting approved the first time is somewhat of a miracle. I have to say I had one of those miracles but I think it is really important to do your homework, and get the necessary documentation. Do not leave it up to the social security office to get the necessary document from your doctors, it can take month and can cause you to not be approved due to lack of evidence.
Also once you apply you will probably receive a questionnaire on your abilities to do daily tasks and you only have a certain period fill out the document and send it back so be sure to meet all deadlines set by the social security office.
The social security office has 5 months waiting period before you can start getting benefits and it the usual waiting period of knowing whether you have been approved or not is about 3 to 5 months.
I want to thank other CHD patients who have applied for SSDI and especially Dr Paul Quck who sent me invaluable information that helped me understand the application process.