Ischemic Heart Disease and Social Security Disability: Understanding Listing 4.04 for Texas Claimants
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Ischemic Heart Disease and Social Security Disability: Understanding Listing 4.04 for Texas Claimants
Ischemic heart disease (IHD) is one of the most serious and widespread cardiovascular conditions evaluated by the Social Security Administration (SSA). For many Texans, IHD causes chest pain, shortness of breath, fatigue, and reduced exercise tolerance that make full‑time work impossible. Yet many disability claims involving IHD are denied because the SSA requires very specific medical evidence—and most claimants don’t know how to present it.
This comprehensive guide explains how the SSA evaluates ischemic heart disease under Listing 4.04, how you can qualify even if you don’t meet the listing, and how the social security lawyers at MLF Legal help Texans build strong, medically supported ischemic heart disease and social security disability claims. If you’re struggling with IHD and can’t work, call MLF Legal at 214‑357‑1782 for a free case evaluation.
What Is Ischemic Heart Disease?
Ischemic heart disease occurs when narrowed or blocked arteries reduce blood flow to the heart. This lack of oxygen can cause chest pain (angina), shortness of breath, fatigue, and—in severe cases—heart attacks.
Common symptoms of IHD include:
Chest pain or pressure
Shortness of breath
Fatigue with minimal exertion
Pain radiating to the arm, jaw, or back
Dizziness or lightheadedness
Reduced stamina
Irregular heartbeat
These symptoms often worsen with physical activity or stress, making it difficult to maintain consistent work performance.
Common causes of IHD:
Coronary artery disease (CAD)
Atherosclerosis
High blood pressure
High cholesterol
Diabetes
Smoking history
Prior heart attacks
Even after treatment—such as stents, bypass surgery, or medication—many people continue to experience disabling symptoms.
How SSA Evaluates Ischemic Heart Disease (Listing 4.04)
Listing 4.04 outlines the medical criteria required to qualify for disability based on ischemic heart disease. To meet the listing, you must show:
1. Objective Evidence of Coronary Artery Disease
SSA requires diagnostic testing such as:
Angiography showing blockages
Stress tests showing reduced exercise capacity
Imaging showing ischemia
Abnormal EKG results
Evidence of prior heart attacks
2. Symptoms Consistent With Reduced Blood Flow
These may include:
Angina
Shortness of breath
Fatigue
Exercise intolerance
3. Severe Functional Limitations
SSA looks for:
Poor performance on exercise testing
Inability to complete stress tests
Low METs (metabolic equivalents)
Symptoms that occur at low levels of exertion
If your medical records show persistent symptoms despite treatment, you may meet or equal the listing.
FAQs Ischemic Heart Disease
Does ischemic heart disease automatically qualify for disability?
Not always. You must meet Listing 4.04 or show that your symptoms prevent full‑time work.
Do I need an abnormal stress test to qualify?
Not necessarily, but stress test results can strengthen your claim.
Can I qualify if I had a stent or bypass surgery?
Yes. Many people continue to experience disabling symptoms after treatment.
Does chest pain alone qualify for disability?
Chest pain must be supported by objective medical evidence.
How long does it take to get approved for IHD disability?
Initial decisions take 3–6 months, but appeals may take longer.
Qualifying for Disability Even If You Don’t Meet Listing 4.04
Most people with an ischemic heart disease and social security disability claim do not meet the exact listing criteria. Many still qualify through a medical‑vocational allowance, which evaluates how your symptoms limit your ability to work. This type of review includes your residual functional capacity and the SSA’s sequential evaluation process.
SSA considers:
How far you can walk
How long you can stand
How much you can lift
How often you need rest breaks
Whether you can sustain work for 8 hours a day, 5 days a week
Common limitations that support disability:
Chest pain with minimal exertion
Shortness of breath when walking short distances
Fatigue that limits concentration
Inability to tolerate stress
Needing frequent breaks
Unpredictable flare‑ups
Reduced ability to lift or carry objects
Difficulty climbing stairs
Even if your imaging is borderline or your stress test results are inconclusive, your functional limitations may still qualify you.
Essential Medical Evidence for IHD Disability Claims
SSA requires objective medical evidence, not just symptoms. Strong IHD claims typically include:
1. Diagnostic Testing
Angiograms
Stress tests (exercise or pharmacologic)
Echocardiograms
EKGs
Cardiac catheterization
CT or MRI imaging
2. Treatment Records
Hospitalizations for chest pain or heart attacks
Emergency room visits
Medication lists (beta blockers, nitrates, antiplatelets)
Notes from your cardiologist
Records showing medication side effects
- Medical source statements
3. Functional Evidence
Difficulty walking more than short distances
Needing frequent rest breaks
Chest pain triggered by light activity
Fatigue that limits daily activities
Difficulty concentrating due to symptoms
4. Compliance With Treatment
SSA expects:
Medication adherence
Follow‑up appointments
Lifestyle modifications
If you have difficulty affording treatment, that should be documented.
How Ischemic Heart Disease Limits Your Ability to Work
IHD affects both physical and cognitive functioning. SSA evaluates how your symptoms impact:
Physical Demands
Walking
Standing
Lifting
Carrying
Climbing stairs
Cognitive Demands
Concentration
Memory
Pace
Reliability
Environmental Demands
Heat
Humidity
Stress
Physical exertion
Many IHD claimants cannot sustain even sedentary work because chest pain, fatigue, and shortness of breath limit their ability to sit upright, focus, or maintain productivity.
Common Reasons IHD Disability Claims Are Denied
Even legitimate claims are often denied due to:
1. Lack of Objective Testing
SSA needs imaging and diagnostic results.
2. Gaps in Treatment
Missed appointments or inconsistent care can hurt your case.
3. Underreporting Symptoms
If you tell your doctor “I’m fine,” SSA assumes you are.
4. No Documentation of Functional Limitations
SSA must see how your symptoms affect work activities.
5. Failure to Explain Flare‑Ups
Many IHD claimants don’t describe how symptoms vary day‑to‑day.
MLF Legal helps you avoid these pitfalls by building a complete, well‑documented case.
How MLF Legal Helps Texans With IHD Disability Claims
Ischemic heart disease and social security disability claims require detailed medical evidence and strong legal arguments. MLF Legal supports you by:
Gathering all cardiology records
Obtaining detailed medical opinions
Documenting your functional limitations
Preparing you for SSA exams
Handling appeals and social security disability hearings
Presenting your case clearly and effectively
When your heart condition makes work impossible, you deserve support. Call MLF Legal at 214‑357‑1782 for a free consultation.
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