Hypoplastic Left Heart Syndrome and Disability Benefits

Hypoplastic Left Heart Syndrome (HLHS) is a rare congenital heart defect in which the left side of the heart is significantly under-developed. This may include the aorta, aortic valve, left ventricle, and mitral valve. Therefore the left side of the heart is unable to send enough blood throughout the body, causing the right side of the heart to overcompensate. This eventually will cause the right side of the heart to fail as well.

While this condition is unfortunately terminal, there are many surgeries that can be done to prolong the lifespan of someone with HLHS. The first surgery, known as the Norwood operation, occurs within the first few days of life, while the second, called the Hemi-Fontan procedure or Glenn shunt, is generally done once the child is 4 to 6 months old. The final surgery is called the Fontan procedure. Although most adults with HLHS do not survive beyond their thirties, a heart transplant may be a possibility.

Blue Book Requirement

Due to the severity of the condition, it can prove extremely difficult to work. But unfortunately, a medical diagnosis of HLHS does not automatically qualify you for Social Security Disability (SSD) benefits. Instead, the Social Security Administration (SSA) must decide whether your HLHS is considered a disability under the terms of SSD benefits. The SSA determines this by looking at its “Blue Book” of requirements.

In order for the SSA to approve someone for SSD benefits under HLHS, the individual must meet the following requirements:

• The claimant must have a “symptomatic congenital heart disease (cyanotic or acyanotic), documented by appropriate medically acceptable imaging [as listed in the Blue Book] or cardiac catheterization,” with one of the following:
  • Cyanosis at rest, and:
    • Hematocrit of 55 percent or greater; or
    • Arterial O2 saturation of less than 90 percent in room air, or resting arterial PO2 of 60 Torr or less.

OR

• “Intermittent right-to-left shunting resulting in cyanosis on exertion (e.g., Eisenmenger’s physiology) and with arterial PO2 of 60 Torr or less at a workload equivalent to 5 METs or less.”

OR

• “Secondary pulmonary vascular obstructive disease with pulmonary arterial systolic pressure elevated to at least 70 percent of the systemic arterial systolic pressure.”

Which Diagnostic Testing is Approved?

As mentioned, diagnostic testing must be documented via the appropriate medically acceptable imaging listed in the SSA’s Blue Book. Testing may include:

• Cardiac catheterization;
• Electrocardiogram (ECG); and/or
• Echocardiogram; and other imaging studies.

A physical exam conducted by a medical professional can also help to diagnose HLHS by identifying the following:

• Faster than normal heart rate;
• Rapid breathing;
• Shortness of breath;
• Enlargement of the liver;
• Weak pulses;
• Poor feeding;
• Cold extremities (hands and feet);
• Bluish (cyanosis) or poor skin color;
• Weight loss;
• Abnormal heart sounds; and/or
• Lethargy.

While HLHS can greatly impact daily life for the individual suffering from it and his or her loved ones, SSD benefits can help to make things easier. A knowledgeable and experienced Las Vegas SSD Attorney can help guide you through the application process to give you the best chance for approval of benefits

The Las Vegas SSD Attorneys at Roeschke Law, LLC Can Help

If you or a loved one is struggling with a disability that prevents you from working, you may not know how to proceed. Fortunately, the attorneys at Roeschke Law, LLC can help. We understand the impact that a disability can have on your physical, emotional, and financial health as well as that of your loved ones. That’s why it’s our mission to help you. To learn more, or to schedule a consultation, contact us today!