Deep vein thrombosis (DVT), or blood clots in the deep veins, is a relatively common condition, affecting up to 900,000 people a year, according to the Centers of Disease Control and Prevention (CDC). Usually accompanied by pain and swelling in the legs, DVT is a serious condition because the blood clots can loosen and become lodged in the lungs.

When DVT worsens to the point of developing other serious related conditions such as chronic venous insufficiency (CVI), you may qualify for disability benefits. Below, we discuss when someone with DVT might qualify for Social Security disability benefits and what the criteria are to prove the case. For questions or help getting Social Security disability for deep vein thrombosis, contact our Social Security disability lawyer in Raleigh at Lunn & Forro, PLLC for a free consultation: 888-966-6566.

Does the SSA consider DVT a disability?

In order to obtain Social Security disability benefits, you must meet the Social Security Administration’s (SSA) definition of disabled. The Administration provides a list of impairments with specific criteria for each that the SSA uses to evaluate disabilities. DVT is not on the list, but CVI, a condition often caused by DVT, is on the listing of impairments.

An estimated 30 percent of people with DVT will develop CVI within 10 years of diagnosis, according to Cleveland Clinic. This vascular disease occurs when DVT has damaged the venous walls and valves to the point that it is difficult for the blood to return from the legs to the heart.

What are the medical criteria to obtain disability benefits for CVI?

The SSA’s listing of impairments provides that CVI may qualify for disability benefits if one of the following two characteristics exist:

  1. “Extensive brawny edema involving at least two-thirds of the leg between the ankle and knee or the distal one-third of the lower extremity between the ankle and hip.
  2. Superficial varicosities, stasis dermatitis, and either recurrent ulceration or persistent ulceration that has not healed following at least three months of prescribed treatment.”

If your CVI does not qualify under these criteria, you may still qualify for disability benefits if it prevents you from engaging in substantial gainful activity.

What are the other criteria for disability benefits?

In addition to the criteria listed in the previous section, the SSA also considers the following when determining if you qualify for disability benefits:

  • Your disability is on the listing of impairments or is equally as disabling as a condition on the list.
  • A doctor expects your condition to last a year or longer or result in death.
  • Your disability affects your ability to work in any significant capacity, despite treatment.
  • Your monthly income is less than $1,130. If you are still capable of working or can still engage in what the SSA calls “substantial gainful activity” and are earning more than that, the SSA will deny your claim.

If you are pursuing Social Security Disability Insurance (SSDI), you must prove you have sufficient work credits, which you earn every year that you are gainfully employed. The number of credits you need depends on your age. And if you are pursuing Supplemental Security Income (SSI), you must meet certain income and resources requirements to qualify.

How do I prove that I meet the requirements for benefits?

Meeting the medical evidentiary requirements is the crux of winning your Social Security benefits. You need valid medical evidence to prove your disability to the SSA. You have to prove that:

  • You have a disability, and
  • It is severe enough to render you unable to work.

The Administration is looking for a detailed picture of your impairment. This includes diagnostic test results, prognoses, and reports about your functional capacity from your treating physicians such as your primary care physician, cardiologist, and venous specialists.

Insufficient medical evidence is one of the most common reasons for disability application denials. It is highly recommended to have a legal professional assist you with preparing your records. Our attorneys have decades of personal and professional experience handling disability claims.

What do I do if the SSA denies my claim?

If you received a benefits denial letter from the SSA, you can appeal your claim. Only an average of 28 percent of claims are initially accepted, according to the Administration’s Annual Statistical Report.

The SSA denies most claims because, as mentioned before, there is insufficient medical evidence that proves you are disabled. The SSA also denies applications if it finds that you can adjust to other work or because your condition is not severe enough or is not expected to last at least 12 months.

If the SSA denies your application, call our office to schedule a consult about how to approach your appeal.

The first level of appeals is to ask the SSA to reconsider its first decision. We will gather additional evidence from medical experts and other sources to support your claim before requesting a reconsideration. Solid preparation is paramount to winning the benefits you need and deserve.

Someone at the SSA who was not part of the first decision will review your file and any new information we send, and make a determination about your benefits. If the SSA denies your claim again, there are still other levels of appeals.

Call today for a FREE consultation with a disability lawyer in Raleigh.

When you work with Lunn & Forro, PLLC, we will continue to advocate for your rights and fight for the benefits you deserve. To speak to disability attorney in Raleigh about applying for disability benefits for DVT-related conditions, contact Lunn & Forro, PLLC today for a no-cost, no-obligation consult: 888-966-6566.