Postural Orthostatic Tachycardia Syndrome (POTS) is a complex chronic condition characterized by an abnormal increase in heart rate upon standing, leading to various symptoms. These symptoms can significantly disrupt daily life, affecting an individual’s ability to perform routine tasks and maintain employment. While challenging, obtaining disability benefits for POTS is possible for individuals whose symptoms prevent them from working. This article guides you through the process of seeking disability benefits for POTS, focusing on eligibility, evidence gathering, and application steps.
POTS and Disability Eligibility
The Social Security Administration (SSA) defines disability as the inability to engage in substantial gainful activity (SGA) due to a medically determinable physical or mental impairment. This impairment must be expected to last for a continuous period of not less than 12 months or result in death. For 2025, the monthly SGA amount for non-blind individuals is $1,550. POTS is not explicitly listed in the SSA’s “Blue Book” (Listing of Impairments), which outlines conditions automatically considered disabling if certain criteria are met. Despite not being listed, individuals with POTS can still qualify for benefits if their condition significantly limits their functional capacity. The SSA evaluates these cases based on a “medical vocational allowance,” focusing on the overall impact of the illness. This involves assessing how symptoms like severe fatigue, dizziness, lightheadedness, and cognitive dysfunction prevent an individual from performing basic work tasks. The SSA administers two main types of benefits: Social Security Disability Insurance (SSDI), which is for those with a sufficient work history and who have paid Social Security taxes, and Supplemental Security Income (SSI), a needs-based program for individuals with limited income and resources.
Gathering Medical Evidence for Your Claim
A strong disability claim for POTS relies on comprehensive medical evidence. This includes detailed medical records from all treating physicians, encompassing doctor’s notes, hospital visit summaries, and specialist reports from cardiologists, neurologists, or autonomic specialists. Diagnostic test results are also crucial, such as tilt-table tests, which measure heart rate and blood pressure changes upon standing, and other autonomic testing that assesses nerve function. Documentation should clearly outline how your symptoms limit daily activities and work ability. For example, it should specify if you experience frequent syncope (fainting), severe orthostatic intolerance preventing prolonged standing or walking, or cognitive dysfunction often referred to as “brain fog” that impairs concentration and memory. An invaluable piece of evidence is a Residual Functional Capacity (RFC) form, completed by your treating physician. This form details your specific limitations, such as how long you can sit, stand, or walk, your ability to lift, and any environmental restrictions.
Steps in the Disability Application Process
Applying for disability benefits with the SSA begins with an initial application, submitted online, by phone, or in person. After submission, your application is forwarded to a state agency called Disability Determination Services (DDS). The DDS reviews medical evidence and may contact doctors for additional information. In some cases, they may schedule a consultative examination (CE) with an independent doctor. If the initial application is denied, you have the right to request a reconsideration, where your case is reviewed again by a different DDS examiner. If the reconsideration is also denied, the next step is to request a hearing before an Administrative Law Judge (ALJ). At this hearing, you can present new evidence and testimony, often with legal representation. Further appeals to the Appeals Council and then to federal court are possible if the ALJ denies the claim.
Addressing Challenges in POTS Disability Claims
Obtaining disability benefits for POTS presents unique challenges due to its fluctuating, often “invisible” symptoms. Daily symptom variation makes consistent demonstration of functional limitations difficult. The lack of objective diagnostic markers, compared to conditions with clear structural damage, and insufficient medical documentation are common reasons for denial. To mitigate these issues, maintain a detailed symptom diary, recording frequency, severity, and impact on daily activities. Ensure consistent medical care and clearly communicate your limitations to treating physicians; for complex cases or during appeals, legal representation from a disability attorney can significantly improve your chances.