Hypertrophic Cardiomyopathy (HCM) is a condition characterized by the abnormal thickening of the heart muscle, often affecting the wall separating the heart’s bottom chambers. This excessive muscle growth makes it harder for the heart to pump blood effectively, leading to fatigue, shortness of breath, and potentially life-threatening heart rhythms. Whether HCM qualifies as a legal disability depends entirely on the severity of the symptoms and the extent to which they prevent a person from working. A diagnosis of HCM alone is insufficient; the claim must demonstrate that the functional limitations meet strict governmental standards.
Understanding the Legal Standard for Disability
A medical condition is considered a legal disability by the Social Security Administration (SSA) only if it prevents a person from engaging in Substantial Gainful Activity (SGA). This initial threshold means the individual cannot earn above a certain monthly income, which for non-blind individuals in 2025 is set at $1,620. The definition of disability is strict, requiring total inability to work rather than partial disability.
The second core requirement is that the medical condition must have lasted, or be expected to last, for a continuous period of at least 12 months, or be expected to result in death. Simply having a severe heart condition that requires a few months of recovery will not meet this duration standard. The SSA’s evaluation process first determines if the applicant is working above the SGA level and then moves to assessing the medical severity of the impairment.
If the applicant is not working, the SSA attempts to determine if the medical evidence is severe enough to qualify under a specific list of impairments. This list is commonly known as the Blue Book, and the criteria for cardiovascular disorders are outlined in Section 4.00. Having a diagnosis like Hypertrophic Cardiomyopathy is merely the starting point; the medical documentation must show the condition’s objective severity and functional consequences.
Meeting Specific Medical Criteria for Hypertrophic Cardiomyopathy
HCM does not have its own dedicated listing in the Blue Book, but it is evaluated under related cardiovascular criteria, such as those for chronic heart failure or recurrent arrhythmias. Meeting a Listing requires specific, objective medical evidence demonstrating a high level of severity, resulting in an automatic finding of disability.
Chronic Heart Failure and Structural Abnormalities
Applicants may qualify by meeting criteria for chronic heart failure, which focuses on objective signs of systolic or diastolic dysfunction. Documentation must include imaging results showing specific structural abnormalities, such as left ventricular wall thickness greater than 15 mm, often alongside functional limitations. A key measurement is the left ventricular outflow tract (LVOT) gradient; a finding of 50 mm Hg or greater, documented via echocardiogram or cardiac catheterization, is a significant indicator of severity. Severe symptoms must persist despite prescribed medical treatment.
Recurrent Arrhythmias
A third path relates to recurrent, life-threatening arrhythmias. The SSA requires documentation of repeated episodes of fainting (syncope) or near-fainting caused by the arrhythmia, occurring despite prescribed treatment. Diagnostic tests like Holter monitoring are necessary to capture the arrhythmia coincident with the symptoms. Longitudinal clinical records, typically covering at least three months, are needed to show the limitations are not temporary.
Proving Disability Through Functional Limitations
If an applicant’s HCM does not meet the strict objective criteria of a specific Listing, the SSA will then assess the individual’s Residual Functional Capacity (RFC). The RFC is an assessment of the most a person can still do in a work setting despite the limitations caused by their medical condition. This secondary step considers the cumulative effect of all symptoms, not just the raw medical measurements.
The evaluation focuses on the individual’s ability to perform work-related activities like lifting, standing, walking, sitting, and concentrating. HCM symptoms such as persistent shortness of breath, profound fatigue, dizziness, and chest discomfort (angina) are carefully considered in this assessment, even if the condition is not severe enough to meet a Listing. The treating cardiologist’s detailed opinion on these physical limitations is extremely valuable in this phase of the review.
An RFC assessment may determine that the applicant is limited to only sedentary work, which involves lifting no more than 10 pounds and standing or walking for no more than two hours in an eight-hour workday. If the SSA finds that the applicant’s limitations prevent them from performing any past relevant work and cannot adjust to any other work that exists in the national economy, disability benefits may be awarded. This path is more individualized and relies heavily on the documented severity of subjective symptoms and their impact on daily function.
Preparing and Submitting a Disability Application
The most important step in preparing a disability application for Hypertrophic Cardiomyopathy is gathering comprehensive medical evidence. This includes detailed reports of the medical history, physical examinations, laboratory studies, and all prescribed treatments and the patient’s response to them. A complete record ensures the SSA has the necessary information to evaluate the severity and duration of the impairment.
Applicants must authorize the SSA to obtain all medical records from every hospital and physician who has treated the condition. This should include all diagnostic test results, such as the full report of the echocardiograms, cardiac stress tests, and any Holter monitor readings. The longitudinal nature of the records is important to show that the condition has been continuously severe over time.
It is highly beneficial to obtain a detailed statement from the treating cardiologist that addresses the patient’s specific functional limitations. This statement should go beyond the diagnosis and explain exactly why the HCM symptoms, such as fatigue or shortness of breath, restrict the ability to perform work-related tasks like walking or lifting. If an application is initially denied, which is common, the applicant has the right to appeal the decision, continuing to submit new medical evidence as their condition progresses.