Does POTS Qualify for Disability? POTS Disability Accommodations From the SSA

by Shay Fleming   ·  2 weeks ago  

POTS is an often-misunderstood disability that can have far-reaching and debilitating effects on the body, limiting the ability to work and earn a living for people who have it. But is POTS a disability in the eyes of the Social Security Administration?

The answer, as is often the case, is that it depends. POTS is a type of dysautonomia that can cause dizziness, extreme fatigue, and even fainting (among other issues). Depending on the severity, these symptoms may inhibit your ability to work, at which point the SSA may consider your case. Because of this, POTS can potentially qualify you for disability benefits.

If you’re hoping to seek disability benefits for POTS, read more to learn more about how to apply.

Getting Social Security Disability for POTS: Key Takeaways

  • POTS is a condition that causes dizziness, fainting, chronic fatigue, brain fog, and other debilitating symptoms
  • The SSA awards disability benefits to individuals who have severely debilitating symptoms that keep them from being able to work
  • SSI and SSDI eligibility requirements vary but typically include income and resource limits, work history information, and proof of disability
  • POTS disability benefits can be awarded if your symptoms are severe enough that they’ll keep you from work for a year or more

What is Postural Orthostatic Tachycardia Syndrome (POTS)? Symptoms and Side Effects

Postural Orthostatic Tachycardia Syndrome (POTS) is a condition that affects the autonomic nervous system, which controls involuntary functions like heart rate, blood pressure, and digestion. In POTS, there is an abnormal response to changes in position, particularly from lying down to standing up.

Symptoms of POTS can vary from person to person, but common ones include:

  1. Tachycardia: This is a rapid increase in heart rate, usually more than 30 beats per minute from lying down to standing up. This can cause palpitations and a sensation of a racing heart.
  2. Orthostatic Intolerance: People with POTS often experience symptoms like dizziness, lightheadedness, or even fainting when they stand up. This happens because blood pools in the lower body instead of being pumped back to the heart and brain efficiently.
  3. Fatigue: Chronic fatigue is a significant symptom of POTS and can be debilitating for some individuals. It can interfere with daily activities and quality of life.
  4. Brain Fog: Many individuals with POTS report cognitive difficulties, such as difficulty concentrating, memory problems, and overall mental fogginess.
  5. Headaches: Headaches, often of the migraine type, are common in people with POTS.
  6. Gastrointestinal Symptoms: These may include nausea, vomiting, abdominal pain, and irregular bowel movements.
  7. Sleep Disturbances: POTS can disrupt sleep patterns, leading to insomnia or unrefreshing sleep.
  8. Temperature Regulation Problems: Some individuals may experience symptoms related to poor temperature regulation, such as feeling excessively hot or cold.

POTS can significantly impact daily life, making simple tasks like standing or walking difficult. It can also lead to secondary complications such as deconditioning due to decreased physical activity, anxiety, and depression.

Disability Criteria From the SSA

The Social Security Administration (SSA) provides disability benefits through two programs: Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). Both programs have their own criteria for determining disability.

For SSDI, you must meet the following criteria:

  1. Work Requirement: You must have worked in jobs covered by Social Security, and you must have worked long enough and recently enough to qualify for benefits through the acquisition of work credits.
  2. Medical Condition: You must have a medical condition that meets the SSA’s definition of disability. This means you are unable to work due to a severe medical condition that is expected to last at least one year or result in death.

For SSI, you must meet the following criteria:

  1. Income Requirement: You must have limited income and resources.
  2. Medical Condition: You must have a medical condition that meets the SSA’s definition of disability, similar to SSDI.

In both cases, the SSA uses a five-step evaluation process to determine if you are disabled:

  1. Are you working?: If you are currently working and your earnings exceed a certain threshold (known as substantial gainful activity), the SSA will typically not consider you disabled.
  2. Is your condition severe?: Your condition must interfere with basic work-related activities.
  3. Is your condition found in the list of disabling conditions?: The SSA maintains a list of medical conditions that are considered severe enough to prevent a person from engaging in substantial gainful activity. If your condition is on this list, you are generally considered disabled. If not, the SSA will assess whether your condition is of equal severity to those on the list.
  4. Can you do the work you did previously?: If your condition is severe but not on the list, the SSA will determine if it interferes with your ability to do the work you did before.
  5. Can you do any other type of work?: If you cannot do the work you did before, the SSA will consider your age, education, past work experience, and transferable skills to determine if there is other work you can do despite your condition.

It’s important to note that the disability determination process can be complex, and the criteria may vary depending on individual circumstances. It’s often beneficial to seek assistance from a qualified attorney or advocate experienced in disability claims to navigate the application process effectively.

Is POTS Considered a Disability by the SSA?

While POTS is considered a disability according to the SSA, it doesn’t appear in the Blue Book, which means it isn’t a condition that automatically qualifies you for disability benefits. However, despite not being in the Blue Book, you may still get Social Security disability benefits for a nervous system disorder by proving your condition is comparable to other disabilities in the book. Working with a lawyer can help strengthen your claim and improve your chances of getting approved.

How Hard Is it to Get Disability for POTS?

Obtaining disability benefits for POTS can be challenging because it depends on various factors such as the severity of your symptoms, how they affect your ability to work, and the extent to which they are documented by medical professionals.

To qualify for disability benefits, you would need to demonstrate that your POTS symptoms are severe enough to prevent you from engaging in substantial gainful activity (SGA) for at least one year. This often involves providing detailed medical documentation, including records of diagnostic tests, treatment plans, and statements from treating physicians regarding the nature and extent of your limitations.

It’s important to note that the SSA evaluates disability claims on a case-by-case basis, and the outcome can vary depending on individual circumstances. Working with a knowledgeable attorney or advocate who understands the disability claims process can be beneficial in presenting your case effectively and increasing your chances of a successful outcome.

Which POTS Symptoms Might Limit Your Ability to Work?

Several symptoms of POTS can potentially limit your ability to work, depending on their severity and how they affect your daily functioning. Some of these symptoms include:

  1. Dizziness and Lightheadedness: POTS often causes dizziness and lightheadedness, particularly upon standing or sitting up quickly. These symptoms can make it difficult to perform tasks that require standing for extended periods, such as working in retail or hospitality.
  2. Fainting or Near-Fainting Spells: Individuals with POTS may experience fainting or near-fainting episodes, especially when changing positions. These episodes can pose a significant risk in work environments where sudden loss of consciousness could lead to injury or accidents.
  3. Fatigue: Chronic fatigue is a common symptom of POTS and can impact your ability to sustain attention and focus throughout the workday. This may affect productivity and performance in tasks that require concentration and mental acuity.
  4. Brain Fog and Cognitive Dysfunction: Many individuals with POTS experience cognitive symptoms such as brain fog, difficulty concentrating, and memory problems. These cognitive impairments can interfere with job-related tasks that require complex thinking, problem-solving, or multitasking.
  5. Heat Intolerance: Heat intolerance is common in individuals with POTS and can exacerbate symptoms such as dizziness, fatigue, and palpitations. Working in hot environments or outdoors may be challenging and may exacerbate POTS symptoms.
  6. Orthostatic Intolerance: POTS is characterized by orthostatic intolerance, meaning symptoms worsen when standing upright. This can make tasks that involve prolonged standing or walking difficult to perform consistently.

It’s important to note that the severity and combination of symptoms vary among individuals with POTS, and their impact on work ability will depend on factors such as job requirements, accommodations available, and individual coping strategies. Working with healthcare providers and occupational specialists can help individuals with POTS identify strategies to manage symptoms and optimize their work capacity.

Other Medical Conditions & Comorbidities That May Help You Get Disability for POTS

Individuals over 50 or with multiple conditions, such as autoimmune disorders or those causing autonomic neuropathy like lupus, celiac disease, diabetes, or Lyme disease, may find it easier to qualify for disability benefits alongside POTS. These conditions, when combined, provide additional evidence of the cumulative impact on work capacity, supporting the disability claim.

Medical Evidence You’ll Need for Your POTS Disability Claim

To improve your chances of getting disability for POTS, gather the following proof of disability documentation to present to the SSA.

Medical Records

When preparing a disability claim for POTS, gathering comprehensive medical evidence is crucial. This includes obtaining detailed medical records that document the diagnosis of POTS by a qualified healthcare provider. These records should include reports of diagnostic tests such as tilt table testing, autonomic function tests, and cardiac evaluations, as well as a thorough treatment history including medications and therapies used to manage POTS symptoms.

Medical Evidence

In addition to medical records, providing medical evidence that illustrates the severity and frequency of POTS symptoms is essential. This evidence should outline symptoms such as orthostatic intolerance, tachycardia, dizziness, and fatigue, and how they impact daily functioning. Documentation of any comorbid conditions, such as autoimmune disorders or neuropathies, and their contribution to POTS symptoms should also be included.

Evidence that Work Triggers Your Symptoms

It’s also beneficial to include evidence demonstrating how work triggers your POTS symptoms. Personal statements detailing how work-related activities exacerbate symptoms like dizziness, palpitations, and fatigue can provide valuable insight. Reports from supervisors or colleagues corroborating observations of symptom exacerbation during work tasks can further strengthen the claim.

Proof of Other Conditions

Lastly, providing proof of any other conditions that coexist with POTS is important. Medical records confirming the diagnosis of comorbid conditions, along with reports from specialists detailing their impact on overall health and functional ability, can help paint a comprehensive picture of the individual’s medical condition and its effects on their ability to work.

How to Apply for POTS Disability Benefits

Navigating the process of applying for disability benefits for POTS can be complex, but understanding the steps involved can help streamline the process. From gathering medical evidence to completing the application, individuals with POTS can take proactive steps to present a strong case for any types of disability benefits. By following the guidelines set forth by the Social Security Administration (SSA), applicants can increase their chances of a successful outcome in obtaining the assistance they need.

Applying for Social Security Disability Insurance (SSDI) With POTS

To apply for Social Security Disability Insurance (SSDI) benefits for POTS, you first need to determine your eligibility. This includes meeting the criteria of having worked and paid Social Security taxes for a specific period and having a medical condition that meets the Social Security Administration’s definition of disability.

Once you confirm your eligibility, gather comprehensive medical evidence documenting the diagnosis of POTS by a qualified healthcare provider. This evidence should include reports of diagnostic tests, treatment history, and documentation of how POTS symptoms impact your daily functioning. Complete the SSDI application online, over the phone, or in person at your local Social Security office, providing detailed information about your work history, medical condition, and functional limitations.

Be sure to submit all supporting documentation, including medical records and statements from healthcare providers, to strengthen your disability claim. If requested, attend any consultative examinations scheduled by the SSA to assess your condition further. After submitting your application, the SSA will review your medical evidence and determine your eligibility for SSDI benefits, a process that may take several months. Be patient while waiting for a decision.

Applying for Supplemental Security Income (SSI) With POTS

To apply for Supplemental Security Income (SSI) benefits for POTS, you must first determine if you meet the eligibility criteria. This includes having limited income and resources, as well as having a medical condition that meets the SSA’s definition of disability.

Gather documentation of your income, assets, and resources, as well as information about any other benefits you may be receiving. Complete the SSI application online, over the phone, or in person at your local Social Security office, providing detailed information about your financial situation, medical condition, and functional limitations. Include all relevant medical evidence, financial documents, and any other supporting documentation to strengthen your SSI disability claim.

Similar to SSDI, attend any consultative examinations requested by the SSA to assess your condition further. After submitting your application, the SSA will review your medical and financial evidence to determine your eligibility for SSI benefits. This process may also take several months, so it’s essential to be patient while awaiting a decision. If your disability claim is denied, you have the right to appeal the decision by following the instructions provided in the denial letter to request a reconsideration or appeal hearing.

Whether you apply for SSI or SSDI to help support your experience living with POTS, a disability lawyer can help bolster your chances at success.

Work With a Disability Lawyer to Improve Your Odds of Approval

Take the proactive step towards securing your disability benefits by partnering with a skilled disability lawyer. With their expertise and guidance, you can navigate the complexities of the application process and improve your chances of approval. Don’t navigate the process alone – enlist the support of a knowledgeable legal advocate to advocate for your rights and help you obtain the benefits you deserve for your POTS.

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Shay Fleming is the SEO Content Manager at LeadingResponse. A proud graduate of Texas State University, she has been based in Austin since 2016, where she lives with her dog. Shay has contributed extensively to various domains, writing and publishing articles about real estate, investing, disability, and urban living.