If you have been diagnosed with DVT (deep vein thrombosis) and you experience recurrent blood clots or your condition is treatment resistant, then you should consider applying for Social Security disability.
Deep vein thrombosis (DVT) and peripheral artery disease (PAD) are the most common vascular diseases seen by Social Security disability judges. There are, of course, other vascular diseases, such as intestinal ischemic syndrome, aneurysms, lower extremity ulcers, and other diseases of the blood vessels.
DVT occurs when a blood clot develops, usually in internal leg veins. If not properly treated, a part of the blood clot can break free and travel to the lungs (where it is called a pulmonary embolism) or to the heart, where it can cause a heart attack, or to the brain, where it can cause a stroke.
According to the National Institutes of Health, only about half the people with DVT will exhibit symptoms such as swelling of the legs, discolored skin, or pain and tenderness. DVT are sometimes revealed in diagnostic tests such as an MRI or CT scan performed for some other reason.
Why DVTs are Often Disabling
In a Social Security disability context, DVTs are often disabling because effective treatment often lasts a year or longer and because patients with one DVT are at greater risk for recurrent DVTs.
The main focus a Social Security disability case considers whether you have the capacity to perform the duties of a simple, entry-level job. DVT creates job reliability problems in that patients often need to keep their legs extended and raised over heart level, pain that would interfere with attention and concentration and frequent periods of 24 hour bed rest.
DVT is also a condition that can be documented objectively with ultrasound, blood tests (elevated D dimer), venography and CT or MRI scans. Social Security adjudicators and administrative law judges look favorably on medical conditions that can be directly imaged.
If your DVT symptoms have been present or are expected to be present for 12 consecutive months, you would be eligible for SSDI or SSI.
Most DVT based claims are decided either under a Listing argument or under a functional capacity argument.
The Listing Argument
If you are going to pursue a listing argument, the listings to review are 4.11 and 4.12. Listing 4.11 references chronic venous insufficiency of a lower extremity with incompetency or obstruction of the deep venous system, and listing 4.12 references peripheral arterial disease documented by extremely low blood pressure (i.e., poor circulation) in the feet and ankles.
If a blood clot has traveled to your lungs, resulting in a pulmonary embolism, listing 3.02 would likely apply and if you have experienced a stroke listing 11.04 would likely apply.
If you are not yet represented, you may be able to secure your doctor’s cooperation by printing out the appropriate listing or listings, and asking your doctor to write a narrative report which includes all of the elements of the listing.
When I am representing a client with DVT and complications I will create a checklist statement that tracks the language of the listing or listings and ask the doctor to complete this form. I will then submit the form along with medical records and a brief/request for on-the-record decision.
The Functional Capacity Argument
When I am representing a client with DVT issues, I present both a listing argument and a functional capacity argument. DVT treatment and complications will inherently produce work activity problems. Every DVT client I have represented has had doctor’s orders to keep his/her legs extended over at least waist level, and every one of these clients has experienced episodes lasting 2 to 4 weeks where he/she was totally bedridden while medications were administered to dissolve clots.
Generally, when I draft a questionnaire for the doctor I will include questions that track the language of the listing as well as questions that document how the DVT treatment would negatively impact the claimant’s reliability and attendance.
In general claims involving DVT are solid disability cases because this condition is painful and because any vocational witness will testify that workers at any skill level need come to work prepared to either sit or stand, and cannot perform job tasks reclining or lying down.
If you have been diagnosed with a lower extremity DVT, or if you are dealing with a pulmonary embolism, I would be happy to explain how Social Security disability might be able to offer financial security and access to Medicare.
Here are some case studies from recent cases I have tried that involve vascular diseases
Vascular Disease Case Study #1: 40 year old man who developed DVT after minimally successful spine surgery. His case was also complicated by diabetes and a significant anxiety and depression history. This case resulted in a favorable decision.
DVT Case Study #2: 46 year old male with recurrent DVT flare-ups and non-healing stasis ulcer likely caused by lupus and antiphospholipid antibody syndrome. This case resulted in a fully favorable bench decision.
Vascular Disease Case Study #3: 61 year old male with diabetes and decreased heart function. He experiences dangerous leg swelling unless he keeps his legs elevated at least half of the day. This case resulted in a favorable decision.