Symptomatic congenital heart disease (cyanotic or acyanotic) SSDI Claims in Wyoming

Medical criteria

SSA Blue Book listing

4.06 Symptomatic congenital heart disease (cyanotic or acyanotic)

Listing criteria (20 CFR Appendix 1, Part A)

documented by appropriate medically acceptable imaging (see 4.00A3d) or cardiac catheterization, with one of the following: A. Cyanosis at rest, and: 1. Hematocrit of 55 percent or greater; or 2. Arterial O 2 saturation of less than 90 percent in room air, or resting arterial PO 2 of 60 Torr or less. OR B. Intermittent right-to-left shunting resulting in cyanosis on exertion (e.g., Eisenmenger's physiology) and with arterial PO 2 of 60 Torr or less at a workload equivalent to 5 METs or less. OR C. Secondary pulmonary vascular obstructive disease with pulmonary arterial systolic pressure elevated to at least 70 percent of the systemic arterial systolic pressure.

Body system category

4.00 Cardiovascular System

Common denial reason

Congenital heart disease claims are often denied when cyanosis, exercise intolerance, or right-to-left shunt evidence does not meet listing thresholds.