POTS, or postural orthostatic tachycardia syndrome is one of several malfunctions of the autonomic nervous system.
The autonomic nervous system is part of the body’s ability to control body functions through unconscious and automatic methods.
If you suffer from a POTS, which is a form of dysautonomia, you may qualify for Social Security disability benefits.
The Social Security Administration (SSA) oversees the Social Security Disability Insurance (SSDI) program, which pays monthly benefits to disabled workers, including those with POTS.
In order to be eligible for disability benefits with POTS, you have to have worked enough to earn sufficient credits and to have paid an adequate amount of taxes to the SSDI and have a serious disability that forces you to be unable to work for at least 12 months.
Since POTS can essentially affect any body system, the symptoms experienced and their severity can vary significantly from patient to patient.
Patients may experience fatigue, headaches, fainting, nerve and muscle pain, orthostatic hypotension (falling blood pressure when standing), anxiety, sleep disorders, sensory disorders, muscle and nerve pain, digestive disorders, and many other issues.
Those conditions can make it impossible to work full time and if you have POTS and you think you won’t be able to work anymore because of it, then you may be able to qualify for disability.
Is POTS a Disability?
Yes, POTS can be considered a disability by the Social Security Administration (SSA) if an applicant is able to meet the administration's definition of and criteria for disability outlined in their Blue Book.
If your POTS symptoms are severe and you are unable to continue working or do not expect that you will be unable to work for at least the next 12 months, then you may be able to obtain disability from the SSA.
How to Medically Qualify for Disability with POTS
The SSA uses a comprehensive guide called the Blue Book to classify disabilities that qualify for Social Security disability benefits.
The Blue Book is the list of conditions that qualify for disability. While there is no specific listing for POTS, but there are listings for the different body systems that are impacted by the disorder.
In order to file for your condition, you need to focus on the severity of the symptoms and which body systems are most severely impacted.
Some common symptoms associated with POTS include:
- anxiety;
- digestive disorders;
- fainting;
- fatigue;
- headaches;
- muscle pain;
- nerve pain;
- orthostatic hypotension;
- sensory disorders;
- sleep disorders.
Many of the common symptoms associated with POTS are listed in the SSA’s Blue Book and can qualify for disability.
If you focus on the primary body area that is impacted by your POTS, you can narrow down the listings in the Blue Book that the SSA can compare to your application.
This enables you to better understand the medical evidence you need to provide in order to give Disability Determination Services the evidence required to show that you cannot work anymore because of POTS.
As an example, if you are suffering symptoms that impact your blood pressure and heart from POTS, you should focus on the Blue Book Section pertaining to the Cardiovascular System, which is Section 4.00 and see if you can match your medical records and their details to the requirements for being disabled according to that particular condition.
There are several other Blue Book sections that may apply to POTS, including:
- Neurological – Section 11.00
- Digestive System – Section 5.00
The kind of POTS, the symptoms experienced, and any other medical conditions in conjunction with POTS will impact your eligibility for SSDI benefits.
You have to provide evidence to prove your POTS disability claim, so you have to provide medical records that document several things, including:
- Your medical diagnosis
- Symptoms and length and frequency of episodes
- Treatments undertaken and their results
Your doctor should include statements that also indicate:
- The manner of the appearance of symptoms
- The effect of those symptoms on your abilities and daily life, including work
- Any other information that may be pertinent in determining how your particular condition limits you
If you cannot prove the severity of your POTS by using a Blue Book listing, you may still qualify for disability with POTS through a medical-vocational allowance.
What To Do If Your POTS Does Not Meet the Criteria
If your POTS does not meet a listing in the Blue Book, you can still qualify for disability, but you will have to do so using a medical vocational allowance.
A medical vocational allowance shows that your POTS symptoms are severe enough to keep you from seeking and maintaining gainful employment.
This approach uses a residual functioning capacity (RFC), which is a form that your doctor fills out that clearly states any limitations or restrictions you may have because of your POTS.
You have to provide supporting documents that show your POTS, prevent you from finding a job and continuously performing it despite your qualifications because of your symptoms.
As an example, your RFC may indicate that you cannot stand for more than an hour because of the severity of your fatigue and pain from POTS, or you may not be able to stay in one position long because of fainting.
This is a very thorough and detailed approach that is effective in getting approved for disability with POTS. Documentation is the key to a successful POTS disability claim.
Applying Specific Medical Tests to Your POTS Disability Case
POTS can have many symptoms, so your documentation should include extensive test results. These may include a tilt table test to determine blood pressure fluctuations, digestive system testing, and various scans and x-rays as well as lab work.
The SSA may order a medical evaluation from a physician that they choose at their expense to get additional information and to confirm the severity of your condition.
This is for informational purposes only and not for medical treatment.
If you work with a disability lawyer, your lawyer will be able to tell you what tests to include in your disability case that can give you the bast chance of winning.
The Cost of Treating POTS
According to Dysautonomia International, treating POTS or dysautonomia can be expensive.
An individual with the disorder will have copays and coinsurance for doctor visits, prescriptions to treat the symptoms, various medical equipment such as compression stockings, and medical tests.
On average, an individual with POTS that has health insurance pays out about $1,500 per year for the condition.
If the POTS worsens, or becomes more severe, those costs will increase. There are specialized clinics that treat dysautonomia and those costs considerably more but do often provide a better relief of symptoms.
With the help of Social Security Disability, you may be able to receive money to offset these financial challenges.
Get Help With Your POTS Disability Case
If you think that your POTS will make it impossible for you to work full time, then you may want to apply for disability.
If you are planning on applying for disability with POTS, then you should get help from a disability lawyer.
When you work with a disability lawyer, you are 3x more likely to get approved for disability than those who go in alone.
A disability lawyer will be able to help you with your application and any appeals that you have. A disability lawyer will be able to testify for you on why you can no longer work because of POTS.
A disability lawyer does not charge for upfront costs, they are only paid if you win your case. Take our free disability evaluation case today to get started.
