4.04: Ischemic Heart Disease

What actually decides a claim under 4.04

Evidence of myocardial ischemia: exercise tolerance test results at specified workloads, three separate ischemic episodes requiring revascularisation in twelve months, or angiographic findings of specified severity plus very serious limitation. There is also a rule people miss after bypass or valve surgery — a recovery period is generally allowed before the durable outcome is judged, so filing too soon can produce a denial that says more about timing than about your heart.

Conditions evaluated under 4.04

• Ischemic Heart DiseaseHow SSA evaluates it, the evidence that decides it, and why claims are denied

Frequently asked questions

Do you have to meet 4.04 to be approved?

No. Meeting a listing is one route to approval and not the most common one. Most awards are made on residual functional capacity — what SSA concludes you can still do across a full working week, given your age, education and past work. A claim that falls short of 4.04 can still be approved that way, which is why a denial citing this listing is not the end of the matter.

What if my records do not meet 4.04 exactly?

Two things can still happen. SSA can find your condition medically equals the listing — equal in severity and duration without matching every criterion — or it can move on to the functional assessment described above. What sinks these claims is usually a gap in the file rather than a gap in the criteria: a limitation you live with that no doctor wrote down.

Which conditions are evaluated under 4.04?

Ischemic Heart Disease. The criteria are the same; what differs is the evidence each condition needs to satisfy them.