ConditionsCardiovascular SystemChronic Heart Failure
Blue Book Listing 4.02

Chronic Heart Failure

Long-term inability of the heart to pump enough blood to meet the body's needs.

What you have to prove

Show: (1) medically documented systolic or diastolic failure, AND (2) either (a) persistent symptoms that very seriously limit ability to independently initiate, sustain, or complete activities of daily living, OR (b) three or more separate episodes of acute congestive heart failure within 12 months, OR (c) inability to perform on an exercise tolerance test at 5 METS.

Medical evidence SSA expects

Echocardiogram showing ejection fraction (typically ≤30%), chest X-ray, exercise tolerance test (or documented medical contraindication), hospital admission records, and a cardiologist's functional assessment.

Common misconceptions

An ejection fraction alone doesn't guarantee approval — SSA wants documented functional limitation. Patients who respond well to medication may not meet the listing even with low EF.

Didn't meet the listing? You can still qualify via a Medical-Vocational Allowance — SSA's determination that your residual functional capacity, combined with your age, education, and work history, leaves no jobs you can do. See our appeals guide for what to do after an initial denial.