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.