Ventricular Assist Device Recipient

Definition
A ventricular assist device (VAD) is a surgically implanted device to support your heart’s function and blood flow if you have a weakened or failing heart. It pumps blood from the lower chambers of your heart (ventricles) to the rest your body to nourish your vital organs. A VAD is different from an artificial heart because its role is to assist one or both of your ventricles, as opposed to taking over the cardiac function completely.

There are three main reasons you might receive a VAD:

  • You have had heart surgery and a VAD is needed temporarily until your weakened heart recovers.
  • You are awaiting a heart transplant so a VAD is implanted until a donor can be found. This is sometimes called a ‘bridge to transplant.’
  • You have end-stage heart failure but are not a candidate for a heart transplant. This is due to your clotting disorder, irreversible kidney failure, severe liver disease, or infection that cannot be treated with antibiotics. This is sometimes referred to as “destination therapy.”

General Information
The two basic types of VADs are the left ventricular assist device (LVAD), and the right ventricular assist device (RVAD). If both types are used at the same time, it is called a biventricular assist device (BIVAD). The LVAD is the most common type of VAD. It helps the left ventricle pump blood to the aorta. The aorta is the main artery that carries oxygen-rich blood from your heart to your body. RVADs usually are used only for short-term support of the right ventricle after LVAD surgery or other heart surgery. An RVAD helps the right ventricle pump blood to the pulmonary artery. This is the artery that carries blood from the heart to the lungs to pick up oxygen. A BIVAD might be used if both ventricles cannot meet the body’s needs.

Until recently, VADs were too big to fit in many people’s chests, especially women and children. People who had large chests were the only patients who were able to benefit from VADs. However, recent medical advances have resulted in smaller, more reliable devices. This now makes treatment with VADs an option for more people, including children. Technological advances also have enabled patients with earlier stages of heart failure to benefit from VADs.

The procedure to implant a VAD requires open-heart surgery and has serious risks. However, a VAD can be lifesaving. In the last few years, VADs have improved significantly in terms of providing survival and improving quality of life among recipients.

SSA POMS: DI 23022.570 — Ventricular Assist Device Recipient: Left, Right, or Biventricular

If you are the recipient of a ventricular assist device, then your condition meets Social Security Administration (SSA) Medical Listing 4.09, or 104.09 if you are a child. Disability is based on one year after the date of your surgical implantation. After one year, your residual impairments will be evaluated.

Clinical descriptions of findings, your hospital admission and discharge summary, operative reports, cardiology consultations, imaging studies, electrocardiograms (EKG), and echocardiography all will be useful in evaluating your inability to work due to the implantation of your ventricular assist device.

Ventricular assist device recipients also may qualify for disability benefits under the SSA’s Compassionate Allowance Program, which was launched in 2008 to expedite certain disability claims. Applying for disability benefits under the Compassionate Allowance Program requires the same procedure every applicant must follow when applying for SSA disability benefits; however, you will be notified if your condition is being considered as a compassionate allowance.

Your representative may be able to expedite your disability claim if you are the recipient of a ventricular assist device.