POTS Can Qualify for Disability Benefits. Here's How.

POTS, or postural orthostatic tachycardia syndrome, can qualify you for disability benefits if the disorder prevents you from working. As a disorder of the autonomic nervous system, POTS would likely qualify under Social Security Administration (SSA) criteria as a nervous system disorder, though the specifics of your condition will shape your application. Currently, more than 777,000 workers receive Social Security disability benefits for a disease of the nervous system, accounting for 9.90% of recipients overall.

Is POTS a disability?

POTS is considered a disability by the SSA. As such, POTS could qualify you for Social Security disability if your condition leaves you unable to work. You'll also need to meet other criteria outlined by the SSA to be eligible for benefits.

How the SSA defines POTS

POTS does not appear in the SSA Blue Book, but it can still qualify you for Social Security disability benefits as a nervous system disorder. However, due to the varying nature of POTS, the specifics of your condition and its symptoms will determine how you proceed in your application for disability benefits.

Symptoms of POTS, which are often exacerbated when moving from sitting down to standing up, can include:

• Dizziness or lightheadedness
• Fainting or nearly fainting
• Heart palpitations and chest pain
• Shortness of breath
• Difficulty thinking and concentrating
• Shakiness and sweating
• Fatigue
• Headache
• Blurry vision

Common types of POTS

Eligibility is mostly about whether or not you're able to work as opposed to a specific diagnosis, but the following types of POTS can all qualify you for disability:

• Neuropathic POTS: This classification of POTS is related to damage to the peripheral nerves, which regulate the contraction and expansion of certain blood vessels, particularly in the legs and abdomen.
• Hyperadrenergic POTS: This describes POTS that's associated with an overactive nervous system, with elevated levels of norepinephrine, a stress hormone.
• Hypovolemic POTS: In some cases, POTS is due to low levels of blood circulating.

Can you get disability for POTS?

Yes, you can get Social security disability benefits for POTS, as long as your condition prevents you from being able to work. You should still know that even if your condition qualifies, the process of actually getting benefits is challenging and requires meeting strict conditions.

Generally, it's easier to qualify if you are over age 50 or applying with multiple conditions,like an autoimmune condition or another condition that causes autonomic neuropathy. Common examples that can help you qualify for disability include:

• Sjogren’s syndrome
• Lupus
• Celiac disease
• Diabetes
• Lyme disease

Criteria for getting disability with POTS

You will need to provide medical evidence that your POTS prevents you from being able to work or perform necessary daily tasks, in spite of the fact that you're receiving treatment and managing symptoms.

Here are some types of documentation you should expect to provide the SSA:

• Medical records from a relevant specialist(s) showing your diagnosis and symptoms: Because of the variance in potential POTS symptoms, how you present your condition to the SSA will depend on your situation. For instance, if you predominantly experience heart issues, you may provide medical records from a cardiologist. If your POTS mostly affects your nervous system and you suffer from symptoms like insomnia, headaches, or fatigue, you should consult a neurologist and provide medical records from those visits. If you experience an array of symptoms, you'll need records from multiple specialists.
• Medical tests for your POTS: Consider taking certain tests to bolster your medical records. Potential examples include a functional capacity evaluation (FCE), tilt test, cardiovascular stress tests, and neuropsychological tests.
• Evidence that your work triggers your POTS symptoms:. ​​In addition to medical evidence, you'll want to offer specific details about your daily work duties and explain how those duties can trigger your POTS symptoms. One possibility is to get a vocation assessment, which is where a vocational expert will provide an explanation for why your POTS prevents you from working.
• Proof of another condition that appears in the Blue Book: As mentioned, POTS does not have a listing in the SSA Blue Book. You can still get disability benefits for POTS alone, but it can help your case if you also have another condition that appears in the Blue Book. For example, POTS is often a secondary condition that appears alongside an autoimmune condition or other conditions that cause autonomic neuropathy.

Questions to ask yourself before applying

Before you move forward with your application, ask yourself these questions. Answering yes to most or aloof these questions is a sign your POTS could qualify for benefits.

• Do I see a specialist for my POTS and have proof of my symptoms and diagnosis?
• Have I undergone testing for my POTS, such as an FCE, tilt test, or cardiovascular and neuropsychological tests?
• Do I experience disorganization of my motor functions? Do I have a difficult time standing from a seated position?
• Do I have other conditions that could qualify, like an autoimmune disorder?

My POTS meets the criteria. Now what?

If your POTS meets the criteria described above, the next step is to apply for disability benefits. Since the process of applying for Social Security benefits isn't quick or simple, you may want to have some level of certainty before you sink too much effort into the process. Here's some guidance that might help you to reach greater clarity about whether or not now is the time to apply for benefits.

Apply now if:

• You've received a POTS diagnosis and have thorough medical documentation of your condition and the testing you've undergone.
• Even with treatment, the symptoms of your POTS impair you to the extent that you remain unable to work.
• You have another health condition that qualifies for disability.

Consider waiting and applying later if:

• You've been diagnosed with POTS but are able to manage your symptoms enough to keep working.
• You're not planning to stop working right now, even if you think you might need to in the future.

Probably don’t apply if:

• You're still able to work in some capacity with your POTS.
• You make over $1,400 per month (the income limit for SSDI and SSI).

Atticus can also help you through the process by matching you with an experienced disability lawyer. Start with our Social Security disability quiz to see what benefits you could qualify for. A member of the Atticus team will reach out to learn more about your condition and pair you with a lawyer. It's up to you whether you want to work with the lawyer and you won't pay anything unless you win benefits.

What type of benefits should I apply for?

As you begin to navigate the world of disability benefits, you might come across two acronyms: SSDI and SSI. These are both government programs offering support to those who are unable to work due to a medical condition, alongside health insurance (Medicare for SSDI and Medicaid for SSI), but there are key differences between SSI and SSDI.

SSI, or Supplemental Security Income, is for people who haven’t worked much or at all and who have low income (about $900 or less per month) and few savings or other assets. Meanwhile, SSDI, or Social Security Disability Insurance, is for people who have worked and paid taxes for at least 10 full years.

POTS tends to develop in adolescents and young adults, so you may also be helping a loved one to navigate the application process. If that's your situation and you have questions, here is some more information on helping a loved one apply for disability benefits.

How much is a disability check for POTS?

The average monthly Social Security disability check is $1,342.17 for diseases of the nervous system and sense organs, which is how the SSA treats POTS. That said, the maximum possible benefit amount for POTS in 2023 is $3,627 per month for SSDI and $914 per month for SSI.

The maximum payments are the same regardless of how serious your POTS is or even if you're applying with multiple conditions. The amount you receive will depend on other factors. SSI is calculated based on your other sources of income, whereas SSDI is calculated based on your work and income history.

What if my POTS doesn’t meet the criteria?

Even if you don't think your POTS meets the criteria outlined above, you can still apply for benefits. Before moving forward, just keep in mind that qualifying for disability isn't an easy process, and you will need to prove that your POTS prevents you from being able to work.

Don't be surprised if your initial application gets denied —about 75% of benefits applicants are turned down on the first attempt. From there, you can appeal and the chances of winning a disability appeal are higher than the approval odds for your initial application. Not only will an appeal allow you to submit new medical evidence, but you'll have a chance to make your case before a judge.

And if you need any help along the way, either legally or financially, know that there are resources for people with disabilities to turn to.