Living with Postural Orthostatic Tachycardia Syndrome (POTS) can feel overwhelming, especially when symptoms prevent you from maintaining employment. The financial strain of lost income, combined with mounting medical expenses, creates additional stress during an already difficult time. Still, many people with POTS experience severe symptoms and functional limitations that interfere with daily activities and work capacity.
Many people living with POTS wonder if their condition qualifies them for disability benefits and how to navigate the complex application process. The good news is that while POTS is not explicitly listed in the Social Security Administration’s Blue Book, individuals with severe symptoms may still qualify for disability support. If you are struggling with POTS and need help securing the benefits you deserve, our disability attorneys at Ryan Bisher Ryan & Simons are here to guide you through every step of the process.
What Is Postural Orthostatic Tachycardia Syndrome (POTS)?
Postural Orthostatic Tachycardia Syndrome is a chronic condition that affects the autonomic nervous system, which controls involuntary body functions such as heart rate and blood pressure. POTS disrupts the body’s ability to regulate blood flow and maintain proper circulation when changing positions, leading to symptoms upon standing. POTS is characterized by an abnormal increase in heart rate when moving from a lying or sitting position to standing. According to medical research, individuals with POTS experience an increase of at least 30 beats per minute within ten minutes of standing, without a corresponding drop in blood pressure that would indicate orthostatic hypotension.
The condition primarily affects women of childbearing age, with estimates suggesting that 0.1 to 1% of the North American population lives with POTS. Symptoms extend far beyond the hallmark rapid heart rate and can include:
- Lightheadedness
- Tremulousness
- Mental clouding
- Nausea
- Chronic fatigue
- Migraine headaches
- Sleep difficulties
- Cognitive impairment
These symptoms are typically relieved when lying down, but can severely impact daily activities and work capacity when upright. Secondary POTS can also develop as a result of other underlying medical conditions, such as diabetes, Lyme disease, or autoimmune disorders.
POTS often goes undiagnosed for years. Research shows that patients experience an average diagnostic delay of almost five years from their first symptoms, indicating significant challenges with recognition and probable underdiagnosis within the medical community.
To confirm a POTS diagnosis, healthcare professionals rely on specific diagnostic criteria, including a sustained increase in heart rate of at least 30 beats per minute within ten minutes of standing (or 40 bpm in adolescents), in the absence of orthostatic hypotension. The diagnostic process typically involves a comprehensive clinical evaluation, symptom assessment, and the use of medical tests such as the tilt table test. These medical tests are essential for substantiating the diagnosis and supporting disability claims related to POTS.
The key to establishing disability for POTS lies in demonstrating the severity and persistence of your symptoms through comprehensive medical evidence and documentation of how these symptoms impact your functional capacity.
Can You Get Disability For POTS?
Yes, you can get disability for POTS, though the path to approval requires careful documentation. Is POTS a disability recognized explicitly in the SSA’s Blue Book? The answer is no. However, this does not prevent individuals from qualifying for benefits. The SSA evaluates claims based on how severely a condition limits your ability to perform work-related activities. The SSA uses a specific disability definition to determine whether a medical condition like POTS qualifies for disability benefits.
To determine if you qualify, the SSA examines whether your POTS symptoms prevent you from maintaining substantial gainful activity for at least 12 months. They consider your symptoms in combination with your work history, education level, and transferable skills to assess whether any jobs exist that you could reasonably perform given your limitations. Applicants must meet strict eligibility criteria, including providing documentation of symptoms, test results, and the impact on work capacity to satisfy the SSA’s standards.
The key to establishing disability for POTS lies in demonstrating the severity and persistence of your symptoms through comprehensive medical evidence and documentation of how these symptoms impact your functional capacity. Individuals with POTS often face significant employment challenges, such as difficulty maintaining consistent attendance or performing job duties, and these challenges should be thoroughly documented in your claim.
How to Qualify for Disability Benefits From POTS
Qualifying for disability benefits under POTS requires detailed medical documentation and proof of functional limitations. Seeking SSD benefits means thoroughly documenting symptoms, test results, and the impact of POTS on daily life to improve your chances of approval. Gathering comprehensive evidence strengthens your claim and improves the likelihood of approval.
Some things that can help your disability application include the following:
- Confirmed Diagnosis: Obtain a formal diagnosis from a licensed physician. Tests like the tilt table test provide objective evidence of abnormal heart rate and blood pressure responses.
- Symptom Documentation: Record daily symptoms such as chronic fatigue, dizziness, brain fog, and exercise intolerance. Physician notes detailing how these symptoms impair work and daily life are essential.
- Functional Testing: Consider a Functional Capacity Evaluation (FCE) to measure physical limitations and a neuropsychological evaluation to document cognitive limitations.
- Medical Records: Collect thorough medical documentation, including detailed treatment histories, ongoing treatment records, lab results, and specialist reports to support the severity and duration of your condition.
- Application Accuracy: Complete and submit a disability application for POTS disability benefits, ensuring all medical and employment documentation is included to avoid delays or denials.
Vocational evidence, such as statements from employers or vocational experts, can help demonstrate how POTS symptoms limit your job performance and work capacity, further strengthening your claim for disability benefits.
Disability Insurance Benefits For POTS
Because POTS imposes significant health limitations—such as dizziness, fatigue, and heart palpitations—that can affect daily activities and quality of life, both short-term and long-term disability insurance coverage may be necessary. These policies typically fall into two categories: short-term and long-term disability.
Short-Term Disability Policy
Short-term disability policies typically replace 60% to 70% of your income for a limited period, usually six months to one year. After a brief waiting period of one to two weeks following proof of disability, benefit payments begin. These policies can provide crucial financial support during the initial stages of dealing with severe POTS symptoms, though the limited duration means they are not a long-term solution if your condition persists.
Long-Term Disability Policy
Long-term disability policies offer more extended coverage, typically providing 60% of your income for several years. Some policies continue until you reach retirement age, depending on the policy terms and conditions. These policies become relevant when your disability extends beyond the short-term coverage period, and you remain unable to work due to ongoing symptoms.
Why Are POTS Disability Claims Often Denied by Insurance Companies or the SSA?
Despite the debilitating nature of POTS, many disability claims are denied due to several common issues. Lack of objective evidence is a major hurdle, as symptoms like fatigue, brain fog, and nausea are often self-reported and subjective. Insufficient medical tests, such as the absence of a tilt table test or other relevant assessments, can also contribute to claim denials. Insurance companies demand more concrete medical documentation to substantiate claims.
Symptom variability also complicates approval; insurers may argue that good days indicate the ability to work full-time. Pre-existing condition exclusions pose another barrier, particularly if symptoms appeared before coverage or diagnosis was delayed. Insurers often require independent medical examinations or conduct surveillance, misinterpreting normal daily activities as proof of work capacity.
Research underscores the real impact of POTS: only 48% of patients are employed, and over 70% report income loss, with 36% losing more than $10,000 annually. Despite this, insurers frequently resist approval, making thorough medical evidence and legal advocacy essential for successful disability claims.
How a Disability Lawyer Can Help with Your POTS Disability Claim
Given the complexities and high denial rates, working with an experienced disability attorney is crucial. A lawyer can help you gather the necessary medical evidence, ensuring your doctors provide detailed documentation that clearly links your symptoms to functional limitations.
Attorneys familiar with POTS cases know which tests and evaluations strengthen claims. They can coordinate with medical providers to obtain comprehensive reports, guide you through FCE and neuropsychological testing, and ensure all documentation is submitted before deadlines.
If your claim is denied, an attorney can file a strong appeal that addresses the specific reasons for denial and presents additional evidence to counter the insurer’s arguments. They can also identify when insurers have acted in bad faith or violated policy terms.
For cases governed by ERISA (Employee Retirement Income Security Act), strict deadlines and procedural requirements apply. Missing these deadlines can permanently bar your claim. An attorney ensures compliance with all requirements and builds a complete administrative record for potential litigation.
Contact Ryan Bisher Ryan and Simons Today
At Ryan Bisher Ryan & Simons, our attorneys have decades of experience handling disability claims for injured and disabled Oklahomans. We have successfully recovered millions of dollars in verdicts and settlements for deserving clients throughout Oklahoma City and across the state.
Our team treats every client with the personalized attention and respect you deserve during this difficult time. Does POTS qualify for disability in your situation? Let us evaluate your case and fight for the benefits you need. Contact Ryan Bisher Ryan & Simons today to schedule a free consultation about your disability for POTS claim.
We are Ryan Bisher Ryan & Simons, a legal firm that, for decades, has been fighting for the rights of hardworking Oklahoma residents. Our mission is to hold the powerful accountable.
