On October 30, 2026, the Social Security Administration’s revised medical rules for evaluating heart and blood vessel disorders took effect. SSA published the updated instructions for children’s claims in its Program Operations Manual System (POMS) the day before.

If your child has a heart condition and you’re applying for Supplemental Security Income (SSI), these are the rules SSA and North Carolina’s Disability Determination Services will now use to evaluate the claim. That’s true whether you live in Charlotte, Raleigh, Asheville or a small town in between.

What changed?

SSA renamed this part of its children’s rulebook from “Cardiovascular System” to “Cardiovascular Disorders” and comprehensively revised the criteria. These are the rules SSA uses to decide whether a child’s condition is severe enough to qualify. Under the revised rules, SSA evaluates children’s heart conditions in five main categories:

• Chronic heart failure
• Recurrent arrhythmias (irregular heart rhythms)
• Congenital heart disease (heart defects present at birth)
• Heart transplantation
• Cardiac allograft vasculopathy (narrowing of the arteries in a transplanted heart)

Chronic heart failure

A child with chronic heart failure who is on prescribed treatment can qualify by showing one of the following:

• A persistently fast resting heart rate. It must be measured at least twice, at least 90 days apart, within 12 months. The threshold depends on age, for example 150 beats per minute for babies under 1 and 100 for teens over 15.
• Persistently fast breathing at rest, or markedly reduced exercise tolerance, measured on the same schedule.
• Growth failure: three weight or BMI measurements below the 3rd percentile, at least 60 days apart, within 12 months.
• An implanted heart pump, such as an LVAD. SSA considers the child disabled for one year from the date it’s implanted. Short-term devices like ECMO don’t count.
• Three hospitalizations for heart failure within 12 months, at least 30 days apart, each lasting at least 48 hours. Time spent in the emergency room just before admission counts toward the 48 hours.

Congenital heart disease

Children born with heart defects may qualify with:

• Chronically low blood oxygen, shown by specific blood tests or repeated pulse-oximetry readings
• Pulmonary hypertension confirmed by cardiac catheterization
• A single ventricle (for example, hypoplastic left heart syndrome) that has required or will require Fontan surgery
• For infants under age 1: a life-threatening heart defect that requires surgery in the first year of life. SSA considers these babies disabled until at least their first birthday.
• Three hospitalizations within 12 months, under the same rules as above

Arrhythmias and transplants

Irregular heart rhythms can qualify when they cause repeated fainting or near-fainting episodes despite treatment, documented by an EKG, a Holter monitor or other appropriate testing. A child who receives a heart transplant is considered disabled for one year after the transplant, and SSA then re-evaluates.

What evidence SSA needs

SSA generally wants at least three months of medical records showing your child’s condition, treatment and how they’re responding. After a recent heart surgery, a hospitalization for heart failure, or a new medication, SSA will usually wait about three months to see how your child stabilizes before deciding. SSA won’t pay for cardiac catheterization, and it won’t order exercise stress tests for children under 6.

Tips for North Carolina parents:

• Ask your child’s pediatric cardiologist for complete records, including echocardiograms and test results.
• Keep copies of growth charts from every visit.
• Save hospital discharge papers, and note how long your child spent in the ER before admission.
• Write down fainting episodes, shortness of breath and feeding problems as they happen.

Not meeting a listing doesn’t mean no

Even if your child doesn’t match these criteria exactly, SSA can still find them disabled if their limitations are as serious as a listed condition, or if several conditions together are severe enough. Many valid claims are denied at first and approved later on appeal. Keep in mind that child SSI also has family income and resource limits.

Adults with heart conditions: the same rule change also revised the listings SSA uses for adults, adding conditions like cardiomyopathy and aortic valve disease. Read our guide to the new adult heart disability rules.

How Golson, McCracken Inc. can help

Our team has helped North Carolina families with children’s disability claims for decades. We serve clients statewide, including at hearings in Charlotte, Raleigh, Greensboro and Fayetteville. (See approval rates by hearing office.) You pay nothing unless we win.

Call (888) 529-3678 or fill out our Client Questionnaire to get started.

Source: SSA POMS DI 34005 TN 38, Listings of Impairments: Cardiovascular Disorders (effective 10/30/2026). This post is general information, not legal advice for any individual case.