What Is Social Security Listing 4.02?
Listing 4.02 applies to adults with chronic heart failure who remain severely limited despite following prescribed medical treatment.
To qualify under this listing, both Part A and Part B must be satisfied. In other words:
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You must have objective medical proof of severe heart dysfunction, and
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That condition must cause serious, ongoing functional limitations or repeated acute episodes.
Part A: Medical Proof of Severe Heart Failure
Social Security first looks at imaging and test results, not just symptoms. You must have documented evidence of either systolic failure or diastolic failure during a period of medical stability.
1. Systolic Heart Failure
You may qualify if testing shows:
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Left ventricular end diastolic dimension greater than 6.0 cm, or
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Ejection fraction of 30% or less
These measurements must be taken when your condition is stable, not during a sudden heart failure crisis.
2. Diastolic Heart Failure
Alternatively, you may qualify if imaging shows:
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Combined posterior wall and septal thickness of 2.5 cm or greater
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Enlarged left atrium measuring 4.5 cm or more
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A normal or elevated ejection fraction
Again, these findings must be documented during a stable period, not during an acute episode.
Part B: How Heart Failure Limits Your Daily Life
In addition to medical imaging, Social Security requires proof that your heart failure causes severe functional consequences. You only need to meet one of the following:
1. Persistent, Severe Limitations in Daily Activities
You may qualify if:
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You have ongoing symptoms of heart failure that very seriously limit daily activities, such as walking, dressing, cooking, or personal care, and
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A medical professional concludes that exercise testing would be unsafe due to the risk to your health
This often applies to individuals whose condition is too fragile for treadmill or stress testing.
2. Repeated Episodes of Acute Congestive Heart Failure
You may qualify if you have:
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Three or more separate episodes of acute congestive heart failure within 12 consecutive months
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Each episode includes evidence of fluid retention
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Each episode requires extended medical intervention, such as:
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Hospitalization, or
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Emergency room treatment lasting 12 hours or more
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Episodes are separated by periods where symptoms temporarily stabilize
Hospital records and imaging reports are especially important for this category.
3. Inability to Perform an Exercise Tolerance Test (5 METs or Less)
You may also qualify if testing shows you cannot safely perform exercise at a workload equivalent to 5 METs or less due to:
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Severe shortness of breath, fatigue, palpitations, or chest pain
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Dangerous heart rhythm abnormalities
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A significant drop in blood pressure during exercise
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Signs of reduced blood flow to the brain, such as confusion or unsteady walking
These findings must be documented by appropriate medical testing.
Why Many Claims Are Denied — Even With Heart Failure
Social Security frequently denies claims because:
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Medical records do not clearly document the required measurements
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Hospitalizations are not fully documented
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Doctors do not explain how symptoms limit daily functioning
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Testing results are incomplete or taken during acute episodes only
This is where experienced legal guidance makes a difference.
How We Help
At the Law Office of Jonathan W. Cole P.C., we:
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Review cardiology records and imaging for listing-level findings
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Identify qualifying hospitalizations and episodes
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Work with medical providers to clarify functional limitations
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Present your case in a way Social Security understands
You do not have to figure this out alone.
Get Help With a Heart Failure Disability Claim
If you or a loved one is living with chronic heart failure and can no longer work, benefits may be available — but the rules are strict and evidence matters.
If you have questions about a Social Security Disability claim, contact the Law Office of Jonathan W. Cole P.C. at (708) 529-7794 — Your Neighborhood Law Firm.
📞 (708) 529-7794 | Law Office of Jonathan W. Cole P.C. — “Your Neighborhood Law Firm.”
