Listing code
4.09
Adult (Part A)
Body system
4.00
Cardiovascular system
Subsections
0
No lettered criteria
Step in evaluation
3 of 5
Listing match approves the claim
SSA listing text and criteria
Heart transplant . Consider under a disability for 1 year following surgery; thereafter, evaluate residual impairment under the appropriate listing. Back to Top
This listing has no lettered subsections. The diagnosis itself, supported by the medical evidence described in the body-system overview, is what SSA evaluates.
Source: SSA Blue Book listing 4.09. Last synced 2026-05-04.
Where claims under 4.09 usually fail
Claims often fail when the record clearly shows a transplant but does not include enough medical evidence to show what residual cardiovascular impairment is present after the first year, so the evaluation cannot move forward under the correct post-transplant listing. Another pitfall is assuming the 1-year rule means disability continues automatically forever, even though the rule says residual impairment is evaluated under the appropriate listing after that 1-year period. Some people also expect the cardiovascular general criteria to translate into one specific set of symptoms or test results for 4.09, but this specific listing has no lettered subsections, so the criteria focus on the diagnosis plus the medical evidence SSA evaluates for cardiovascular impairments. Lastly, people sometimes confuse other cardiovascular problems (for example, vein or artery disorders) with a transplant listing, even though those conditions are evaluated under other specific listings (like 4.11 or 4.12 for peripheral vascular disease) rather than 4.09.
Medical evidence that strengthens this claim
To support 4.09, medical documentation should establish that a heart transplant occurred and provide medical evidence for cardiovascular impairment evaluation in general, since cardiovascular listings are based on symptoms, signs, laboratory findings, response to prescribed treatment, and functional limitations. After the post-surgery year, documentation should also describe any continuing cardiovascular consequences that fit the cardiovascular impairment framework, such as chronic heart failure or ventricular dysfunction, myocardial ischemia-related discomfort or pain, syncope or near-syncope due to inadequate cerebral perfusion, or central cyanosis related to right-to-left shunt or reduced arterial oxygen concentration. Medical evidence that shows how the person's limitations persist and how they respond to prescribed treatment is particularly important because functional limitations are part of how cardiovascular impairments are evaluated.
What happens if your records do not meet this listing
4.09 is a 1-year post-transplant evaluation path. If disability is not treated under 4.09 for the full period, SSA then evaluates residual impairment after the post-surgery year under the appropriate cardiovascular listing(s) for the remaining problems. Many claims that miss 4.09 for timing or documentation still can be approved later if the medical evidence shows ongoing cardiovascular consequences that fit another specific listing in the cardiovascular section.
Work activity and the SGA gate for this condition
SSDI eligibility begins with the SGA work-activity rule, which generally requires not performing substantial gainful activity while the claim is pending. For heart transplant cases, the 1-year post-surgery evaluation under 4.09 is a key timing concept, but sustained work after transplant depends on the person's residual cardiovascular impairment and functional limitations that SSA evaluates using the cardiovascular impairment framework (including chronic heart failure or ventricular dysfunction, myocardial ischemia-related discomfort or pain, syncope or near-syncope, or central cyanosis). If approved, eligibility continues through the trial work period and then may continue through the extended period of eligibility, which applies after the trial work period for those who remain eligible under program rules.
Listing 4.09 FAQ
Questions that come up repeatedly for heart transplant disability claims.