The Social Security Administration has finished rewriting the medical rules examiners use to decide cardiovascular disability claims, and the new version takes effect October 30, 2026. The rule closes a gap that has existed since the agency’s last full rewrite of the heart listings in January 2006, when severe aortic valve disease and cardiomyopathy had no listing written specifically for either one and had to be evaluated under criteria built for other heart conditions. Disability examiners will apply the updated criteria to every new application filed on or after the effective date, and to every claim still pending on that date, regardless of when the person originally filed. The rule follows a proposal that first circulated for public comment in 2022.
Two Heart Conditions Get Listings of Their Own
Before this rewrite, neither aortic valve disease nor cardiomyopathy had a listing written specifically for it. Examiners instead had to fit those claims into listings built for chronic heart failure, ischemic heart disease, recurrent arrhythmias, congenital heart disease and other conditions, along with a general neurological listing, none of which were designed around the specific findings those two conditions produce. The Social Security Administration’s own account of the rulemaking says the agency added dedicated listings because the two conditions can progress quickly and cause a level of disability the older, borrowed criteria were not built to capture.
The finished rule, published July 2, 2026 under Docket No. SSA-2019-0013 and RIN 0960-AI43, creates listing 4.07 for aortic valvular disease, commonly called aortic valve disease, and listing 4.08 for cardiomyopathy, with parallel child listings, and sets the whole rewrite to take effect October 30, 2026. A third new listing, 4.16 for adults and 104.16 for children, covers cardiac allograft vasculopathy, a narrowing of the heart’s blood vessels that can develop after a heart transplant. The agency drew a clear boundary around that listing in response to a public comment: 4.16 applies only to vasculopathy tied to a prior transplant, while narrowed heart arteries without a transplant history continue to be evaluated under the existing ischemic heart disease listing, 4.04.
Cardiomyopathy claims illustrate how the final version changed from the 2022 draft. One commenter told the agency that some Disability Determination Services offices face logistical barriers to ordering the exercise tolerance tests used in listing 4.08, and asked Social Security to add a functional alternative. The agency agreed, adding functional criteria to listing 4.08A that mirror an existing exception used in the chronic heart failure listing, so a claim can still meet the standard when a treating source or medical consultant concludes an exercise tolerance test would pose a significant risk to the person.
The line that ends a payment: SSI counts income and resources every month, and a change that crosses the limit is usually found later, during a review. See the 2026 limits in The SSI & Disability Action Kit.
A 2022 Proposal Reworked After Fourteen Public Comments
Social Security first proposed the rewrite in a notice of proposed rulemaking published June 29, 2022, then extended what was originally a 60-day comment window after multiple requests for more time, closing it on September 30, 2022. The agency received 14 public comments from advocacy groups, legal services organizations, medical organizations and individual commenters, and the final rule spends dozens of pages responding to each one. The rewrite draws on a report the Institute of Medicine produced on cardiovascular disability, but the agency says it supplemented that report with current medical research and consultation with its own cardiologists before finalizing the listing language.
Several of the changes between the proposal and the final rule came directly from those comments. Chronic heart failure criteria now use separate left ventricular end-diastolic dimension cutoffs for men and women, 6.8 centimeters and 6.1 centimeters respectively, rather than one shared threshold, after commenters argued the original measurement did not reflect how heart size differs by sex. The agency’s Office of Disability Policy, whose contact for the rule is listed as Michael J. Goldstein, also revised terminology throughout the listings, replacing outdated terms such as “peripheral arterial disease” with “peripheral artery disease” to match current medical usage.
A Four-Month Runway Before Examiners Use the New Criteria
Social Security said it delayed implementation on purpose, to give the agency time to update its internal systems and train the disability examiners and adjudicators who apply the listings nationwide before the new criteria take hold. Until the rule takes effect, the current, unrevised listings continue to control every determination, including new applications filed in the months between the rule’s July 2026 publication and its effective date. An applicant filing an aortic valve or cardiomyopathy claim today is evaluated under the older, more general listings unless the case is still open when the new listings take effect.
The rule states plainly that the new listings will apply to new applications filed on or after the effective date, and to claims that are pending on or after the effective date, meaning a claim filed in August and still awaiting a decision on October 30 would be judged under the same criteria as a claim filed after the rule takes hold. Cases already decided before that date, including denials issued under the old listings, are not automatically reopened.
The rule has already required one official fix. The Federal Register published a one-page correction on September 16, 2026, catching a typographical error on page 40837 of the original text, where a numbered subheading about how examiners evaluate ECG evidence had dropped its number. The correction does not change any listing criterion, income figure or eligibility standard; it fixes formatting in the appendix so the printed listing text matches what the agency intended when it drafted the rule.
Claimants whose heart condition does not precisely match the wording of listing 4.07, 4.08 or any other cardiovascular listing are not automatically denied. The rule’s introductory text preserves Social Security’s long-standing medical equivalence policy, under which an impairment that is not specifically named can still qualify if the agency determines it is equal in severity to a listed condition, a standard the agency reaffirmed repeatedly in its responses to commenters throughout Docket No. SSA-2019-0013.
What a Cardiac Claim File Has to Show
Meeting the medical criteria in a listing such as 4.07 or 4.08 only answers whether Social Security recognizes a heart condition as disabling; it says nothing about staying eligible once a claim is approved. SSI recipients remain subject to monthly income and resource limits and periodic reviews that can end a payment even after a listing-level diagnosis is confirmed. Aligning a new medical listing with the program’s existing eligibility rules is a separate process most recipients never see spelled out.
The SSI & Disability Action Kit is a 10-page kit that lays out the 2026 SSI income and resource limits alongside review and reporting steps recipients use to keep a payment in place.
See the current limits and reporting steps in The SSI & Disability Action Kit.
This article was researched and drafted with the assistance of AI and reviewed by The Money Overview editorial team.
