This report, distributed by Greg Marks, Social Security Law, examines a final rule from the Social Security Administration that will change how the agency evaluates heart and blood vessel conditions in disability claims beginning October 30, 2026.
The rule, titled Revised Medical Criteria for Evaluating Cardiovascular Disorders, was published in the Federal Register on July 2, 2026, at 91 Fed. Reg. 40804. It revises the criteria in the agency’s Listing of Impairments used to evaluate cardiovascular disorders in adults and children under Titles II and XVI of the Social Security Act, which govern Social Security Disability Insurance and Supplemental Security Income. A correction was published on September 16, 2026.
According to the rule, an adult who meets a listing is presumed unable to perform any gainful activity, regardless of age, education, or work experience. The agency does not deny a claim solely because a person’s condition does not satisfy a listing. If a claim does not meet or medically equal a listing, the agency continues its evaluation and may still find the person disabled at the final step.
The agency last comprehensively revised the cardiovascular listings on January 13, 2006. The final rule completes a rulemaking that began with a proposal published on June 29, 2022. The agency received 14 public comments after extending the comment period to September 30, 2022, and said the revisions reflect its adjudicative experience, advances in medical knowledge, and those comments.
Among the changes, the rule adds new listings for aortic valvular disease (4.07), cardiomyopathy (4.08), and cardiac allograft vasculopathy (4.16 for adults and 104.16 for children), conditions the agency previously evaluated under other listings. For chronic heart failure with reduced ejection fraction, it sets a left ventricular end-diastolic dimension threshold of greater than 6.8 centimeters for males and 6.1 centimeters for females during a period of stability. It also adds instantaneous wave-free ratio as a second measure of stenosis severity for ischemic heart disease.
Some commenters asked the agency to raise the ejection fraction criterion for reduced-ejection-fraction heart failure from 30 percent or less to 40 percent or less. The agency declined, explaining that 40 percent is a threshold for diagnosing heart failure rather than for the severity required to meet a listing. It retained hospitalization criteria as one of several alternative ways to meet certain listings.
The current rules continue to apply until the effective date. Beginning October 30, 2026, the agency will apply the final rule to new applications filed on or after that date and to claims pending on or after that date, according to the rule. The agency delayed the effective date to train adjudicators.
The rule has an expiration date of October 30, 2031, five years after its effective date, unless the agency extends, revises, or reissues it. The agency’s actuaries estimate that it will result in net increases of $446 million in scheduled Old-Age, Survivors, and Disability Insurance benefit payments and $94 million in federal Supplemental Security Income payments over a 10-year period.
This release is based on the text of the final rule as published in the Federal Register. It is presented for general public awareness and is not a substitute for individualized legal advice. Whether a particular listing is met depends on the medical evidence in each case.
Greg Marks, Social Security Law, represents claimants in Social Security Disability claims and appeals in Louisville and throughout Central Kentucky and Southern Indiana.
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