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Social Security Disability Benefits For Chronic Obstructive Pulmonary Disease (COPD)
I have been diagnosed with chronic obstructive pulmonary disease (COPD). Can I receive Social Security Disability benefits (SSI/SSDI), Disability Insurance Benefits (DIB), or Supplemental Security Income benefits (SSI)?
Receiving a diagnosis of chronic obstructive pulmonary disease (COPD) is just the start of a possible disability claim. The main focus in a Social Security disability claim is usually on the symptoms you experience from COPD and how those symptoms affect your ability to engage in physical and mental work-related activities full-time – that is, eight (8) hours per day, five (5) days per week.
The term “chronic obstructive pulmonary disease” refers to any of the chronic (long-term) diseases involving an obstructed airflow to or from the lungs. The obstruction may be due to the inflammation of pulmonary tubes or of the air sacs in the lungs, caused by factors like cigarette smoke, dust, and chemical fumes.
The most common examples of COPD are chronic bronchitis and emphysema. These diseases may be life-threatening in certain cases and may also lead to complications such as lung cancer.
Is Chronic Obstructive Pulmonary Disease a Disability?
Though COPD is typically treatable, it often does not show symptoms until significant pulmonary damage has occurred. Watch out for signs such as shortness of breath, wheezing, chest tightness, chronic coughing, lack of energy, and a bluish tinge on the lips or fingernails.
Before you can receive disability benefits, the Social Security Administration (SSA) uses a five-step process to decide if you are disabled.
Step 1. Are you earning with a gainful activity?
At the first step, SSA considers your work activity. If you are engaged in Substantial Gainful Activity (SGA),you will not be found disabled. The amount you must earn to be working at SGA changes each year. For 2018, it is $1,180 per month if you are not blind and $1,970 per month if you are blind. If you are working, and your earnings average more than the SGA limit, then you will not be found disabled. If you are not working, or your earnings are less than SGA, the process proceeds to Step 2 where your COPD and any other physical or mental conditions are considered.
Step 2. Is your COPD “severe”?
For SSA to determine that you are disabled, your medical condition must significantly limit your ability to do basic work activities such as sitting; standing; walking; lifting; carrying; understanding, remembering, and carrying out simple instructions; making simple work-related decisions; responding appropriately to supervision, co-workers, and work stress; and dealing with changes in a routine work setting.
To be found disabled, you must have a medically determinable physical or mental impairment (or a combination of impairments) that is severe and has lasted or is expected last one (1) year or end in death. If your medical condition is not that severe, you will not be found to meet the requirements for Social Security disability benefits. If your condition is that severe, the SSA goes to Step 3.
Step 3. Does your COPD match an SSA Listing?
The Social Security Administration maintains a listing of medical criteria that are considered to be so severe that you will be found disabled if your medically determinable physical or mental impairment(s) matches them.The Adult Listing for COPD can be found here.
If you do not have an impairment that meets or equals one of the listings or the duration requirement is not met, the SSA determines what you’re capable of doing despite your impairments – your Residual Functional Capacity (RFC) – and will proceed to Step 4.
RFC is a function-by-function assessment of your maximum ability to do sustained work-related physical and mental activities on a regular and continuing basis (8 hours a day, for 5 days a week) despite the limitations and restrictions resulting from your medically determinable impairments.In short, it is an evaluation of your capacity for full-time work.
Step 4. Are you still able to perform any work you’ve done in last fifteen (15) years?
At this step, the SSA decides if your medical condition prevents you from being able to work full-time at jobs you have done in the past fifteen (15) years. If the SSA decides you can perform any of your past relevant work (PRW), you will be found not disabled. To be PRW, the work must have been substantial gainful activity(SGA); performed in the fifteen (15) year relevant period; and performed long enough to learn the job. If the SSA decides you cannot perform your past relevant work, or if you have not worked in the past fifteen (15) years, the SSA goes on to Step 5.
You have the “burden of proof” at Step 4 – in other words, you must present evidence. Two of the strongest types of evidence at this stage are medical records and the opinions of the doctors who are treating you for the conditions that are affecting your ability to work. The strongest medical evidence is what is known as objective medical evidence, or evidence that does not rely upon what you tell your doctors. The strongest opinions are opinions that are offered by doctors who specialize in the condition that is keeping you from working and which are supported by objective medical evidence.
Some types of objective medical evidence that can support a claim for disability based upon COPD include:
- Hospital, emergency facility and/or physician records indicating the dates of treatment
- Clinical and laboratory findings, such as the results of spirometry and arterial blood gas studies (ABGS)
- Treatment administered
- Time period required for treatment
- Clinical response.
Doctors and professionals who specialize in treating COPD include:
- Pulmonologists – doctors who focus on illnesses concerning the lungs and breathing.
- Cardiothoracic surgeons – surgical doctors for the organs in the chest area such as the lungs
- Pulmonary rehabilitation specialists – may include non-doctor professionals trained to help patients manage breathing problems.
If you are only treating with your family doctor or primary care doctor for your COPD, the SSA may interpret this as meaning that your condition is not that serious (otherwise you would be treating with a specialist). An experienced Social Security disability lawyer can help you locate sources of treatment even if you don’t have health insurance.
Step 5. Is there any other work you can do?
At Step 5, the “burden of proof” shifts to SSA. If you cannot do your past relevant work, SSA looks to see if you would be able to do other work. It evaluates your medical condition, your age,education, past work experience, and any skills you may have that could be used to do other work. If you can do other work, the SSA will determine that you are not disabled. If you cannot do other work, the SSA will find you disabled.
Can I Get a Disability Check For COPD?
Are you over 50 years old? There are special rules that may apply to your claim that can result in a finding of disability even if there is some other work you could perform on a full-time basis. An experienced Social Security disability lawyer will be familiar with these rules and can ensure that they are considered in the evaluation of your case
Having chronic obstructive pulmonary disease can be a daily struggle, not just physically but also financially. You may truly deserve assistance, so don’t be discouraged by the rigorous evaluation process of the SSA.
Contact Gillette Law Group
You can pursue a highly effective disability application with our help at the Gillette Law Group. We can provide the experienced legal service you need to make your disability claim much more likely to get approved – just as we have successfully served numerous applicants over the years.
Whether this is your first time applying or if you are in the process of an appeal, let us assist you. Consult with us for free by calling (855) 873-2604 today.