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Social Security Disability Benefits For Cystic Fibrosis
I have been diagnosed with cystic fibrosis. Can I get Social Security Disability benefits (SSI/SSDI), Disability Insurance Benefits (DIB), or Supplemental Security Income benefits (SSI)?
Have you received a diagnosis of cystic fibrosis? That is just the start. The main focus in a Social Security disability claim is usually on the symptoms you experience from cystic fibrosis and how those symptoms affect your ability to engage in physical and mental work-related activities full-time – that is, eight (8) hours a day, five (5) days a week.
Cystic fibrosis is a genetic, progressive disease involving the mucus that should normally serve as lubricant for our internal organs. The disease makes the mucus thick and sticky. When cystic fibrosis affects your respiratory system, it causes the thick mucus to plug up ducts and airways.
This results not only in breathing problems and coughing but also in frequent lung infections, since the mucus can be a thriving habitat for bacteria. Other symptoms of cystic fibrosis include poor growth or weight gain, bowel issues, and very salty-tasting skin. Over time, the disease may cause permanent lung damage.
Can I Get Disability Benefits for My Cystic Fibrosis?
To determine if cystic fibrosis is disabling you, the Social Security Administration (SSA) uses a five-step evaluation process:
Step 1. Are you working?
The first thing that the SSA considers is 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 cystic fibrosis and any other physical or mental conditions are considered.
Step 2. Is your medical condition “severe”?
A chief indicator of disability is that your medical condition significantly limits your ability to do basic work activitiessuch 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.
For the SSA to consider you disabled, you must have a medically determinable physical or mentalimpairment (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 medical conditionmeet or equal the severity of a Listing?
A “Listing” refers to an item on the Social Security Administration’s list of medical criteria that are considered to be sosevere that you will be found disabled if your medicallydeterminable physical or mental impairment(s) matches them.The Adult Listing for cystic fibrosis can be found here.
If none of your impairments meets or equals oneof the listings, or if the duration requirement is not met, the SSA determines what you’re capable of doing despite your impairments. This isyour Residual Functional Capacity (RFC).
In determining your RFC, the SSA will conduct an evaluation of your capacity for full-time work. This involves a function-by-functionassessment of your maximumability to do sustained work-related physicaland mental activities on a regular andcontinuing basis (8 hours a day, for 5 days aweek) despite the limitations and restrictionsresulting from your medicallydeterminable impairments.
Step 4. Can you do any of the jobs you have performed in the past fifteen (15) years?
The SSA now checks 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 workmust have beensubstantial gainful activity(SGA); performed in the fifteen (15) year relevant period; and performed long enough tolearn the job. If the SSA decides you cannot perform your past relevant work, or you have not worked in the past fifteen (15) years, the SSA goes on to Step 5.
Here at Step 4, you must present evidence (or in legal terms, you have the “burden of proof”). 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.
For your objective medical evidence, these are some types of documentation that can support a claim for cystic fibrosis disability:
- 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.
In terms of specialists’ opinions, these doctors specialize in treating cystic fibrosis:
- Pulmonologists – Their focus is on illnesses concerning the lungs and breathing.
- Internists – These are doctors specializing on our internal organs.
- Specialists on specific infections – These doctors are needed depending on the type of infections that develop due to cystic fibrosis.
Specialized medical care is vital if you have cystic fibrosis – not only for the sake of your health but also for your disability claim. If you are only treating with your family doctoror primary care doctor for your cystic fibrosis, 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. Can you do any other type of work?
At this point, the SSA has the “burden of proof”. If you cannot do your past relevant work, the 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.
After age 50, 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 your evaluation.
Dealing with cystic fibrosis likely requires you to have a tailored treatment plan. The expenses that this entails, alongside your restricted ability to earn, can quickly become a huge burden. But you should not have to carry this alone. Receiving disability benefits can be a form of relief from your struggles.
Contact Gillette Law Group
To help you ensure that your disability application gets approved, count on us at the Gillette Law Group. For years, we have served numerous claimants like you, enabling them to pursue highly effective disability claims. Regardless if this is your first time applying or if your previous claim has been denied, we can work with you to give you your best chance of success.
Your consultation with us is free. Call (855) 873-2604 today.