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Social Security Disability Benefits For Emphysema

I have been diagnosed with emphysema. Can I receive Social Security Disability benefits (SSI/SSDI), Disability Insurance Benefits (DIB), or Supplemental Security Income benefits (SSI)?

Having a diagnosis of emphysema can be the start of a disability claim. However, the main focus in a Social Security disability claim is usually on the symptoms you experience from emphysema and how those symptoms affect your ability to engage in physical and mental work-related activities eight (8) hours per day, five (5) days per week – in other words, full-time.

Emphysema is a long-term progressive disease that centers on the over-inflation of the air sacs in the lungs called the alveoli. This over-inflation weakens and even ruptures the walls of these air sacs, resulting in reduced oxygen supply in your bloodstream.

Can You Get Disability If You Have Emphysema?

The key symptom of emphysema is shortness of breath. This condition can develop so gradually that you may not notice the signs at first, or you may simply think you are out of shape. But as the condition progresses, the breathing difficulty can seriously affect your physical and mental functioning. If emphysema is left untreated, it may even lead to a collapsed lung or heart problems.

To determine if emphysema is disabling you, the Social Security Administration (SSA) uses a five-step evaluation process.

Step 1. Are you working?

First, the SSA looks at your current 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 the SSA examines your emphysema more closely.

Step 2. Is your medical condition “severe”?

A disability entails that your medical condition significantly limits 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.

For the SSA to find you 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. But if your condition is that severe, your evaluation proceeds to the next step.

Step 3. Does your medical condition meet or equal the severity of a Listing?

A “listing” refers to the medical criteria in the Social Security Administration’s list.These medical criteria 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 emphysema can be found here.

If your impairment does not meet or equal any of the listings, or the duration requirement is not met, the SSA looks instead into your Residual Functional Capacity (RFC).In simple terms, this is what you’re capable of doing despite your impairments.

Determining the RFC involves 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.

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 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 evaluation goes on to the fifth step.

Still here at Step 4, you have the “burden of proof” or the obligation to 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.

In terms of objective medical evidence, these are some documentation that can support a claim for disability based upon emphysema:

  • 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, these are some doctors who specialize in treating emphysema:

  • Pulmonologists – They are specialists in illnesses concerning the lungs and breathing.
  • Cardiothoracic surgeons – They perform surgeries on the organs in the chest area such as the lungs.
  • Internists – These doctors specialize in internal organs.

You’ll need to consult a specialist for your emphysema, instead of just relying on your family doctor or primary care doctor. If you don’t see a specialist, 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?

The SSA has the burden of proof at this stage. 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 you are not disabled. But if you cannot do other work, the SSA will find you disabled.

If you are over 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 disability evaluation.

Many people may dismiss emphysema as a simple and passing irregularity in breathing. But if you have been suffering from this condition for a while, and if it has started affecting your ability to work, you know it is a real burden for which you need assistance.

Contact Gillette Law Group

You can successfully apply for disability benefits with our help at the Gillette Law Group. Over the years, our legal service has enabled numerous disability claimants to pursue applications that are effective and more likely to get approved by the SSA. We can do this for you, too. Whether this is your initial claim or your appeal for a previous SSA denial, we can provide the help you need.

Don’t wait to pursue your Social Security disability claim. We provide you with a free consultation, so talk to us today at (855) 873-2604.

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