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Social Security Disability For Restrictive Lung Disease (RLD)
I have been diagnosed with restrictive lung disease. Can I apply for Social Security Disability benefits (SSI/SSDI), Disability Insurance Benefits (DIB), or Supplemental Security Income benefits (SSI)?
Receiving a diagnosis of a restrictive lung disease is only the beginning of pursuing a claim. In a Social Security disability claim, the main focus is usually on the symptoms you experience from restrictive lung disease and how those symptoms affect your ability to engage in physical and mental work-related activities full-time.
The term “restrictive lung disease” (RLD) refers to any of the conditions that make it difficult for you to fully expand your lungs with air. It can be a disorder that causes your lungs or chest wall to be stiff, weakens your muscles, or damages your nerves. Examples are interstitial lung disease, sarcoidosis, scoliosis, neuromuscular diseases, and obesity.
Is lung disease a disability?
A common symptom of RLD is shortness of breath. At the beginning, you may experience this only when exerting yourself during physical activity. But as the condition progresses, you may experience breathlessness even during minimal activity. Another symptom is coughing, especially dry cough.
The Social Security Administration (SSA) has a five-step process to decide if you are disabled by a restrictive lung disease.
Step 1. Are you working 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 restrictive lung disease and any other physical or mental conditions are considered.
Step 2. Is your lung condition “severe”?
For the 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, SSA goes to Step 3.
Step 3. Does your medical condition satisfy the severity of a Listing?
The SSAmaintains a listing 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 restrictive lung disease can be found here.
If you donot have an impairment that meets or equals oneof the listings or the duration requirement is not met, SSA determines your Residual Functional Capacity (RFC), which is what you’re capable of doing despite your impairments. The process will proceed to Step 4.
RFC is 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.In short, it is an evaluation of your capacity for full-time work.
Step 4. Can you perform any of the jobs you have done in the last fifteen (15) years?
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 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 SSA decides you cannot perform your past relevant work, or you have not worked in the past fifteen (15) years, SSA goes on to Step 5.
Here at Step 4, you have the “burden of proof”or the responsibility 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.
Some types of objective medical evidence that can support a claim for disability based upon restrictive lung disease include:
- Results of pulmonary function studies (PFS) such as spirometry and arterial blood gas study (ABGS)
- Hospital, emergency facility and/or physician records indicating the dates of treatment
- Any treatment and response
These are some types of doctors who specialize in treating restrictive lung disease:
- Pulmonologists – focus ondisorders concerning the lungs and breathing.
- Cardiothoracic surgeons – perform surgeries on 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.
Note that if you are only treating with a primary care doctor or your family doctor for your restrictive lung disease, the SSA may conclude 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 perform any other work?
The SSA has the “burden of proof” at this step. 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, SSA will determine you are not disabled. If you cannot do other work, SSA will find you disabled.
For patients over 50, there are special rules that may apply 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.
A restriction in your breathing can substantially restrict all other aspects of your life, including your ability to earn. This may mean that you should receive assistance, though you still have to pass the SSA’s strict evaluation process. To ensure that you have an effective application, it is worth a great deal to enlist the help of a reliable lawyer.
Contact Gillette Law Group
Whether this is your initial disability claim or you are appealing a previously-denied application, we at the Gillette Law Group can provide valuable services. Over the years, we have been helping disability applicants pursue a successful claim, and we can do this for you, too. Consult with us for free – call 855-806-4269 today.