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Social Security Disability For Stroke-related Respiratory Issues
I have been diagnosed with a breathing issue related to stroke. 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 stroke-related respiratory issue is just the beginning. For your disability claim, the main focus of the Social Security Administration (SSA) is on the symptoms you experience from stroke and/or respiratory condition 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.
A stroke can affect various bodily functions, even during recovery. Among the common experiences of stroke survivors are disturbances in their respiratory system, which means they have breathing problems. This can be due to a variety of post-stroke conditions such as partial paralysis of the diaphragm. Aside from changes in breathing control and patterns, respiratory problems after stroke can include sleep apnea and pneumonia.
What is the criteria for social security disability for COPD?
The SSA evaluates post-stroke disability as well as respiratory disorder disability. However, since post-stroke respiratory conditions (such as diaphragmatic paralysis) are not immediately considered by the SSA’s experts, a disability applicant must be more diligent in satisfying the SSA’s evaluation. This evaluation is a 5-step process to decide if an applicant is really disabled by the condition.
Step 1. Do you work or have a gainful activity?
First, the 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 $1,970per 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 stroke-related respiratory problem and any other physical or mental conditions are considered.
Step 2. Is your medical condition “severe”?
Disability, by SSA standards, means 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.
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 meet the severity of a Listing?
The SSA maintains a list 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. There is an Adult listing for respiratory conditions, and a separate Adult listing for stroke (which the SSA calls a “cerebrovascular accident” or a “vascular insult to the brain”).
If your impairment does not meet one of the listings or if the duration requirement is not met, SSA determines your Residual Functional Capacity (RFC) and will proceed to Step 4.
Your RFC is what you’re capable of doing despite your impairments.It 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.In short, it is an evaluation of your capacity for full-time work.
Step 4. Can you do any of the jobs you have done in the last fifteen (15) years?
At this step, 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 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 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.
You have the burden of proof at Step 4. 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 a post-stroke respiratory issue include:
- Hospital, emergency facility and/or physician records indicating the dates of stroke and dates of treatment
- Results of pulmonary function studies (PFS) such as spirometry and arterial blood gas study (ABGS)
- Any treatment and response.
Doctors who specialize in treating stroke-related breathing problems include:
- Pulmonologists – focus ondisorders concerning the lungs and breathing.
- Cardiothoracic surgeons – perform surgeries on the organs in the chest area such as the lungs
- Neurologists – specialize in nerve functions, including treatments for paralysis
- 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 post-stroke respiratory condition, 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 other work?
Here 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, SSA will determine you are not disabled. If you cannot do other work, SSA will find you disabled.
Are you 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 the evaluation of your case.
Because stroke-related respiratory issues are often complicated, and certain conditions are even sometimes overlooked, it can be very challenging to claim disability benefits based on these. But if such a condition is significantly limiting your ability to earn and live your life, you’ll want to fight for the assistance you deserve. It is important for you to have a reliable attorney to help you succeed in the demanding SSA application.
Contact the Gillette Law Group
With years of successful experience in disability claims, we at the Gillette Law Group can provide you your best chance of succeeding. We help disability applicants like you pursue an effective claim, even when the condition is complicated. Consult with us for free – call 855-806-4269 today.