The Social Security Administration (SSA) is the government agency responsible for implementing the federal disability programs. As such, the SSA has the authority to determine which medical conditions qualify for coverage.
To standardize the way in which the SSA distributes disability benefits they created a list of impairments known as the “Blue Book.”
Social Security examiners, health care professionals, lawyers, and patients all utilize the Blue Book to help determine if an individual meets the criteria required to be deemed disabled under the SSA rules. The Blue Book is divided into sections addressing specific medical conditions.
How the Blue Book Can Help You Medically Qualify for Disability for Your COPD
Chronic Obstructive Pulmonary Disease, or COPD, is a name given to a handful of chronic lung diseases that are characterized by difficulty moving air in and out of the lungs. This progressive disease often begins with mild symptoms such as coughing, wheezing, and shortness of breath.
Over time, however, the symptoms worsen and sometimes put additional strain on the heart.
COPD is evaluated in the respiratory section, 3.00, of the Blue Book. More specifically, it is addressed under the chronic respiratory disorder section, 3.02. There are precise criteria which must be met for someone to be considered disabled with COPD.
First and foremost, applicants must have a recent spirometry test. Spirometry measures airflow in and out of the lungs and involves three maneuvers in which an individual forces air out of their lungs.
For this test, an individual takes a deep inhalation and then forces as much air out of their lungs as possible for as long as possible. The total amount of air that a person can exhale is the FVC.
The volume of air that a person exhales in the first second of the maneuver is the FEV1. The SSA uses a person’s highest FEV and FEV1 value to evaluate their disability eligibility for COPD.
The FEV and FEV1 values that determine disability eligibility are dependent on several factors including age, gender, and height. Additionally, several specific requirements must be met before taking the test.
For example, an individual must be medically stable at the time of the test and cannot have changed respiratory medications in the two weeks leading up to the test. The Blue Book includes several charts in section 3.02 that can be reviewed with a doctor or pulmonologist to determine where your specific test results fall.
COPD disability applicants must also take a DLCO test. This test measures the gas exchange across cell membranes in your lungs. The SSA uses the average of your two DLCO readings to evaluate your respiratory disorder.
The third critical test used to determine the severity of COPD are arterial blood gas measurements. Arterial blood gasses, or ABGs, measure the amount of oxygen, carbon dioxide, and hydrogen ions in your blood.
As with the spirometry and DLCO tests, the Blue Book includes a specific chart indicating the various ABG levels with which one could qualify for SSDI.
The SSA will also be looking for your pulse oximetry level readings, which measures the percentage of oxygen saturation to blood hemoglobin. Your medical record should have several of these readings, as they are a typical vital sign measurement for patients with COPD.
Finally, if you have experienced severe exacerbations or complications from your COPD that have required you to have at least three hospitalizations within a 12-month period and at least 30 days apart, you will be considered disabled for one year from the discharge date of your last admission.
What Evidence Do I Need to Win My COPD Claim?
The Blue Book carefully spells out what medical evidence is needed to support a claim. For respiratory disorders such as COPD, the evidence required is substantial. First and foremost, you will want to submit records from your pulmonologist indicating your symptoms, the progression of your respiratory disease, as well as a full physical exam.
As indicated above, you will want to provide the results of the following medical tests:
- Spirometry tests indicating FEV and FEV1 values (sometimes referred to as lung function tests)
- DCLCO tests
- Arterial blood gas levels, preferably over time
- Pulse oximetry levels, also over time
Other helpful medical documentation would include imaging tests that show evidence of COPD, such as a chest x-ray or CT-scan, if applicable.
As with all conditions in the Blue Book, the SSA will pay close attention to what type of medical treatment you have received and how you have responded to that treatment. For many patients, COPD is a manageable illness if medication and lifestyle changes are implemented.
Can A Lawyer Help Me Win My Claim for My COPD?
While many sections of the Blue Book are complicated, the one involving the respiratory system is unusually complex. Understanding the various pulmonary tests needed for disability consideration is difficult, even for a medically trained individual.
An experienced Social Security lawyer is well-versed in the Blue Book requirements. He or she can help you understand what documentation you have on hand, as well as what other medical evidence you should seek to collect to strengthen your claim.