Chronic obstructive pulmonary disorder or COPD can be a very debilitating respiratory health problem. When severe enough it can make it impossible to work normally and earn a living. COPD sufferers may be able to obtain a social security disability benefit from the Social Security Administration (SSA) but their applications are often rejected initially for a number of different reasons.
Fortunately, the SSA has an appeal process and if you have had your initial SSD benefit application for COPD rejected, you may be able to have this decision overturned by persevering through one or more of the following steps which are listed below in sequence:
- ask for a reconsideration of the decision;
- request a hearing with an administrative law judge (ALJ);
- take the decision on your benefit application to an appeals council review;
- resort finally to a hearing by a federal district court.
The Initial Application for a Disability Benefit for COPD
Although COPD is listed in the SSA’s Blue Book under chronic respiratory disorders, section 3.02 as well as under section 4.0, which covers cardiovascular disorders. The SSA’s Disability Determination Services (DDS) assess the evidence you have presented with your application for a benefit against the criteria in the Blue Book first and make their determination based on how severe your symptoms are and how their severity has had an impact on your ability to work. Much depends on how complete the medical evidence is and whether there is sufficient proof in the compilation of medical records, doctor’s assessment, tests and scans to grant you a benefit based on the listing criteria.
One assessment you can get done which can help your claim is a residual functional capacity (RFC) assessment. This should be done by a physician and is a series of tests of your capacity to carry out a range of physical activities such as standing up, lifting and carrying. The RFC assessment can help your SSD benefit claim gain approval.
In Case of a Denial
It is important to remember that many initial SSD benefit denied claims can be reversed on appeal. Your chances of obtaining a benefit at some stage of an appeal can be improved by using a disability benefit lawyer to help you with your case.
There are four stages of the appeal process. You could successfully reinstate your chance of obtaining a benefit at any of these stages. Most denied claims are rejected because of insufficient medical evidence to back up your claim, so if you can obtain more relevant information this will help your appeal.
The stages of appeal are described briefly below.
The first step is to ask for your claim to be reconsidered by the SSA. They will re-examine the evidence you presented again to see if anything has been missed that could match the criteria for a benefit approval.
The next step, if reconsideration fails, is to request a hearing with an administrative law judge (ALJ). The judge is not a medical expert as such, but will examine the evidence available and ask you questions about your condition and why you are claiming that your COPD is so severe that you can no longer work. Your lawyer can attend and there may be medical experts in attendance to ask questions as well.
It is less likely that you would have much chance of success if the ALJ confirms the SSA’s decision to reject your benefit claim, but there are two further stages of the appeal process. The next step would be to take your case to an appeals council review and the last step would be a hearing at a federal district court.