Chronic Obstructive Pulmonary Disease (COPD) refers to various inflammatory lung diseases like bronchitis and emphysema that occur and worsen on a regular basis. Those who suffer from COPD experience shortness of breath, coughing, and related pain that can prevent activity and work.
If you suffer from COPD and are no longer capable of working or supporting yourself, you may qualify for Social Security disability benefits, created to provide monthly assistance to those in severe need. Fill out your information to receive a free case evaluation. Start the disability benefits process today.
Is COPD a Disability?
Yes, COPD may be considered a disability by the SSA, but the criteria for obtaining disability benefits are quite exacting, so just being diagnosed with COPD is not in itself sufficient. The symptoms you experience must match the descriptions listed in the relevant section of the SSA’s Blue Book and you will need evidence that you are unable to work for at least the next 12 months.
In addition to proving that your COPD symptoms are severe enough, you may also need to have accumulated enough work credits from your history of employment if you intend applying for disability benefits through the SSDI program.
How Hard Is It To Get Disability Benefits For COPD?
Disability benefits are challenging to get. Initial applications are often rejected and then applicants may have to appeal the decision, a process which can be quite arduous, but may eventually lead to approval for disability benefits being paid.
The main criteria for obtaining disability benefits from the SSA include the following.
- Your COPD symptoms need to match the descriptions listed in the relevant part of the Blue Book under Section 3.02: Chronic Respiratory Disorders. The SSA may also assess your criteria under a different section such as Section 4.00; Cardiovascular Diseases, as symptoms may arise because of COPD.
- You must have sufficient medical evidence, including medical history of all known assessments and treatment you have received to date.
- Having enough work credits accumulated unless you qualify for SSI (when income and assets are below a certain low threshold).
- Working with a lawyer can help.
Can You Can Get Disability for COPD?
There are more than 200 medical conditions that make someone eligible for Social Security disability benefits, including COPD. Disability benefits are available to help pay for living expenses like food, housing, and utilities for people that can’t work because of a medical condition. If you have been diagnosed with COPD and you can’t work any longer because of the COPD you may be eligible for Social Security disability benefits. If you have worked in the past and earned work credits through paying into the Social Security system with the Social Security tax that is withheld from paychecks you are eligible to draw Social Security disability benefits.
But before your claim for Social Security disability benefits can be approved by the SSA you will need to meet the medical requirements that the SSA has set for COPD. You can find the special requirements that you have to meet in the Social Security Administration’s Blue Book. The Blue Book is a collection of all the conditions that qualify for disability benefits and the requirements that must be met for each condition. You can also find the requirements on the SSA’s website if you search for "COPD."
Be sure to submit as much medical evidence as you can that supports your claim. You can submit X-rays, MRIs, lung capacity tests, Pulse Ox levels, Arterial Blood Gas readings, prescriptions for supplementary oxygen, records of hospitalizations, and any other medical evidence that proves that you can’t work because of COPD.
Step One: Determine how much your COPD limits you.
The Social Security Administration (SSA) handles thousands of disability applications a year. For your application to be approved, it is important to show that your disability is severe enough to require continued monthly financial support. To do this, you must first analyze all the ways your COPD affects your daily life.
For instance, most people with moderate to severe COPD experience shortness of breath and coughing. This may make it difficult to walk any distance or lift objects reliably, which would make working any physical job difficult. This could also make it difficult to clean the home, cook, or even walk to the bathroom, which would further explain your need for assistance.
If the lasting symptoms of your stroke make working life and daily life painful or more difficult, Social Security is more likely to approve you for benefits.
Step Two: Get test results confirming the severity of your condition.
While some people with COPD experience crippling side effects, others continue to function rather normally and may not even know they have it. This means, when applying for SSDI, it is important to provide the SSA with as much physical evidence as possible to show that your COPD prevents you from living your normal life.
The best types of evidence you can provide for COPD are spirometry tests (determine your lung capacity), DLCO tests (measure how much oxygen your blood can carry), oxygen saturation tests, and imaging scans of the lungs. If your results show a severe obstruction of your breathing in relation to your age, weight and height, you may qualify for disability via the “Blue Book”, the SSA’s disability guidebook.
If your diagnosis does not fit the Blue Book listing, this doesn’t mean you are disqualified from receiving disability benefits — you can still get your application approved by providing enough supporting evidence.
Step Three: Gather tax info, work history, and prepare to fill out the application.
Before applying for SSDI, you should prepare as much information about your life and history as possible. Two of the most important additional documents you must provide on your application are a) your tax information, and b) your past work history.
Tax information allows the SSA to see how much money you have contributed to Social Security in your years of work. Depending on your age, you must have contributed a certain amount of money (called “credits”) to Social Security in order to qualify.
Work history is also provided to show the SSA what types of work you have experience in, when/if you stopped working, and whether or not your illness prevents you from working similar jobs.
Using Your COPD Disability Rating
Chronic obstructive pulmonary disease (COPD) is an especially prevalent disease among American military veterans. COPD blocks the airways, which makes it difficult to breathe normally.
The tubes and air sacs within the respiratory system trap some of the oxygen in the lungs. Because of exposure to toxic chemicals both during training and in the field during combat, military veterans represent one of the largest groups of Americans that seek Social Security disability benefits for COPD.
The Veterans Administration (VA) provides a rating for each veteran that is treated by the federal government agency. VA criteria used to calculate a rating for veterans differ among the different types of medical conditions.
The VA examination for COPD determines how long it takes you to breathe properly, how much air you can inhale, and how much air you can exhale.
In addition, the VA puts you through a few simple exercises to observe your respiratory performance. The pulmonary function tests conducted by the VA include FEV1, which is called the forced expiratory volume test. You receive a rating for the FEV1 test and the higher you score, the lower your VA disability rating.
If you receive a VA disability rating of 100 percent, you might qualify for the expedited claim process administered by the Social Security Administration (SSA).
The SSA does not guarantee approval for Social Security disability benefits with a VA rating of 100 percent for COPD. However, you should expect a faster decision than the amount of time other COPD applicants have to wait.
Other Ways To Qualify
If you don’t meet the criteria of a medical listing, you may still be able to qualify for disability benefits using a medical-vocational allowance. When a medical vocational allowance is used, Disability Determination Services (DDS) will consider your medical conditions, your age, your work history, your restrictions and limitations, your transferrable skills, and your educational background.
When there is medical-vocational allowance review, a residual functional capacity (RFC) will be completed. This form is very detailed and will clearly indicate what you can and cannot do. As an example, it would indicate because of your COPD you cannot work around dust or inhalants. Because of shortness of breath, you may be limited in how far you can walk, what you can lift and carry, your ability to bend, squat, and crouch, and so forth.
If your treating physician will complete the RFC that can be very beneficial. Because, after all, the doctor who has been treating you for the condition knows more about your abilities than anyone else. You will also need to provide very detailed medical records, that confirm your diagnosis and how you are affected by COPD.
When you are using the medical vocational allowance, the testimony of others can be helpful. These statements would be from those who are familiar with your situation and how your medical issues affect you. Your former co-workers and former supervisors could explain how your health has changed your ability to work, your family members will know how your daily routine is affected, and if you have a caregiver, they can also provide additional details.
Multiple Medical Problems
If you cannot qualify for disability benefits based on your COPD alone, you may be able to qualify if you have other medical conditions. All your medical conditions should be mentioned, and they will all be reviewed as part of your disability claim. Having multiple medical conditions can increase your chances of having your claim approved and being awarded disability benefits.
Even if your impairments don’t meet the criteria of a listing exactly, the SSA is required to review whether your symptoms are medically equivalent to the criteria in the listing. To equal a listing, your diagnoses, symptoms, and test results don’t have to match the requirements of the listing exactly. The SSA cannot evaluate each of your medical conditions individually to see if the evidence supplied meets the criteria for a listing.
As an example, you have COPD and experience shortness of breath, but your FEV1 is higher than the criteria in the listing for Chronic Pulmonary Insufficiency in the Blue Book. Then you also have arthritis. To meet the listing for Inflammatory Arthritis in the Blue Book, you must show that you have repetitive flare-ups that limit your daily living activities, your social functioning, and your ability to complete tasks along with at least two of these symptoms – malaise, extreme fatigue, weight loss, and fever. You are severely affected by joint pain and stiffness, but you don’t have two of the required symptoms.
The SSA will review both conditions – COPD and arthritis – then consider if the combined effects of the two conditions equal an impairment that is severe as the COPD or arthritis listings. If the SSA finds that your two medical problems are medically equal to the Blue Book listing for COPD, you will be awarded disability benefits just as if you met the listing criteria.
Using A Medical-Vocational Allowance
If you are unable to meet the criteria of a listing, you may still qualify using a medical-vocational allowance. A medical-vocational allowance takes several things into consideration. They will consider your age, your medical conditions, your work history, your transferable skills, and your educational background. All these things along with your symptoms, treatments, and side effects are reviewed to determine if you can perform any kind of work and earn a living.
You will supply all the details, such as your work history, work responsibilities, and job title along with your salary history. You should make sure you provide all the details about your educational background as well. Documentation is essential to the success of the claim, so be sure to provide detailed medical records that clearly state the severity of your symptoms, confirms your diagnosis, and details your treatments, your response to the treatments, and any side effects that are caused by the treatment.
If you are older, and if you have limited education, they will consider it more difficult for you to retrain for a new job or to switch careers. Also the job market will come into play because if you can only do a job that isn’t in demand in the current economy or in your community, they will view you as unemployable because you couldn’t get work doing the job that you are capable of doing.
COPD For Veterans
If you are a veteran that has been diagnosed with COPD, it is possible to qualify for disability benefits and VA benefits at the same time. In fact, the medical evidence that is required VA benefits can help your SSDI case.
For example, if you are already receiving VA disability you will have gone through the VA disability rating process for COPD. Disability rating for the VA is given as a percentage of being completely disabled.
The most common tests to determine COPD disability is FEV-1/FVC. The combination of these two tests essentially determine the strength of your lungs. The results of those tests are then compared to he results that would be expected from healthy lungs. Disability ratings for the VA is given as followed:
- If FEV-1/FVC is 71%-80% of expected, that will result in a 10% VA disability rating
- If FEV-1/FVC is 56%-70% of expected, that will result in a 30% VA disability rating
- If FEV-1/FVC is 40%-55% of expected, that will result in a 60% VA disability rating
- If FEV-1/FVC is Less than 40% of expected, that will result in a 100% VA disability rating
The FEV-1/FVC test is not the only determinate for disability rating. Other complications, along with the FEV-1/FVC level can increase disability rating.
When you begin the disability benefits application process, having the medical documentation from your VA disability rating is a great piece of evidence for your case. A high disability rating from the VA is recognition from another government organization that your COPD is a disabling and affects your ability to work.
Disability Benefits Application Process For Veterans
Receiving VA disability does not guarantee that you will qualify for disability benefits because there are other factors, such as work history, that determine SSDI eligibility. However, evidence used for one can be used for the other to speed up the process.
The SSA also provides an accelerated application process for veterans. Military members that became disabled while on active military service after October 1, 2001 will have their application accelerated. This can mean the application process can potentially be cut from over a year down to a matter of weeks.
It is also important to know that military pay that you are receiving will generally not impact your ability to qualify for disability benefits. SSDI is based on your work history and ability to work, therefore income should not have impact on your chances of being approved.
How Long Does It Take To Get Disability Benefits for COPD
The length of the disability benefits application process can vary from person to person. The typical case will range from 3-6 months to hear the initial decision. If you are missing documentation the process can be extended. After the initial application, the next step is reconsideration. Again this process can vary in time from case to case, but you can expect 3 months to hear a decision.
The last step is an appeal that is heard in front of a judge. This stage has the highest chance of approval, but it can also take 1-2 years for a final decision. Once you have gone through the appeals process, this is the last stage and you will have the ultimate decision on your case.
To ensure that the process is as efficient as it can be, make sure that you have collected all of the evidence that you might need.
Why Use A Disability Attorney?
A disability lawyer will help you gather the supporting documentation that your claim needs to be approved. Your attorney will also review all your medical records and make sure that your records have the detailed information that will let the SSA review the severity of your case and determine how you are affected by your medical problems.
With the help of a disability attorney, your chances of having your claim approved and being awarded benefits increase. Disability attorneys have undergone extensive training and stay current on the SSA laws and when changes are made. When you enlist the help of a disability lawyer, you will not pay anything out of pocket because your lawyer will not be paid until your claim has been approved and you are awarded back pay.
The SSA has set the regulations that determine how much an attorney can be paid for a disability claim. A lawyer will not receive more than 25 percent of your back pay and their payment cannot exceed $6,000. You can enlist the help of an attorney at any point during the disability claims process.
