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Obtaining disability for Chronic Obstructive Pulmonary Disease – COPD

Appealing for benefits is best done under the guidance of an experienced disability lawyer.

Can I qualify for Social Security disability if I am suffering from the effects of Chronic Obstructive Pulmonary Disease?

Author Attorney Greg Reed:

Approximately 11 million people in the United States suffer from Chronic Obstructive Pulmonary Disease (COPD). Often misdiagnosed, COPD can cause long-term disability and is the third leading cause of death in the U.S.

The SSA recognizes COPD in its Blue Book. To prove disability under this listing, evidence will need to be submitted documenting COPD and its severity.

COPD refers to a group of progressive lung diseases characterized by breathlessness that includes emphysema, chronic bronchitis, and refractory (non-reversible) asthma.

Over time, exposure to cigarette smoke, dust, and other pollutants and fumes (many of them inhaled in a work environment), irritates and damages the lungs. Emphysema is caused by damage to air sacs (alveoli) in the lungs causing the small sacs to enlarge. The alveoli are no longer able to absorb oxygen resulting in less oxygen being delivered to the bloodstream. Air becomes trapped in the lungs and it becomes difficult to exhale. COPD can also be caused by a genetic condition called alpha-1 deficiency-related emphysema. Alpha-1 is a protein that protects the lungs.

In chronic bronchitis, damage to the bronchial tubes results in coughing and shortness of breath.

The bronchial tubes become irritated and cilia, the hair-like fibers lining the bronchial tubes, become damaged. It becomes difficult to cough up mucus, leading to more inflammation and coughing. Bronchitis is considered chronic when a cough lasts for at least three months and occurs two years in a row.

Contact a Social Security disability attorney at 512-454-4000 for a free consultation and see if you can get disability benefits while suffering from Chronic Obstructive Pulmonary Disease (COPD). If you have been denied disability don’t give up!

Refractory (non-reversible) asthma is asthma that does not respond to normal asthma medications.

The bronchial airways tighten and swell. Medications can open the airways and return the lungs to normal breathing, but in refractory asthma, medications typically used to treat asthma fail to reverse tightening and swelling in the airways.

Common symptoms of COPD include:

  •   Shortness of breath and increased breathlessness
  •   Wheezing
  •   Tightness in chest
  •    Frequent coughing, with or without mucus
  •   Coughing up blood
  •   Clearing throat first thing in the morning because of mucus in lungs
  •   Unintentional weight loss
  •   Swelling in lower legs

COPD occurs in four stages.

In the first stage, mild COPD, airflow is limited, but not very noticeable and the individual coughs up mucus only once in a while. In the moderate stage, airflow becomes more restricted and the individual experiences shortness of breath after activity. When COPD becomes severe, the person is unable to perform normal exercise without shortness of breath and other symptoms become more frequent. COPD is very severe when airflow is limited, and flareups become regular and intense, directly impacting the individual’s quality of life.

COPD is often not diagnosed until the disease has become advanced.

A doctor will first review a patient’s medical history and exposure to cigarette smoke and other pollutants.

Several tests are employed in diagnosis:

  •   Pulmonary function tests that measure the amount of air you inhale and exhale and whether enough oxygen is delivered to the bloodstream.
  •    Chest x-rays
  •   CT scans
  •   Arterial blood gas analysis
  •   Laboratory tests to determine the cause of symptoms and rule out alpha-1 deficiency, a genetic disorder and other lung conditions

Though there is no cure, most people with COPD have a mild form, and therapy can manage symptoms, allowing individuals to live a normal life.

The first and most important step in any treatment plan is to quit smoking. After that there are a number of different therapies that can alleviate symptoms:

  •   Bronchodilators can relax muscles around airways
  •    Inhaled steroids can reduce inflammation
  •   Oral steroids
  •   Oxygen therapy – devices that deliver oxygen to the bloodstream
  •   Pulmonary rehabilitation programs combining education, exercise training, nutrition advice and counseling.

The Social Security Administration recognizes chronic obstructive pulmonary disease in its Blue Book under Section 3.00 Respiratory Disorders.

Chronic bronchitis and emphysema are included under chronic obstructive pulmonary disease while asthma is listed as a separate respiratory disorder.

3.00 Respiratory Disorders

A. Which disorders do we evaluate in this body system?

1. We evaluate respiratory disorders that result in obstruction (difficulty moving air out of the lungs) or restriction (difficulty moving air into the lungs), or that interfere with diffusion (gas exchange) across cell membranes in the lungs. Examples of such disorders and the listings we use to evaluate them include chronic obstructive pulmonary disease (chronic bronchitis and emphysema, 3.02), pulmonary fibrosis and pneumoconiosis (3.02), asthma (3.02 or 3.03), cystic fibrosis (3.04), and bronchiectasis (3.02 or 3.07). We also use listings in this body system to evaluate respiratory failure (3.04D or 3.14), chronic pulmonary hypertension (3.09), and lung transplantation (3.11).

To prove you are disabled under this listing, you will need to submit medical evidence documenting COPD and its severity. Social Security expects you to provide the following:

  •   Your medical history, including any treatments you have received and your responses
  •   Physical exam results
  •    Imaging and computerized tomography such as x-rays and CT scans used to diagnose COPD
  •   Pulmonary function test results
  •   Laboratory test results
  •   Documentation that you need supplemental oxygen

The following pulmonary function tests are very important in evaluating the severity of COPD:

  •   Spirometry test to measure the amount of air you can exhale in one second
  •    DLCO test to measure how much oxygen passes into the lungs
  •   ABG test to measure the partial pressure of oxygen, PaO2, and carbon dioxide, PaCO2, in the blood

The value measured in these tests is called the forced expiratory volume (FEV) which is the amount of air you can exhale in one second.

Social Security provides tables that measure FEV based on gender, age, and height; if you meet the required FEV1, you are considered to be in very poor health and may automatically qualify for disability. Also, if you have at least three hospitalizations due to COPD in one year, each at least 48 hours and at least 30 days apart, you can be approved for disability.

If you don’t meet the listing requirements, the SSA will evaluate your functional limitations.

For example, some people with COPD cannot tolerate dust, smoke, and other fumes or they may have difficulty with extreme temperatures or humidity. Also, COPD usually impairs a person’s exertion level and limits the number of hours they can walk or stand or how much they can lift. Your treatment history and doctors’ opinions under these circumstances can be instrumental in achieving a disability determination.

If you have COPD, and it has affected your ability to work, you may be eligible for Social Security Disability benefits.

In order to qualify for Social Security Disability, you will need to satisfy a few specific requirements in two categories as determined by the Social Security Administration.

The first category is the Work Requirements which has two tests.

  1.   The Duration of Work test.   Whether you have worked long enough to be covered under SSDI.
  2.   The Current Work Test.   Whether you worked recently enough for the work to actually count toward coverage.

The second category is the Medical Eligibility Requirement.

  1.   Are you working?   Your disability must be “total”.
  2.   Is your medical condition severe?    Your disability must be “severe” enough to interfere with your ability to perform basic work-related activities, such as walking, sitting, and remembering.
  3.   Is your medical condition on the List of Impairments?   The SSA has a “List of Impairments” that automatically qualify as “severe” disabilities. If your disease is not listed this does not mean you cannot get disability, it means you must prove you cannot maintain employment due to your limitations.
  4.   Can you do the work you did before?   SSDI rules look at whether your medical condition prevents you from doing the work you did prior to developing the condition.
  5.   Can you do any other type of work?   If you cannot do your prior work, an evaluation is made as to whether you can perform any other kind of work.

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Disability benefits are an important source of income for those who are unable to work. If you not able to work due to accident or illness, you may be eligible for Social Security Disability or Long Term Disability benefits. If you have applied for benefits and been denied, contact the attorneys at Bemis, Roach and Reed for a free consultation. Call 512-454-4000 and get help NOW.

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Author: Attorney Greg Reed has been practicing law for 29 years. He is Superlawyers rated by Thomson Reuters and is Top AV Preeminent® and Client Champion Gold rated by Martindale Hubbell. Through his extensive litigation Mr. Reed obtained board certification from the Texas Board of Legal Specialization. Greg is admitted to practice in the United States District Court - all Texas Districts and the United States Court of Appeals-Fifth Circuit. Mr. Reed is a member of the Travis County Bar Association, Texas Trial Lawyers Association, past Director of the Capital Area Trial Lawyers Association, and an Associate member of the American Board of Trial Advocates. Mr. Reed and all the members of Bemis, Roach & Reed have been active participants in the Travis County Lawyer referral service.

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