Getting Disability Benefits for COPD, Asthma, or Other Respiratory Disorders By Aaron Hotfelder , J.D., University of Missouri School of Law Many Social Security disability applicants suffer from breathing problems that prevent them from meeting the demands of full-time employment. 12 a. Remember, COPD affects everyone differently, so your COPD treatment plan will likely change over time to fit your current treatment needs. Specifically, the SSA wants to see results from one of the following tests: The lower the percentage of air flow, the higher your rating. In the GOLD System, stage 2 COPD is categorized as moderate COPD with a FEV1 (forced expiratory volume in one second) between 50 and 80 percent of normal lung capacity. Stage 3 . When you apply for SSDI with COPD, in order to be approved, you need to meet a certain medical criteria outlined by the SSA. Chronic Obstructive Pulmonary Disease and Your Social Security Disability Case. Every day the Lung Health Institute is changing people’s lives. Does the applicant plan to stop working soon and stay out of work for at least 12 months? In fact, only 30 percent of applications are approved at this stage … Russell Winwood reveals 3 tips that can help COPD patients gain a more positive mindset. Pulmonary rehabilitation is a medically supervised program. Below is more information on the medical criteria needed to help qualify you for SSDI benefits. Because the increase in breathlessness, coughing and mucus production have worsened during stage 2 COPD, many people seek medical help from their doctors. To find an independent attorney or advocate in your area who subscribes to the website, click here. It is not uncommon for a patient suffering from COPD to be denied disability benefits at the initial stage of the Social Security Disability application process. Many patients report feeling better after treatment, can live a more active life doing their favorite activities and are able to reduce their oxygen therapy use. Chronic cough and phlegm production 2. 1 You may also get other diagnostic tests, such as a chest X-ray, CT scan, blood tests and exercise tests that will reveal … Cardiovascular System (4.00) – Those with COPD sometimes experience difficulties with their heart due to the decreased oxygen levels. We have adapted and delivered comprehensive infection prevention, including COVID-19 precautions, safety innovations and processes to safeguard you during your visit. The SSA uses a medical guide, known as the Blue Book, to determine whether or not a condition such as COPD is severe enough to warrant disability payments. As Thanksgiving approaches, read our tips for how to curb overeating this holiday season. If you waited for more than five months to get approved, you will be awarded back pay on top of your monthly benefits. Therefore, your condition may also be assessed under the cardiovascular system (4.00) of the Blue Book. Medications that you are receiving, such as bronchodilators, inhaled steroids, and antibiotics, as well as your response to the medications: Respiratory therapy or pulmonary rehabilitation that you may be receiving, Supplemental oxygen needs, especially if your needs have increased, Any surgeries or procedures that you may have had, including operative notes or pathology reports, if applicable, Any related medical complications, such as weakness, neurological complications, heart problems, or intellectual difficulties. The burden of proof falls on the SSDI applicant to prove that you are unable to work due to your COPD diagnosis. Cellular therapy can help people in any stage of COPD, from stage 1 COPD to end stage COPD. If you have COPD and you believe it will force you to be out of work for 12 months or if it is so severe that it will result in your death, then your COPD would be considered a disability and you could qualify for Social Security disability benefits. The treatment for COPD will depend on the severity of the illness. In this article, well foc… As you know, chronic obstructive pulmonary disease (COPD) affects everyone differently and at varying rates of progression. Similar to determining stage 1 COPD, your doctor may use the GOLD System and the BODE Index to figure out your stage of COPD. The SSA may also evaluate your limitations based on body systems affected by your COPD. Providing this information to the SSA is of vital importance. If the patient can show that he or she is unable to work because of COPD, Social Security disability insurance might be available. Stage 3 -- Severe -- FEV-1 … Therefore, you should work with your pulmonologist to gather all of your medical evidence. The first type of medical evidence that the Blue Book directly requests is a complete medical history of your COPD. If just one of these tests shows a severe limitation in lung function, then you may be able to qualify for Social Security disability benefits. You must have been diagnosed with COPD and the SSA will send you for a lung functioning test performed by a consulting doctor. They are independent attorneys or advocates who pay a fee to be listed on the website and have their names provided, on request, to website users. Has anyone been awarded a blue badge with COPD Stage 2 in illness. Symptoms such as coughing and sputum or phlegm production will increase in stage 2 COPD. The typical case will range from 3-6 months to hear the initial decision. If you are currently in the process of applying for SSDI, or if you were denied in the past, getting your medical evidence in order is the most important step that you can take to win your disability claim for COPD. To qualify for benefits, you must first be diagnosed with chronic obstructive pulmonary disease. Impairments caused by COPD disorders generally produce irreversible loss of pulmonary function due to ventilatory impairments, gas exchange abnormalities or a combination of both. To qualify for disability benefits, you will need to meet several requirements listed in section 3.02 of the Blue Book. So, depending on the severity of your COPD, to get disability for COPD it could take anywhere from a few months to upwards of a year. To be considered disabled, you will need to provide sufficient medical evidence to the Social Security Administration (SSA) to illustrate that your COPD is severe enough to warrant disability payments. 2 As we mentioned above, you’ll have Stage II, moderate COPD if your forced expiratory volume in one second (FEV1) – one of the measurements taken during a spirometry test – is between 50% and 79 percent. Stage 1 COPD or mild stage COPD is categorized by a forced expiratory volume in one second (FEV1) of about 80 percent or more of normal lung capacity based on the GOLD System, and stage 2 COPD is categorized with a FEV1 between 50 and 80 percent of normal lung capacity. Be certain that your doctor has documented the following: The Blue Book notes that not every patient who has COPD will meet the listing, but you may be unable to work regardless. 2. Having lung function tests helps your doctor keep track of how your lungs are doing and how well your COPD treatment is working. 0 points 12 b. As a result, you may need to provide the following evidence of heart problems: Pulmonary function tests are noninvasive tests that show how well the lungs are working. We measure our success by our patients’ satisfaction and their satisfaction with our services and the care they receive from our dedicated staff. Subscribing lawyers and advocates are not employees, owners, operators or agents of this website. If your COPD causes you to be out of work for at least 12 months, then yes, you could qualify for Social Security Disability Insurance (SSDI). Because there is not a cure for COPD and it’s a progressive disease, your doctor will work with you to develop or modify your treatment plan. Social Security impairment listing 3.02, addresses Chronic respiratory disorders, including A. COPD, or chronic obstructive pulmonary disease, B. With advanced COPD, you can have symptoms all the time or almost all the time. The human body has an amazing ability to heal itself, but sometimes it needs a little help. If you can prove that your condition is so severe that you are unable to work in the upcoming year, you may be considered for disability assistance. Though, your cough will become chronic, phlegm will be harder to expel, you might have trouble sleeping, and wheezing could become normal as the air you breathe tries to pass through airway obstructions. Symptoms you can experience with end-stage COPD include:1 1. After learning information about chronic obstructive pulmonary disease (COPD), the COPD stages, prognosis and life expectancy and specifics about stage 1 COPD, it’s time to go in-depth in the next COPD stage: moderate COPD or stage 2 COPD. Stage two is called the moderate stage of COPD, and people who are in this stage may begin experiencing shortness of breath, along with cough, much more frequently. In addition, a lung function test performed by a consulting doctor hired by the SSA must show very limited airflow. It can be difficult to talk about dying with your doctor, and particularly with … GOLD Stage 2 80%, FEV1 ≥50% (moderate) GOLD Stage 3 50%, FEV1 ≥30% (severe) GOLD Stage 4 30%, FEV1 very severe airflow limitation Since 2011 the COPD Foundation and global researchers have recognized that many features of COPD exist before the development of airflow limitation. That medical criteria will need to be supported by sufficient medical evidence that shows that your COPD is severe enough that you cannot work. You should be able to provide the following records from your physician or pulmonologist should include your presenting symptoms, the progression of your lung disease, as well as the results of a full physical examination. Overeating can cause shortness of breath, fatigue and inflammation. With new choices for online, pickup and delivery services from stores, you can complete your holiday shopping without overexerting yourself if you have lung disease. expect to be out of work for at least 12 months? Severe COPD can qualify for disability benefits. Based on the GOLD system, people with stage 2 COPD usually have 50 to 70 percent of normal lung function. Along with medications and lifestyle modifications, many people have benefited from alternative COPD treatments, such as acupuncture, chiropractic care and cellular therapy. Typically, stage 2 COPD decreases your lung capacity to 50-79 percent. The SSA defines a disability as the inability to engage in what they called substantial gainful activity, which is work that involves significant and productive duties and pays more than the current monthly income limits set by the SSA by reason of any physical or mental impairment(s) which has lasted or can be expected to last for a continuing period of 12 months or more or result in death. During stage 2 COPD or moderate COPD, airflow limitation begins to worsen, becomes more noticeable and can be easily seen on spirometry. Wheezing 3. If this is the case, your pulmonologist should provide physician notes documenting his or her opinion regarding your limitations and inability to function without unscheduled breaks or days off. To qualify for Social Security disability, you must expect to be disabled for at least 12 months. Talking about this and planning your end of life care, also called palliative care, in advance can be helpful. Depending on your stage 2 COPD symptoms and disease progression, your doctor may prescribe a variety of medications, such as short and long-acting bronchodilators, flu and pneumonia vaccines, combination inhalers and even antibiotics. 4.97, diagnostic code 6604. Several tests will help to confirm your diagnosis, and the following should be included in your records: While any doctor can provide this information, the SSA gives more weight to the opinion of medical specialists. In fact, these lifestyle modifications have been shown to help people live a more active life. After learning information about chronic obstructive pulmonary disease (COPD), the COPD stages, prognosis and life expectancy and specifics about stage 1 COPD, its time to go in-depth in the next COPD stage: moderate COPD or stage 2 COPD. Disability-Benefits-Help.org is not a lawyer or a law firm. COPD is a serious condition that can eventually reach a stage where it becomes life threatening. Moving around. In this article, we’ll focus on what you need to know about stage 2 COPD. After the initial application, the next step is reconsideration. COPD is definately a disability under the disabled persons act or new equality act. If you have COPD, here are some tips on which foods you should avoid during the holidays and which you should try. COPD cannot be cured, but it can often be effectively managed. Thinking of holiday gifts for someone in your life with COPD? Usually, medications only work to manage and reduce COPD symptoms. A user who requests a free evaluation will be provided with the name of a subscriber lawyer or advocate who will contact the user to do the evaluation. If you are missing documentation the process can be extended. However, cellular therapy works to promote healing from within the lungs, potentially improving breathing and quality of life. The results from this test can help show the SSA that your COPD is severe enough that it will force you to be out of work for at least 12 months. VA rates COPD under 38 C.F.R. *For more information, go to LungInstitute.com/Results. Severe shortness of breath even when at rest 4. An oxygen saturation test (SpO2) 2. However, you still may be too ill to work. Financial hardship can sometimes prevent people from seeking treatment and building a medical history in the process. COPD is a chronic condition and disability insurance companies try to argue that the claimant should be able to work in a sedentary capacity. Chronic obstructive pulmonary disease (COPD) is listed under the category of impairments known as Respiratory System – Medical Listing 3.02. It’s helpful to think of COPD in stages. Copyright Disability-Benefits-Help.org 2021, Medical Criteria Needed to Qualify with COPD. For individuals suffering from breathing problems, meeting the demands of a job can be difficult, if not impossible. Often, your doctor will compare your old pulmonary function tests with your newer ones. © Copyright 2020 Lung Health Institute, LLC | All Rights Reserved | Privacy Policy | Terms of Use, CDC Safety and Quality Standards in Place, COPD stages, prognosis and life expectancy, FEV1 (forced expiratory volume in one second), Many patients report feeling better after treatment, 3 Foods That Can Help Reduce Spring Allergies, Info Chronic Lung Disease Patients Should Know About Coronavirus, 3 Ways to Improve Your Mindset When You Have COPD, The Natural Healing Powers of Your Own Body, 3 Holiday Foods to Avoid and 3 Foods to Incorporate When You Have COPD, 5 Holiday Gift Ideas for Someone With COPD, Tips for Holiday Shopping With Chronic Lung Disease. While these symptoms are not listed in the Blue Book under section 3.02, they may still impede your ability to work. To meet the criteria for COPD, you will need to meet the chronic pulmonary insufficiency listing. Neither this site, nor any lawyer or advocate associated with it, is affiliated in any way with, or endorsed by, the Social Security Administration. Pulmonary Vascular Disease Most people start taking medication at this stage. By submitting a request for a free evaluation, I acknowledge that I understand and agree to the disclaimer and privacy policy. Difficulty communicating due to shortnes… There are four different tests available, but the SSA wants to see the results of one of these tests: 1. COPD is listed in the chronic respiratory disorder section of the Blue Book, 3.02. Available ratings are 10, 30, 60 or 100%. Luckily, GOLD has treatment guidelines for every stage of COPD and as your disease progresses, treatment options will be added in an effort to better manage your symptoms . The SSA will need to know what treatments you have received, your response to those treatments, and most importantly if your respiratory status has worsened despite those treatments. How Long Does It Take To Get Disability Benefits for COPD. If you are applying for Social Security Disability Benefits with COPD, having these tests to include with your application can really help show the SSA that your COPD is so severe and that you can no longer work. Many people with COPD do not qualify for SSDI benefits through the Blue Book respiratory listing. In stage 2 COPD, you may need different medications than you used for stage 1 COPD. Can stand and then move more than 200 metres, either aided or unaided. Disability Listing for COPD. If you do not plan to stop working, this site cannot assist you because you will not qualify for the program. The third stage of COPD is referred to as the severe stage, and during this stage a person's quality of life may be greatly impacted by the chronic coughing and shortness of breath they are likely experiencing. Even though many people with chronic obstructive pulmonary disease (COPD) cannot work, disability insurance providers look for reasons to deny their short or long term disability benefits. The length of the disability benefits application process can vary from person to person. It’s normal to have multiple pulmonary function tests over time. Achieving a disability approval though requires you have not just a diagnosis, but appropriate medical evidence to back up your claim. Because each stage of COPD differs in symptom severity, rate of progression and how COPD affects your life, having a good understanding of each stage is important. I had one up until last March 13. When you visit your doctor, it is a good idea to present a written list of symptoms and side-effects that you are experiencing. As with determining any stage of COPD, your doctor will take a detailed medical history, perform certain lung function tests and take into account how COPD affects your life. COPD can cause shortness of breath, coughing, and wheezing that results in fatigue. A Social Security disability attorney or advocate can assist you in ensuring that your claim for disability is thorough, thus increasing your chances for approval. 3) It is a long-term, degenerative disease with no cure, although quitting smoking and using inhaled steroids or bronchodilators can help manage symptoms and make it easier to breathe. Can stand and then move more than 50 metres but … It includes: emphysema – damage to the air sacs in the lungs; chronic bronchitis – long-term inflammation of the airways; COPD is a common condition that mainly affects middle-aged or older adults who smoke. A COPD disability is a chronic obstructive pulmonary disease that prevents a person from performing his or her work duties. And the effects of your disease at the end-stage will be so advanced that they will undeniably affect your day to day activities. Back Pay refers to Social Security Disability benefits that you would have received had your claim been approved immediately. Benefits are provided through two programs: Social Security disability insurance (SSDI), which pays benefits to people with disabilities who have worked long enough, and Supplemental Security Income (SSI), … The disease may be mild at first with only occasional symptoms, such as shortness of breath, wheezing, and coughing. by mpatino | Oct 14, 2017 | COPD, Disease Education, Medical. Many people feel increased breathlessness, especially during physical activity like walking. From performing his or her work duties approved immediately but the SSA is of vital.. 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