Respiratory System

When determining disability claims based on respiratory impairments, the SSA considers how long you have had the condition, how long the condition is expected to last, what types of treatments have been or could be attempted, and what your response to treatment has been. It is important that you continue receiving medical treatment during the disability claims process and that you continue to follow all prescribed treatments.

The Blue Book divides respiratory problems into a number of categories, including:

• Asthma
• Bronchiectasis
• Chronic Pulmonary Insufficiency
• Cor Pulmonale Secondary to Chronic Pulmonary
• Vascular Hypertension
• Cystic Fibrosis
• Lung Transplant
• Mycobacterial, Mycotic, and Other Chronic Lung
• Infections
• Pneumoconiosis
• Sleep Apnea
• Sleep-Related Breathing Disorders

Automatic Approval of Benefits If You Were Hospitalized Multiple Times in a Given Year

It is worth noting that if you were hospitalized three times within a given year and each hospitalization lasted at least two days as a proximate result of your respiratory problems, the SSA may automatically approve your application for disability benefits.

Respiratory Disorders That Could Serve as a Basis for Obtaining Disability Benefits

Asthma

Asthma may be evaluated using the same criteria as CPI/CPD. Alternately, if your condition has been under medical observation for at least a year, the SSA can consider you completely disabled if you are undergoing treatment for asthma and still have severe asthma attacks which require medical intervention:

• At least once every two months or
• Six or more asthma attacks per year.

If your asthma attack requires actual hospitalization for more than a complete day (24 hours or more), the SSA counts it as if it were two attacks.

Chronic Pulmonary Insufficiency (CPI)

If you have CPI, the SSA will consider your height, weight, and breathing capacity. There are a number of breathing and blood tests they may consider in measuring your ability to breathe and whether your CPI is serious enough to merit complete disability. These tests may already be part of your medical record, or the SSA may order the tests done (or both).

Cystic Fibrosis

In considering cystic fibrosis disability claims, the SSA looks for at least six episodes of bronchitis, pneumonia, or hemoptysis per year, or episodes of the same conditions at least every two months. Similar to asthma, episodes which require 24 hours of hospitalization are counted as if they were two episodes. The SSA may also approve disability for cystic fibrosis if you have persistent pulmonary infections every six months of if you have infections severe enough to require a nebulizer or intravenous treatments.

Sleep Apnea

This is a condition that can significantly impact your ability to obtain restful and restorative sleep. As a result, your ability to function during the day could be hindered to the point that you are unable to work. Sleep apnea is routinely diagnosed based on a combination of self-reported symptoms and objective testing by medical professionals.