If you suffer from a respiratory disorder, or respiratory impairment, you may qualify for social security disability payments. Not every respiratory disorder or respiratory impairment will qualify. It’s important to understand what conditions qualify, and what standards the government refers to in assessing whether your specific situation qualifies. These standards are contained in electronic form in something referred to as the “Blue Book.”
Types of Disorders
There are three types of respiratory disorders, as follows:
- Those that involve restriction, meaning a disorder wherein the patient finds moving air into the lungs difficult;
- Those that result in obstruction, meaning a disorder wherein the patient finds moving air out of the lungs difficult; and
- Those that interfere with gas exchange within the lung across cell membranes, also called diffusion.
Chronic Respiratory Disorders Section 3.02
Examples of chronic respiratory disorders include pneumoconiosis, emphysema, pulmonary fibrosis, and chronic bronchitis. Asthma may qualify under chronic respiratory disorders, (Section 3.02 of the Blue Book) or under the separate category, “asthma” (Section 3.03 of the Blue Book). Similarly, bronchiectasis can qualify under chronic respiratory disorders or under the separate category “bronchiectasis” (Section 3.07 of the Blue Book).
Respiratory failures are evaluated in the same section of the Blue Book. Respiratory failures can include some conditions or symptoms of cystic fibrosis, as well as other respiratory failures, lung transplants, and chronic pulmonary hypertension.
Other Respiratory Conditions Not Covered By This Section
There are other respiratory conditions, such as cancers of the respiratory system, and pulmonary effects of autoimmune disorders, as well as pulmonary effects of neuromuscular disorders that are evaluated under different sections of the Blue Book. It should also be noted that this discussion pertains to adults with these disorders. Children with respiratory disorders have different standards.
Signs and Symptoms of Respiratory Disorders
There are several signs and symptoms of respiratory disorders. The following is a standard list of signs, but it is not intended to be exhaustive:
- Rapid breathing rate (tachypnea);
- Shortness of breath (dyspnea);
- Coughing up blood (hemoptysis)
- Chest pain;
Documentation Required to Effectively Evaluate a Respiratory Disorder
Regardless of whether or not you require supplemental oxygen, additional medical evidence is required to evaluate the severity of your disorder. Broadly speaking, social security will want to review the following: “Medical evidence” is defined as your complete medical history. This should include pulmonary function tests, such as tests measuring oxygen saturation of peripheral blood hemoglobin, partial pressure of carbon dioxide and oxygen in arterial blood, gas diffusion, and ventilation of the lungs. It will also include imaging results, such as computerized tomography or an x-ray as appropriate. The findings of any physical examinations will be required. Additionally, any other laboratory tests relevant to your condition, a list of prescribed treatments, and the patient’s response to those treatments may be needed. Depending on your particular disorder, it is possible that not all of these will be required.
Asthma Section 3.03
Asthma is defined as a “chronic inflammatory disorder of the lung airways.” It can be evaluated under 3.03, “Asthma” or 3.02, “chronic respiratory disorders.” If the asthma is chronic and has resulted in respiratory failure, it will be evaluated under 3.14, “respiratory failure.”
Cystic Fibrosis Section 3.04
Cystic fibrosis is a genetic disorder. With cystic fibrosis, “abnormal salt and water transport across cell membranes” in the pancreas, lungs, and other organs in the body. It can also affect the digestive system or the endocrine system. If, for example, cystic fibrosis leads to chronic pancreatic disease, the evaluation of your potential impairment will be done under Section 5.00 of the Blue Book.
Bronchiectasis Section 3.07
Bronchiectasis is another chronic respiratory disorder. It involves irreversible and abnormal enlargement of the airways. This enlargement occurs below the trachea. It can be, but isn’t always, associated with bacterial infections, the scarring of the airway, or the accumulation of mucus.
Chronic Pulmonary Hypertension Section 3.09
Chronic pulmonary hypertension occurs when blood pressure increased in the blood vessels of the lungs. It can lead to heart failure if not adequately treated.
Lung Transplant Section 3.11
If you receive lung transplants, or lung transplants in conjunction with another transplanted organ, social security considers you disabled for 3 years from the date of transplant.
Respiratory Failure Section 3.14
Respiratory failure occurs when the lungs are unable to perform basic gas exchange function.
Sleep Related Breathing Disorders
Sleep apnea, and other sleep related breathing disorders, are characterized by social security as periodic episodes, during sleep, of interrupted sleeping that results in the disruption of normal sleep patterns. Prolonged periods of sleep apnea and other disorders can result in other disorders, such as restricted blood flow within pulmonary blood vessels, (pulmonary vasoconstriction) and low blood oxygen, (also called hypoxemia). Sleep related breathing disorders will be evaluated based on the symptoms being experienced. For example, if sleep apnea causes chronic pulmonary hypertension, it will be evaluated under that section of the Blue Book. However, if the sleep related disorder causes heart failure, it will be evaluated under Section 4.02 of the Blue Book, which covers chronic heart failure.
Mycotic, Mycobacterial, and Other Chronic Lung Infections
Chronic lung infections that limit respiratory functioning are evaluated under Section 3.02, Respiratory Disorders.
If You Have A Disorder That Is Not Included In The List
If you have a respiratory disorder that is not included in the list, don’t despair. The list provides examples of common respiratory disorders that social security views as severe enough that they may prevent you from working.
Sometimes, respiratory disorders are connected to other disorders in other systems of the body. In that case, social security will consider the combined effects of all impairments in determining if you qualify for social security disability.
If You Have a Respiratory Disorder or Disease
If you have a respiratory disorder or disease, having a knowledgeable disability attorney on your side is critical. Call Mac J. Shefman, a Detroit disability lawyer, to help you through the steps required to prevail on your social security claim at 248-298-3003.