Chronic Obstructive Pulmonary Disease is one of the most common lung diseases, and it can make it very hard for you to breathe.
Sometimes the symptoms of COPD are severe enough to prevent you from working any full time job, causing you to have to file for Social Security Disability Insurance benefits, also known as SSDI. You have to have worked and paid enough into the system through paying taxes to get SSDI benefits.
However, even if you do not have a work history or do not have enough “work credits” to get Social Security Disability Insurance benefits, it is still possible to file for Supplemental Security Income benefits, or SSI, on the basis of COPD. I’d like to talk a little bit about how claims for both SSDI and SSI on the basis of COPD are evaluated.
The Social Security Administration uses a five step sequential analysis when deciding claims that is honestly more confusing than it needs to be. In a later blog post I will talk about these steps more in depth.
For now, I will summarize Step 1 as asking if you have a severe medical problem. (If yes, go on to Step 2).
Step 2 asks if you are working and making more than the limit. Assuming you are not, you go onto Step 3, which is when the Social Security Administration looks to see if you meet a “listing,” which is a prescribed set of criteria that is different for different medical conditions. If you meet a listing, you should be approved for benefits. But that’s not the only way for you to be approved for SSDI or SSI benefits for COPD.
There is a listing for COPD, Listing 3.02.
It specifies different values a person could have based on standardized tests – pulmonary function studies (the most common), exercise blood gas studies and carbon dioxide diffusing capacity.
To determine if you meet a listing, you have to compare your results on these tests (along with your particular circumstances, such as your height) to the values in the listing.
For example, according to the listing, a person with COPD who is 5 feet 8 inches tall (or 68 inches) would have to have an FEV1 value on a pulmonary function study (also called spirometry) of 1.45 or less.
Sometimes people are unable to show that they meet the listings because they have not had these tests, which can be very expensive. The listing criteria are also pretty difficult to meet. It is possible to be debilitated and unable to work because of your COPD, even if your test results do not meet the listing criteria.
If you are not found to meet the listings, it is still possible to be approved for Social Security Disability benefits. I will talk a little more about this in my next blog post.