Asthma is a serious condition that causes breathing problems in people of all ages. The Centers for Disease Control reported that over 16 million adults in America have been diagnosed with the disease.
If you or a loved one is suffering from asthma, the Social Security Administration (SSA) may be able to help you. The SSA offers financial support programs for Americans who can’t work because of a debilitating condition.
The Financial Costs of Asthma
According the Centers for Disease Control, the condition cost each affected person $3,300 or more each year on medications, hospitalizations, emergency room trips, doctor visits, and missed work. In 2007, 40 percent of uninsured Americans and 11 percent of insured Americans couldn’t afford their prescriptions medications.
Asthma is one of the leading causes of missed workdays and lost productivity. In the United States, over 14 billion days of work are missed due to asthma attacks or complications every year. This equals roughly $2 billion in lost income.
In most adults Asthma is a lifelong condition. Attacks, which are triggered by allergens, exercise, smoke, air pollution, infections of the respiratory tract, and occupational hazards, can limit a person ability to work certain jobs and cause other health problems. It disproportionately affects families in urban or disadvantaged communities.
In the United States, almost 65 percent of adult asthma is classified as persistent severity, which means without treatment they’re affected and limited throughout the day and night. For some of these adults, treatment isn’t enough to combat the symptoms. Because asthma is so widespread, the SSA recognizes asthma as a disabling condition, and Social Security Disability (SSD) is available for severe cases of the disease.
Medically Qualifying for Benefits with the Blue Book
The Blue Book is the list of impairments the SSA keeps to define all conditions possibly eligible for SSD. They use the Blue Book to assess every application they receive for disability benefits.
Asthma can be found in section 3.00—Respiratory System.
In order to qualify for SSD by the Blue Book, you need medical proof that your asthma is accompanied by either:
- Chronic asthmatic bronchitis, which is evaluated as a chronic obstructive pulmonary disease (COPD) under section 3.02A. Chronic asthmatic bronchitis occurs when you have both asthma and chronic bronchitis.
- Attacks lasting more than 24 hours that occur once every two months or at least six times a year, despite prescribed treatment. Hospitalizations for longer 24 hours count for two attacks. This requires reports for at least 12 months.
Many cases of asthma are manageable with an inhaler, daily medication, and/or allergy shots, so if you’re able to keep it under control with medication, the SSA likely won’t approve you. Additionally, if you are regularly having attacks, the SSA may also examine what you’re doing to manage your asthma and factor that into their decision as well. If they find you aren’t doing enough, they may deny you.
However, if you’re doing all you can to control your asthma, and it’s not enough, it’s possible to be approved. If you find that it’s interfering with your ability to perform daily activities, talk to your doctor to see if he or she thinks you will qualify for SSD.
Qualifying Without Meeting a Medical Listing
The SSA’s listing for asthma is very specific, so you may be more likely to be approved without meeting a medical listing. If you don’t meet a Blue Book listing, but still find asthma interferes with your ability to work, there’s another option for an SSD approval. The SSA will also consider your Residual Functioning Capacity (RFC).
An RFC you condition based on workplace limitations, and happens more commonly than a Blue Book approval. All disability approvals require that you be expected to be out of work for at least 12 months, but this is especially true in RFC approvals.
The SSA will evaluate the condition, your symptoms, treatments, etc. and determine what level of work you can do—sedentary, light, medium, heavy, and very heavy. Then, it will look at your work history, age, education level, and skills to gauge what jobs are available in your work level. Since asthma attacks are triggered by allergens, exercise, and occupational hazards, the available jobs are limited.
Generally, the grid rules for RFCs are only applicable to applicants 45 years and older, because the SSA may find that younger applicants can be more easily retrained for less intensive jobs. For applicants younger than 45, the SSA will often consider you disabled if you’re applying with non-exertional limitations or arguing you can’t even do sedentary work.
The most common asthma symptoms are coughing, wheezing, chest pain or tightness, shortness of breath, and trouble sleeping. However, more severe symptoms that may be more like to affect your ability to work include, constant fatigue, inability to walk for perform other basic physical activity for a time, trouble sitting still, difficulty concentrating, and anxiety.
Individuals who didn’t attend college or are only qualified for outdoor and/or labor intensive jobs such as construction, manual labor, and service or retail employees would have a higher chance of approval than someone who’s qualified to work in an office.
How to Apply for Social Security Disability Benefits
If your asthma is severe, talk to your allergist about your chances of qualifying for disability benefits through either the Blue Book or through an RFC. The application process can take up to two years, so if you aren’t likely to be approved, it may not be worth taking the time to try.
In order to get a decision as quickly as possible, you need to submit all of the necessary medical information with your initial claim. If you leave pieces missing, you may be denied benefits or the SSA will have the take the time to retrieve the information itself.
Important medical evidence will include:
- Results from a forced expiratory volume (FEV1) test
- Records of all hospitalizations due to your asthma for at least one year
- History, length, and outcomes of all prescribed treatments
- Reports from your allergist and your primary care doctor detailing the severity of the asthma and physical limitations
The SSA has a convenient application available online, but you can also apply in your local SSA office if you don’t want to or unable to submit the forms online. Make sure to double-check your application for questions left blank, typing errors, and other mistakes. This will delay your answer and could cause a denial.
If you are hospitalized, seen by a doctor, or have any new medical evidence at any point during your application wait time, make sure to notify the SSA immediately so they can include it in your case. The more evidence you provide of how asthma affects you, the higher your chance of approval.
If you’re approved for SSD, your spouse and children may also be eligible for benefits. To learn more about the different forms about disability benefits, visit our page on Social Security Disability Insurance.