What Is Emphysema?
Emphysema is a chronic lung disease that is usually caused by cigarette smoke or other environmental pollutants. There is no cure for emphysema short of a lung transplant, and most emphysema sufferers are not healthy enough to undergo the required surgery.
Even for those who are able to receive a lung transplant, there is a significant risk that the lung will collapse (the most recent figures as of this writing are 7% of transplant recipient’s lungs collapse).
Common Symptoms of Emphysema
Common symptoms of emphysema include: excessive mucus, shortness of breath, difficulty breathing, wheezing, and skin discoloration. People with emphysema typically have low oxygen levels in their blood, which can further cause heart problems, irritability, and mental impairments. Some emphysema sufferers also get chronic headaches and may have trouble sleeping.
Many of those who have emphysema also have chronic bronchitis. Those who suffer from both diseases at the same time are said to have chronic obstructive pulmonary disease (COPD). However, whether you also suffer from chronic bronchitis or not, emphysema can be debilitating.
The shortness of breath and low oxygen levels experienced by emphysema sufferers tends to lead to fatigue. Additionally, many of the symptoms are triggered by physical exertion. This is especially true of shortness of breath.
The Social Security Administration recognizes emphysema as a potentially disabling condition and has specific guidelines regarding how severe the symptoms need to be in order for applicants to be approved for Social Security Disability benefits.
Emphysema and Your Ability to Perform Physical Work
Many people with emphysema are unable to continue performing physical work. The strain caused by activities such as lifting, bending, and walking for extended periods of time may trigger emphysema symptoms. Shortness of breath is the most common complaint associated with physical work.
In order to qualify for Social Security Disability benefits, your claim needs to clearly show that you are incapable of performing any work that you maybe qualified for. When it comes to your ability to perform physical work, the SSA will look at all of the jobs you have performed in the past 15 years and will determine whether you should be able to perform any of them despite your emphysema.
Additionally, the SSA will look at other jobs that you may qualify for that would require a lesser degree of physical work. If they find that you are capable of performing any work that you are reasonably qualified (or could be trained), your claim will be denied. It is important that your medical records clearly indicate all restrictions and limitations on your physical activities; including walking and lifting.
Emphysema and Your Ability to Perform Sedentary Work
Sedentary work doesn’t require as much physical activity as physical work. To qualify physically for sedentary work, you need to be able to sit in one place for six hours or more, lift up to 10 pounds occasionally and concentrate on tasks that often require hand to eye coordination.
If you are under 55 years old, the SSA may determine that you could reasonably be trained for a sedentary job, even if you are unable to do any of the jobs you have performed up until now. Proving that you are incapable of performing any work, including sedentary work, can provide a significant challenge.
Furthermore, working through the appeals process can be time consuming and frustrating.
Medical Evidence Needed To Qualify
If you are unable to work because of emphysema, you may qualify for disability benefits from the Social Security Administration (SSA). A chronic obstructive pulmonary disease (COPD), emphysema occurs when the lungs’ air sacs lose their elasticity and are gradually destroyed causing difficulty breathing.
Emphysema is most often caused by smoking tobacco, but some individuals who suffer from the condition have never been smokers.
The SSA uses a medical guide, which is called the Blue Book, to determine if a claimant meets the medical criteria to be approved for monthly benefits. There are sections that cover different body systems, and each section has listings for medical conditions that apply to that system that could be considered disabling.
To medically qualify, you must meet the criteria of a Blue Book listing. Listing 3.00 covers Respiratory System impairments with Listing 3.02 indicating that the claimant must have one of the following:
- chronic obstructive pulmonary disease caused by anything with an FEV1 test equal to or less than the specified pulmonary tests
- chronic restrictive ventilatory disease with any cause and an FEV1 test that is equal to or less
than the specified pulmonary tests
- chronic impairment of gas exchange because of pulmonary disease with either single breath
DLCO and PCO2 measured while at rest on at least two occasions taken three or more weeks
apart within a 6-month timeframe that is equal to or less than certain specified pulmonary test
values or arterial blood gas values of oxygen and carbon dioxide measured while breathing air in
a room, during steady exercise, that is equal to or less than certain specified pulmonary test
You must provide hard medical evidence to support your claim and that confirms your condition meets one of the criteria listed. If you can provide medical records and test results that meet the criteria of the listing, you will be disabled per SSA guidelines and your claim will be approved.
You can access the Blue Book online at the SSA website, which is www.ssa.gov. You should talk with your physician, such as your pulmonologist or allergist, and ask if your doctor believes that you would qualify for disability benefits. The wording of the listing is technical, and an attorney or a physician would be able to determine if your medical records would meet the criteria of the listing.
Your doctor can provide a written statement and ensure that the documentation that your claim needs to be approved is included in your medical records. Disability Determination Services (DDS) must be able to get a clear picture of what you can and cannot do. If your medical records show the severity of your condition and make it clear that your ability to perform routine daily tasks as well as work has been affected, you are more likely to have your disability claim approved.
Qualifying With Emphysema Using A Medical Vocational Allowance
If you are disabled because of emphysema, but you are unable to meet the criteria of a Blue Book listing, you may still be able to qualify using a medical vocational allowance. This approach will take your medical conditions, symptoms, treatment, side effects, age, work history, transferrable skills, and
educational background all into consideration together.
If you provide a residual functional capacity (RFC) form completed by your physician, it can improve your chances of having your claim approved. The RFC can detail what you can and cannot do and how emphysema affects you and your ability to work.
The RFC will say how long you can stand, how far you can walk, if you can lift and how much you can lift, if you can bend or squat, if you can reach and grasp, and it will basically paint a clear picture of what you are able to do. As an example, with emphysema, which is a breathing disorder, you cannot be around
dust, chemicals, or inhalants.
If you are older than 50 and have limited education, that will also help your claim because you will not be as flexible when it comes to retraining for a job. With your RFC and your supporting documentation, the disability examiner should be able to determine if you can work, and if you can, what kind of work you are able to do. If it is determined that you are unable to work, your claim for disability benefits will be approved.
How A Disability Attorney Can Help You
If you are unable to work and earn a living because of emphysema, you will need to get your claim for disability benefits underway. You will want to make sure you complete the claims form in detail and provide all the supporting evidence and documentation for your claim. An attorney knows what supporting documentation your claim will need to garner approval.
You can start the claim online by visiting www.ssa.gov or by calling 1-800-772-1213 and speaking with an SSA representative over the phone or by scheduling an appointment at your local field office. You need to make sure that the claim is filed out in detail and accurately and that the supporting evidence and documentation your claim needs is included.
Your lawyer will ensure that all the needed documents are included in your file so they can be reviewed by the disability examiner during the claims process. An attorney will not require payment upfront. Instead, a lawyer will take the case on a contingency basis. That means that your attorney will not get paid until your claim is approved and you are awarded disability benefits.
When a disability claim is handled on a contingency basis, the attorney is paid 25 percent – not to exceed $6,000 – of the backpay that the claimant is entitled to receive. To make sure you have legal representation that can help you get your claim on track, complete the Free Case Evaluation Form on this page to share the details with a lawyer who handles disability claims in your area.
Consult with a Social Security Attorney
Most people who apply for Social Security Disability benefits should contract a Social Security Disability lawyer. A lawyer who has experience working with Social Security Disability claims can help you file a claim that contains the kind of information the SSA is looking for when they determine whether or not to accept your Social Security Disability claim.
You should also continue to see your doctor and make sure that all treatments and your reaction to them are clearly documented, as this information will be considered by the SSA.