Why Was My COPD Claim Denied?

Chronic obstructive pulmonary disease, or COPD, describes a variety of progressive disorders that affect the lungs, such as emphysema, asthma, or chronic bronchitis. Almost 30 million people in the United States are affected by COPD of some kind, with an estimated 15 million not even knowing they have a form of the disorder.

However, it is this frequency that occasionally makes it difficult to get benefits with COPD. Continue below to see what may have caused your initial application to be denied, and see what evidence you can provide to id you through the next steps in the process.

Potential Causes for COPD Denial

Chronic respiratory disorders have one of the most complex entries in the Blue Book. This means that many applications for COPD are at risk of being denied for simple technicalities. Depending on your specific diagnosis, you must compare your height, age, and sex to the chart of the corresponding lung test you must take.

Social Security Benefits for COPD

For instance, a person with severe asthma must obtain a certain score from an FEV test, while chronic bronchitis can qualify with an FEV test, FVC test, arterial PaCO2 test, or DLCO test. The best way to ensure your results meet your diagnosis’ criteria is to bring your application and compare your case to this Blue Book listing.

Another reason your application may have been denied is due to a lack of complications or hospitalizations. Those whose COPD causes them to have three hospitalizations within a 12-month period at least 30 days apart can qualify for benefits without the test results above. However, those whose lung test results are too far from these qualifying test numbers may still have trouble getting benefits.

Preparing for Your Hearing

The next step after your initial claim denial is scheduling your disability hearing. Hearings add a personal element to your application that simple paperwork cannot convey. By allowing you to speak on your own behalf about the ways your COPD hinders you, hearings actually increase your chances of getting benefits over your initial application.

Hearings typically have a very long wait list. This means you should schedule your hearing as soon as you know you’ll be moving forward in the process. Hearings can be scheduled in person at your nearest Office of Disability Adjudication and Review (ODAR), which can be located using the SSA’s online ODAR location tool. Once you are scheduled, you will learn which administrative law judge (ALJ) while be presiding over your case, as well as the time frame before your hearing arrives.

When preparing for your case, include as much information as possible about yourself, your financial history, and your medical history to date. Bring your previous application to show the ALJ during the hearing. Get tests redone that are over a year old, and bring original tests to compare your condition’s progression over time. Get testimonials from family, friends, or past work members that can attest to the severity of your condition. And, if you have any questions, be sure to speak with your physician or a local Social Security worker for more information on what to prepare.

Considering a Disability Attorney

Getting an attorney may seem intimidating during this financially and mentally stressful time. However, disability attorneys exist solely to help people like you get disability benefits. Their legal expertise can help to get your paperwork organized, stay in contact with the SSA, and even potentially move the process forward faster. Their defense of your case in court also highly increase your chances of getting benefits. And, more than anything, federal regulation requires them to work on contingency, meaning you don’t pay your attorney unless they win your case.

Before your hearing, consider a free consultation with a disability attorney to help you get the benefits you deserve.