Can You Get Disability Benefits for COPD in Pennsylvania?

The CDC reports that more than 6% of Pennsylvanians  have been diagnosed with COPD. If you’re among them, and your condition is so severe that you are unable to work, you might qualify for monthly benefits through the Social Security Administration. Our disability lawyers explain how.

What is Chronic Obstructive Pulmonary Disease (COPD)?

Chronic obstructive pulmonary disease, better known as COPD, is a widespread but serious medical condition which affects an estimated 12.7 million adults in the United States. According to the American Lung Association, COPD is now the third most common cause of death in the country, accounting for nearly 135,000 fatalities in 2010 alone.

The CDC reports that most cases of COPD stem from smoking. Other common causes include:

• Exposure to pollutants and second-hand smoke.
• Being related to someone who has COPD.
• Respiratory conditions like asthma.
• Excess weight around the abdomen, which can impair lung function.

COPD is often described as a hybrid form of two other respiratory disorders: chronic bronchitis (where the lungs’ bronchial tubes become narrow, inflamed, and full of mucus) and emphysema (where air sacs called alveoli become less efficient). In COPD patients, this combination leads to serious and in some cases life-threatening medical effects, including:

• Chronic coughing, throat irritation, and production of phlegm/mucus.
• Wheezing and difficulty breathing, especially with physical exertion.
• Quickly becoming short of breath.
• Frequent lung infections.
• Increased risk of pneumonia.

It’s easy to see how these sorts of severe symptoms could interfere with a COPD patient’s ability to maintain steady employment. If you suffer from severe COPD, you may be eligible for disability benefits. However, in order to improve your chance of qualifying, you need to understand what the SSA looks for when evaluating a COPD claim for SSI (Supplemental Security Income) or SSDI (Social Security Disability Insurance).

SSA Medical Standards: How COPD Qualifies for Disability Benefits

Before we discuss how you qualify with COPD, let’s go over the general eligibility requirements which apply to all claimants. Your claim will not be approved unless you satisfy the following criteria:

• You must be severely disabled, meaning you are unable to work (or can only work in a very limited capacity – contrary to popular belief, you can work and receive disability.
• Your monthly earnings must not exceed the income limits specified by the SSA. If they do, the SSA will conclude that you are well enough to support yourself through steady work, and therefore do not qualify for disability benefits.

• Your condition must either:
  • Have already lasted for one year (or more).
  • Be expected to last for one year (or more).
  • Be expected to result in death.

When making disability determinations, SSA doctors use a medical guideline known as the Listing of Impairments, which sets forth medical standards for various conditions. Some of these standards are simple and plain, while others are highly technical and demanding. If you don’t match or meet a Listing, don’t worry: you could still possibly qualify in other ways.

That being said, let’s review what the Listing says about COPD.

The Listing is divided by body system. References to COPD are contained within Section 3.00 (Respiratory System Disorders). The specific listing for COPD is located at Section 3.02 (Chronic Pulmonary Insufficiency), which states the SSA will consider claims based on “chronic obstructive pulmonary disease due to any cause,” provided the claimant’s COPD also meets additional standards which are based on FEV (Forced Expiratory Volume).

Essentially, the medical examiner will check your FEV against the numbers on the SSA’s FEV chart (with values based on the claimant’s height). If your FEV matches or is lower than the FEV values provided in the Listing of Impairments, you should be on your way toward being approved.

However, you should be prepared for extensive medical reviews. As the SSA cautions, “Because these symptoms [e.g. cough, wheezing, chest pain] are common to many other diseases, a thorough medical history, physical examination, and chest x-ray or other appropriate imaging technique are required to establish chronic pulmonary disease. Pulmonary function testing is required to assess the severity of the respiratory impairment once a disease process is established by appropriate clinical and laboratory findings.”

Our Pennsylvania Disability Attorneys Can Help if You Have COPD and Need Benefits

If you have severe COPD, you might be a good candidate for monthly disability benefits. Whether you have questions about applying for the first time, or your claim has already been denied and you want to appeal an SSA decision, the disability attorneys of Young, Marr, Mallis & Associates can help. We have over 20 years of experience handling thousands of claims across Pennsylvania and New Jersey.

To set up a free, completely private legal consultation with our Philadelphia disability attorneys, call Young, Marr, Mallis & Associates today at (609) 755-3115 in New Jersey or (215) 701-6519 in Pennsylvania. We will keep your information confidential.