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Chronic obstructive pulmonary disease (COPD) affects over 16 million people in the U.S., making it one of the more common respiratory disorders. If you suffer from COPD and it impacts your ability to work, even though you’ve received treatment for months, then you could qualify for disability benefits from the Social Security Administration (SSA).
To help you understand whether your COPD qualifies for benefits, this guide will go over how the SSA evaluates COPD and what next steps you should take.
Is COPD a disability?
Yes, COPD is considered a disability by the SSA if its symptoms or the treatment you receive to treat your COPD leaves you unable to hold a job or handle daily activities on your own.
How the SSA defines COPD
Chronic obstructive pulmonary disease is a respiratory condition characterized by a constriction of your airways that makes it hard to breathe. Other common symptoms include coughing, wheezing, excessive mucus production, shortness of breath, interrupted sleep (potentially resulting in insomnia). Your COPD may be triggered by certain conditions or environments, like when you’re near cigarette smoke. It’s also common to have emphysema or chronic bronchitis in addition to your COPD.
Can you get disability benefits for COPD?
You can get disability benefits for COPD as long as your symptoms have progressed enough that prevent you from being able to hold a job. Qualifying is also easier if you’re 50 or older because you only need to prove to the SSA that you can no longer do the jobs you’ve done in the past. If you’re under age 50, you need to prove your COPD keeps you from being able to do any job that exists.
Stages (or grades) of COPD
Your doctors will likely classify your COPD stage or grade — from 1 to 4 — based on its severity. While the SSA does not specifically refer to these phases in their condition listings, the symptoms associated with each stage are a good guide of whether or not you may qualify for disability.
Stage 1 COPD generally involves mild symptoms — lungs functioning at 80% or higher of healthy lungs. Some people won’t realize they have an issue at this stage, making it unlikely their condition is serious enough to qualify for disability benefits.
Stage 2 COPD is defined by lungs that work at between 50% and 80% of healthy lungs. Symptoms are still moderate but you may experience flare ups or attacks when it’s harder than usual to breathe. Even at this stage, secondary conditions, like insomnia or anxiety may begin to appear (potentially making it easier to qualify for disability).
Stage 3 COPD is severe and a point where your lungs function at between 30% and 50% of healthy lungs. Applicants with Stage 3 COPD may have an easier chance to qualify than stage 1 or 2, especially if it leads to secondary conditions.
Stage 4 COPD is extremely severe. Your lungs function at 30% or less than healthy lungs and your breathing difficulties most likely make it so hard to work that you could qualify for disability benefits.
To qualify for disability with COPD, you need to show the SSA medical evidence that proves your condition gets in the way of your ability to hold a job and manage daily tasks on your own.
The SSA will look for a doctor’s diagnosis but also the result of specific tests, such as X-rays or CT scans. Evidence that your condition continues to get in the way of your work even though you’ve received treatment for months will also strengthen your claim.
To determine how severe your COPD is, the SSA will need results from tests that measure the functionality of your lungs, the level of your blood oxygen (oxygen saturation levels), and your FEV1/FVC ratios.
Some specific pulmonary function tests the SSA may consider include:
Spirometry: The highest level of the FEV1 value is used to determine your eligibility for disability.
DLCO tests: Measuring your gas diffusion in your lungs, the SSA will use the average of two uncorrected test measurements reported in mL CO (STPD)/min/mmHg to evaluate your respiratory condition.
ABG tests: The SSA may consider your resting or exercising measurement of partial pressure of oxygen (PaO2) and carbon dioxide (PaCO2) in the arterial blood.
Pulse oximetry: Measuring the oxygen saturation (SpO2) of your blood hemoglobin, the SSA will require that this test is taken while you’re considered “stable.”
The SSA will also consider other conditions that develop alongside or because of your COPD. For example, maybe your coughing interrupts your sleep and leads to insomnia. Or maybe you also develop a mental health condition like anxiety, depression, or panic attacks. Showing the SSA that you have one of these conditions in addition to your COPD may increase your chances of getting approved for disability.
My COPD meets the criteria. Now what?
If your COPD keeps you from working and performing normal daily activities, then your next step is to apply for disability benefits. We suggest applying as soon as possible because the process is long and waiting to apply means waiting longer to get benefits.
To simplify the application process, the best thing you can do is work with a disability lawyer. They can complete the application for you, answer all your questions, and the best part is that you don’t have to pay them unless they win your case. Atticus can match you with an experienced lawyer — just take our 2-minute matching quiz to get started. (Our services are completely free.)
There are two options for disability benefits. Social Security Disability Insurance (SSDI) is available if you’ve worked and paid taxes for years — generally at least five of the past 10 years. The other type of disability is Supplemental Security Income (SSI), which is available if you don’t have recent work history and if you have little to no income, savings, or assets.
Although the SSA does not specifically classify payments for COPD,
The average check for disability recipients with respiratory conditions like COPD is $1,384.27 per month.
However, the maximum possible disability payment is about $3,600 per month for SSDI and $914 per month for SSI in 2023. These maximum payments are set by law and the condition you have doesn’t affect how much you get. Instead, your SSDI payments are based on your work history and income history. SSI payments are set by deducting your total monthly income from the $914 maximum.
If you aren’t sure that your COPD satisfies the criteria above, consider applying for disability benefits anyway. The bottom line is that if you’re unable to work due to the severity of your COPD, you may be able to get Social Security disability benefits.
It’s also important to remember that qualifying for disability is a difficult process. Most people can expect their initial application to be denied. Only about 20% of people applying for disability benefits actually win their claim on the first application. But you have the right to appeal and eventually you may have the chance to state your case before a judge. At that point, more than half of applicants get approved.
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