What is COPD?
Chronic Obstructive Pulmonary Disease (COPD) is a chronic lung condition that obstructs air flow in-and-out of the lungs, causing difficulty with breathing, cough, mucous production, wheezing, and shortness of breath. “Emphysema” (alveolar damage) and “chronic bronchitis” (bronchial inflammation) are older terms that are not used much anymore, because they are included in COPD.
The most common cause of COPD is cigarette smoking, but there are other lung irritants that can cause COPD. There is even a rare genetic disorder, called alpha-1-antitrypsin (AAt) deficiency, that can cause COPD in susceptible patients, who have never smoked.
Getting Disability Benefits for COPD with a "Listing"
COPDis a “listing level disease,” which means the Social Security Administration (SSA) has published a set of criteria for severity that, if you meet those criteria, under most circumstances you will automatically be eligible for disability benefits.
The SSA “listing” for COPD is under 3.02 Chronic Respiratory Disorder.It is based primarily on breathing tests done by your pulmonologist to measure your breathing called “spirometry.” The breathing tests that are included in Listing 3.02 are the FEV-1, FVC, DLCO, and arterial blood gasses (ABG).
The FEV-1 measures your“forced expiratory volume,” which is the amount of air you can force out of your lungs in 1 second. The FVC is “forced vital capacity,” which means the total amount of air you can exhale from your lungs. The DLCO is also called the “diffusing capacity,” which refers to how well your lungs can transfer carbon dioxide and oxygen into and out of your lungs. ABG or “arterial blood gasses” directly measure the concentration of oxygen and carbon dioxide in your blood. There are tables that Social Security uses that take into consideration your age, height, and weight, which list how bad your breathing tests must be to qualify for disability benefits based on a “listing.”
What if Your Breathing Tests Are Not Bad Enough to Meet a Listing?
You can still get Social Security Disability benefits even if you do not meet a “listing.” That will depend on your Residual Functional Capacity (RFC), with respect to what you can and cannot do in an 8-hour workday.
For example, if your COPD doesn't meet a “listing,” you might still be able to present a strong case if your shortness of breath and generalized weakness prevent you from doing even a sedentary job.
Good Communication with Your Doctor is Very Important in Proving-Up Your Case
Ask to see a pulmonologist. Those are the doctors that are experts in diagnosing and treating COPD.
Ask your doctor to order spirometry. These are the “breathing tests” that measure your FEV-1, FVC, DLCO, and arterial blood gasses (ABG). If the results of these tests qualify you for disability benefits based on Listing 3.02, then your chances of a disability award should be good.
If the results of your spirometry aren't bad enough to automatically qualify for disability benefits under a “listing,” then it will be important for you to tell your doctor, and have your doctor document in your medical records, your symptoms(shortness of breath, fatigue) and functional impairments(lift/carry, sit/stand/walk).
Your doctor may also be asked to fill-out Medical Source Statements (MSS). An MSS is astandardized formthat the SSA uses to document your medical condition and how it impacts the kinds of work-related activities that you can and cannot do.
To help you win your disability case, your medical record must contain consistent documentation from your doctor not only of your diagnosis and symptoms, but also of how your symptoms limit you from doing your former occupation or any other occupation considering your age, education and prior work experience.
SSA utilizes the term "Impairments" (and resulting "limitations" - why you cannot work) are the essential bits of information that must be clearly and consistently documented throughout your medical history by the treating sources (medical doctors, psychologists, psychiatrists).
SSA additionally utilizes the term "Residual Functional Capacity" (RFC); this is a key concept related to the resulting physical and/or mental impairments from conditions for which the disability claim is based upon and the impact upon ability to work.
SSA has its own forms that are used for Physical RFC here and for Mental RFC here. These forms can be filled out by the treating source who has the opportunity to examine the patient and understand the limitations which result from his/her condition and thereby document with specificity in the language of SSA disability.
SSA "Listing" or "Blue Book" description can be found here (See 3.02 Chronic Respiratory Disorders)
Your disablity lawyer must work closely with your treating physician to get the proper documentation of your specific findings and impairments into the medical records. At Law Med that's what we do.