Chronic Pulmonary Insufficiency and Disability

Meeting the disability requirements outlined by the SSA will automatically approve you for benefits.

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Chronic pulmonary insufficiency occurs when your lungs cannot take in enough oxygen or expel enough carbon dioxide to keep your body healthy. The most common symptoms of chronic pulmonary insufficiency are coughing, chest pain, shortness of breath during exercise, and excessive mucus production. Chronic pulmonary insufficiency has many causes, including exposure to smoke, harmful chemicals, and air pollution; birth defects; sleep apnea; lung infection; or injury.

Can I Get Disability for My Chronic Pulmonary Insufficiency?

If you meet the requirements for the Social Security Administration’s (SSA) listing for chronic pulmonary insufficiency, your disability claim will be automatically approved. To win automatic approval, you must be diagnosed with chronic pulmonary insufficiency and have one of the following conditions:

1. Chronic obstructive pulmonary disease (COPD) and a forced expiatory volume (FEV1) test that is lower than the values in the chart below. An FEV1 test gauges how much air you can force out in the first second of exhalation.

Height

FEV1(liters)

5' or shorter

1.05

5'1"-5'3"

1.15

5'4"-5'5"

1.25

5'6"-5'7"

1.35

5'8"-5'9"

1.45

5'10"-5'11"

1.55

6' or taller

1.65

2. Chronic restrictive ventilatory disease and a forced vital capacity (FVC) value that is lower than the values in the chart below. An FVC test measures the total amount of air you exhale after a full deep breath.


Height

 

FVC

5' or shorter

1.25

5'1"-5'3"

1.35

5'4"-5'5"

1.45

5'6"-5'7"

1.55

5'8"-5'9"

1.65

5'10"-5'11"

1.75

6' or taller

1.85

3. An ongoing inability of the lungs to effectively send oxygen to the body and remove carbon dioxide (called gas exchange) due to documented pulmonary disease, with one of the following:

  • A single-breath carbon monoxide diffusion capacity (DCLO) test less than 40% of the predicted normal value, or less than 10.5 ml/min/mm. A single-breath DCLO test measures how well your lungs disperse oxygen into your blood stream.
  • Arterial blood gas levels of oxygen pressure (PO2) and carbon dioxide pressure (PCO2) that are lower than the values in the chart below. You must also undergo the tests at least twice, three or more weeks apart during a 6-month span.

Arterial PCO(mm Hg) 

Arterial POEqual to or Less than (mm Hg)

30 or below

65

31

64

32

63

33

62

34

61

35

60

36

59

37

58

38

57

39

56

40 or above

55

(This table is for people tested at less than 3,000 feet above sea level; for testing values at 6,000 and 9,000 feet above sea level, see the SSA's impairment listing for chronic pulmonary insufficiency.) 

4. Arterial blood gas levels of oxygen pressure (PO2) and carbon dioxide pressure (PCO2) that are lower than the values in the chart, while exercising at about the rate of a fast walk and on room air (not oxygen).

If you don’t know whether you qualify for automatic approval from the material above, you should ask your doctor to review the SSA's listing for chronic pulmonary insufficiency.

What If My Pulmonary Insufficiency Doesn’t Meet A Listing?

Even if your pulmonary insufficiency doesn’t meet a listing, you can still win your claim for disability. When an impairment doesn’t meet a listing, the SSA will prepare a residual functional capacity assessment (RFC) that details how your chronic pulmonary insufficiency has impacted your ability to work. For example, your illness may prevent you from working in environments that are dusty, that expose you to harmful chemicals, or that expose you to temperature extremes. You also may need to take time from your workday to self-administer a nebulizer or other breathing treatments. Your chronic pulmonary insufficiency might also limit how far you can walk and how long you can stand. These limitations would make it difficult for you to engage in most fulltime work.

To make sure that the SSA considers all of your functional limitations in its RFC assessment, you should have your treating physician fill out an RFC for you so that the SSA can consider your doctor’s opinion when deciding your claim. For more information, see our article on RFCs and how they can help you.

What Are the Other Requirements for SSI and SSDI?

When you first apply for disability, the SSA will make sure that you meet the basic requirements for disability. You cannot be earning more than $1,010 from work, and your disability must be expected to prevent you from working for at least a year.

In addition, SSDI is awarded only to applicants who have worked long enough paying taxes to the SSA. For more information, see our section on the SSDI requirements.

To qualify for SSI, which is need based, you must meet both an income and asset test. For more information, see our section on SSI requirements.

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