Can You Get Disability for Lung Disease?

You can get disability benefits for respiratory disorders if they severely affect your ability to work and you have medical evidence to prove it.

By , J.D. · University of Baltimore School of Law

Respiratory disorders are medical conditions that affect your lungs' ability to function properly. The main function of your lungs is to provide oxygen to the rest of your body. But your lungs also:

  • remove carbon dioxide from your body
  • help regulate your body temperature
  • maintain the pH balance in your body, and
  • make hormones and other chemicals you need to sustain a healthy body.

Although each respiratory illness has its own specific symptoms and prognosis, they all affect your ability to breathe. If you can't breathe properly, you might not be able to work. Some lung diseases that can be debilitating include:

  • asthma
  • sarcoidosis
  • cystic fibrosis
  • chronic lung infections
  • lung cancer, and
  • chronic obstructive pulmonary disease.

Here's what you need to know about getting Social Security disability insurance (SSDI) or Supplemental Security Income (SSI) disability benefits for your lung disease.

Can I Get Disability for My Lung Disease?

When the Social Security Administration (SSA) first reviews your disability application, the claims examiner will make several initial determinations, including the following:

  • Have you worked and paid FICA taxes (or self-employment taxes) long enough to qualify for SSDI?
  • Are you engaged in substantial gainful activity?
  • Are your income and assets below the limits for SSI disability benefits?

Once Social Security has determined that you meet the non-medical requirements for SSDI or SSI disability benefits, the agency will assess whether you're medically qualified for benefits. Social Security must next answer the following questions:

  • Has your respiratory illness lasted (or is it expected to last) at least 12 months (or until your death)?
  • Is your respiratory illness severe—that is, does it have a significant impact on your ability to perform basic work activities?

If you meet these initial requirements, Social Security will determine whether your illness meets or equals one of the qualifying conditions in the respiratory section of the SSA's Listing of Impairments (also called the Blue Book). If your lung disease is a listed condition and meets all the requirements of the listing, Social Security will automatically approve your disability claim (see which conditions are listed below).

What Does Social Security Consider in Disability Claims for Lung Disease?

Social Security will need to determine whether your lungs function normally and, if they don't, the extent of their dysfunction. Social Security will consider all your respiratory symptoms, including:

  • shortness of breath
  • chest pain, and
  • coughing up blood.

But simply having these symptoms isn't enough to qualify you for disability benefits. For example, shortness of breath is a common condition in patients with respiratory disorders. But other conditions, like being out of shape, can also cause you to be short of breath.

Even if you suffer from shortness of breath, as long as your lung capacity is at least 80%, your lung function is considered normal. To prove your claim, you must provide Social Security with adequate medical records that do all of the following:

  • date back to when lung disease first prevented you from working
  • give the details of your respiratory symptoms, and
  • include the results of all the lung function tests you've had.

What Are Lung Function Tests?

The most important information Social Security needs when evaluating your claim for disability based on your lung disease is the test results that show the extent of your lung disease. These should include the following:

  • x-rays
  • physical exams, and
  • spirometry tests.

Without this information, Social Security won't give much weight to the results of any other tests performed to prove that your respiratory disorder is disabling.

Social Security has specific requirements for the medical tests used to evaluate respiratory disorders. One lung function test Social Security will require is a spirometry test, which measures your "forced expiratory volume," or the amount of air you can breathe out. Although you might have had a spirometry test to evaluate your lung capacity, Social Security will likely send you to a consultative exam (CE)—at their expense—to be retested. That's because Social Security has strict standards when considering the validity of spirometry exams.

Also, the SSA won't consider outcomes of spirometry or arterial blood gas tests that were performed while you were acutely ill with diseases like pneumonia.

It's important that you put forth your best effort when undergoing a spirometry test. If the Social Security doctor giving you the test believes you haven't, that observation will be included in the CE report.

Lung Diseases Included in Social Security's Disability Listings

Social Security disability listing 3.0 discusses the respiratory disorders that can qualify for automatic approval. The respiratory disorders covered in the listings include:

  • asthma
  • cystic fibrosis
  • pneumoconiosis
  • bronchiectasis
  • chronic pulmonary insufficiency (caused by any illness, such as chronic obstructive pulmonary disease, or COPD)
  • chronic bacterial or fungal lung infections (such as tuberculosis or pneumonia)
  • cor pulmonale, secondary to chronic pulmonary vascular hypertension disorders
  • sleep-related breathing disorders, and
  • lung transplants.

Each disorder has its own complicated set of criteria you must meet in order to be automatically approved for disability benefits. But even if you don't meet the requirements of a listing, you might still qualify for Social Security disability benefits, but proving your case to Social Security can be more complicated. It might be helpful to talk to a disability lawyer about your impairments to get advice on how to present your case and the likelihood of winning your disability claim.

How to Apply for Social Security Disability for Lung Disease

You can apply for Social Security disability in several ways. To apply by phone, call the national toll-free number 800-772-1213, and a Social Security representative will make an appointment for you to apply. The hearing-impaired can call the toll-free TTY number: 800-325-0778.

You can also apply in person at your local Social Security field office but contact the office first, as you might need an appointment to speak with a representative. Most offices are open Monday through Friday during normal business hours. You can also apply for SSDI online at your convenience.

Learn more about the Social Security application and appeals processes.

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