I have serious emphysema and have applied for disability. Will this condition qualify me for disability?
It can. Having a specific disease is no guarantee that you will qualify for disability; it depends on how sick you are. To be considered disabled you must prove that your emphysema has reached such a severe level that you cannot work and that your disability is expected to last at least a year or result in death.
The five-step process
The Social Security Administration (SSA) will analyze your case using a five-step process to determine if you are disabled.
1. Are you working? If you are working and your earnings average more than the limit, your claim most likely will be denied.
2. If you are not working, is your condition severe? Does your emphysema interfere with your ability to do basic work-related activities?
3. If your emphysema is a severe impairment, is it on the list of disabling impairments? SSA maintains a list of impairments for each major body system, which are so severe that you will be considered disabled if you can show your impairment is on the list. Emphysema can be described as a “chronic pulmonary insufficiency”.
In the case of respiratory disorders, you must provide SSA with medical evidence of your condition. The evidence must be sufficiently detailed to allow the SSA reviewer to evaluate the severity of your impairment. Evidence typically relied upon to prove section impairments includes a thorough physical exam detailing symptoms and physical signs; a complete medical history; a chest x-ray; and spirometric pulmonary function tests. SSA has data tables to assess an impairment’s severity based on spirometry results.
If SSA decides that an impairment either is not listed or does not meet a listing’s requirements, it will ask whether the impairment is as severe as a listed impairment. If it is, your claim will be approved. If not, SSA proceeds to the next step.
4. Can you do the work you previously did? Specifically, does your condition interfere with your ability to do the work you did in the last 15 years? If not, your claim will be denied. If it does, your claim will be considered further.
5. Can you do any other type of work? If you cannot do the work you did during the last 15 years, the agency looks at various vocational factors to see if you can do any other type of work. SSA considers your age, education, past work experience, transferable skills and the job’s demands. If you cannot do any other kind of work, your claim will be approved. Otherwise, your claim will be denied.
Factors to consider
Results vary depending on the facts of a particular case. For example, in one case, the administrative-law judge found that a severe respiratory impairment prevented a man from doing heavy or moderate work (e.g., carpentry), but that he could still do light work (e.g., sedentary or supervisory work), and benefits were denied.
In another case, a woman claimed she was disabled due to allergic rhinitis and asthma. The judge noted that her x-rays and bronchoscope results showed no strong abnormalities and that she had worked for quite a while despite her condition, traveled extensively and could function in a daily routine in a house without air-conditioning. He concluded that she could not work in a setting involving exposure to environmental irritants (e.g., cigarette smoke, increased dust, mold spores or flowers). However, since her job as a bank teller did not expose her to these irritants, she was denied benefits.
Examples of factors that can strengthen a case are a history of extensive treatment; showing that your condition has worsened; proof that you missed considerable time from work and finally had to quit working due to your impairment; and restriction of your daily activities.
Credibility is vital. Be honest and as detailed as you can. Don’t exaggerate. Loss of credibility can ruin your case.