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Emphysema and Social Security Disability

Emphysema - Condition and Symptoms

Emphysema is a chronic lung disease in which the tiny sacs that let the lungs transfer oxygen and carbon dioxide into and out of the body (the alveoli) deteriorate, inhibiting a person’s ability to breathe. As the disease progresses, more and more alveoli are destroyed, making breathing increasingly difficult. There is no cure for Emphysema, but its progress can be slowed by avoiding lung irritants, such as smoke and airborne chemicals. Emphysema is usually treated with medication that helps breathing, such as oxygen, steroids, and inhalers. Two surgical procedures that are sometimes tried, albeit with quite limited success, are:

  • Placement of valves in lung passages affected by Emphysema; and
  • Full lung transplant.

The symptoms of Emphysema are very similar to congestive heart failure, sarcoidosis, tuberculosis and other lung diseases. In order to diagnose the condition, your physician will review your medical history and perform a physical exam. Your doctor may be able to hear characteristic sounds in your lungs during your physical exam, and by tapping on your chest he or she may be able to hear the hollow sound of ruptured alveoli and overinflated lungs. In addition, a person suffering from Emphysema will sometimes develop a peculiar rounding of the fingernails.

Your doctor will also order lung function tests, which are highly effective in making a diagnosis, even before you start to show symptoms of the disease. Lung function tests measure how much air you can take in when taking a deep breath. X-rays can also be a useful diagnostic tool in advanced cases, although often nothing out of the ordinary will appear in X-ray images in the early stages of the disease.

Other diagnostic methods may include an arterial blood gases analysis (showing how well your lungs transfer oxygen and carbon dioxide), pulse oximetry (which measures the amount of oxygen in your blood to determine if you need supplemental oxygen), a sputum examination (to provide cells for analysis), and a CT scan (allowing your physician to view your internal organs, to see if the characteristic bullae, or holes, caused by Emphysema are present).

Shortness of breath during physical exertion is one of the first symptoms of Emphysema. As the disease progresses, you may experience difficulty breathing, coughing, wheezing, excess mucus, and a bluish tint to the skin. In addition, low oxygen levels in the blood may produce grumpiness, irritability, and impaired mental ability. High carbon dioxide levels in the blood can lead to headaches and insomnia.

Filing for Social Security Disability with a Emphysema Diagnosis

Unfortunately, there is no specific listing for Emphysema in the Social Security Administration’s (SSA) Blue Book. Instead, it is grouped under Section 3.00, which covers Respiratory System impairments, where it is categorized by the SSA as an “obstructive airway disease.” In general, the SSA bases its assessment of the severity of your condition on your ability to perform daily tasks, walk, and move, as well as on the degree to which your symptoms (including pain) limit you, the extent of your treatment, and how you respond to treatment.

Individuals who have been diagnosed with Emphysema may qualify for disability benefits, provided they can produce documented medical records that meet the criteria listed in the relevant section of the Blue Book. The listing is extensive and complicated, and proving total disability based on an Emphysema diagnosis can be difficult due to the lack of specific impairment criteria for Emphysema itself.

When you apply for disability benefits, you must show that you have been clinically diagnosed with chronic pulmonary disease and that your Emphysema is severe enough to prevent you from engaging in gainful activity. You must provide your full treatment history of continuous medical and clinical records, including a description of treatment and your response to that treatment over time.

Your records must document the severity of your condition and should provide information as to how well (or how poorly) you are able function with medical treatment. Because symptoms are common to many other diseases, a thorough medical history, including physical examination, and chest x-ray or other appropriate imaging techniques will be required to establish proof of chronic pulmonary disease, which you will need in order to be awarded benefits on the basis of Emphysema. Pulmonary function testing will also be required to assess the severity of the respiratory impairment once a diagnosis is made.

Your Emphysema Disability Case

If Emphysema has disabled you to the extent that you are unable to work, you may well be entitled to Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) benefits. Although total disability based on Emphysema can be difficult to prove compared to other disabling conditions, working closely with medical professionals and a qualified Social Security disability attorney or advocate to collect and present the appropriate documentation to support your disability claim in front of the Disability Determination Services (DDS) can help to ensure that your Emphysema disability case will have the highest possible chance of success.