Representatives of the Social Security Administration (SSA) use the Blue Book as their guideline for determining whether a person’s disabling condition is considered serious enough to merit complete disability. The Blue Book is divided into sections which cover the various body systems and functions. The third section in the Blue Book covers respiratory system disorders.
When determining disability claims based on respiratory impairments, the SSA considers how long you have had the condition, how long the condition is expected to last, what types of treatments have been or could be attempted, and what your response to treatment has been. It is important that you continue receiving medical treatment during the disability claims process and that you continue to follow all prescribed treatments.
The Blue Book divides respiratory problems into a number of categories, including:
- Chronic Pulmonary Insufficiency
- Cor Pulmonale Secondary to Chronic Pulmonary Vascular Hypertension
- Cystic Fibrosis
- Lung Transplant
- Mycobacterial, Mycotic, and Other Chronic Lung Infections
- Sleep Apnea
- Sleep Related Breathing Disorders
Asthma may be evaluated using the same criteria as CPI/CPD. Alternately, if your condition has been under medical observation for at least a year, the SSA can consider you completely disabled if you are undergoing treatment for asthma and still have severe asthma attacks which require medical intervention:
- At least once every two months or
- Six or more asthma attacks per year.
If your asthma attack requires actual hospitalization for more than a complete day (24 hours or more), the SSA counts it as if it were two attacks.
Chronic Pulmonary Insufficiency
If you have CPI, the SSA will consider your height, weight, and breathing capacity. There are a number of breathing and blood tests they may consider in measuring your ability to breathe and whether your CPI is serious enough to merit complete disability. These tests may already be part of your medical record, or the SSA may order the tests done (or both).
In considering cystic fibrosis disability claims, the SSA looks for at least six episodes of bronchitis, pneumonia, or hemoptysis per year, or episodes of the same conditions at least every two months. Similar to asthma, episodes which require 24 hours of hospitalization are counted as if they were two episodes. The SSA may also approve disability for cystic fibrosis if you have persistent pulmonary infections every six months of if you have infections severe enough to require a nebulizer or intravenous treatments.
Lung transplant recipients are considered disabled for one year after their surgery. After that, their condition is monitored and reconsidered periodically.
Sleep Related Breathing Disorders
In some cases, sleep disorders are considered mental conditions and evaluated under the Blue Book section dealing with those types of conditions. Otherwise, they are treated like other respiratory conditions.
Other Respiratory Disorders
Most other respiratory disorders are considered using the same parameters as CPI. It’s worth noting that those who don’t qualify for disability due to a respiratory disorder alone may still qualify for benefits after all of their benefits are considered.
Other Conditions evaluated by the SSA under respiratory system disorders: