ASTHMA DISABILITY BENEFITS
WHAT IS ASTHMA?
Asthma is a type of chronic obstructive lung disease (COPD) where your lung’s bronchial tubes are inflamed. When you have asthma, muscles in your bronchial tubes constrict due to irritation. Additionally, the inflammation causes excess mucus which narrows the tubes. The muscle constriction and the inflammation in your lungs makes it hard for you to breath. If you have an asthma attack, then you will experience shortness of breath, a tight chest, and coughing.
According to the American Lung Association, 1 in 12 adults suffer from asthma. Asthma often begins during childhood, but it can occur at any time during life. Asthma is known by many names. For example, asthma is also known as bronchitis, chronic bronchitis, and reactive airways disease.
Asthma is a condition which can qualify for benefits. People with asthma can have trouble breathing that varies from mild to severe problems. For example, if you have severe asthma symptoms, you may have shortness of breath, wheezing, coughing, and a tight feeling in your chest.
Over time, you may become unable to speak and get a blue color around your lips or in your fingernails. If you do not get treatment, then you can lose consciousness. Additionally, asthma attacks have also been known to result in death.
IS ASTHMA A DISABILITY?
Asthma is a common condition that causes people to apply for Social Security benefits. However, if your asthma can be controlled with medications, then you will probably not be paid benefits. It is when your asthma symptoms prevent you from working that the SSA will award SSD payments.
The SSA considers asthma a severe medical condition when you need to be admitted to the hospital to receive treatment. For example, you might not be able to breathe due to your asthma so the hospital might give you intravenous antibiotics. Depending on the number of times you have been in the hospital, the SSA will determine whether to pay you SSD and SSI benefits.
If you have an asthma, then you can apply for two types of benefits: Social Security Disability (SSD) benefits and Supplemental Security Income benefits.
APPLY FOR SSDI & SSI BENEFITS IF YOU HAVE ASTHMA AND CAN’T WORK
In order to receive benefits, you must first file an application. You can do this on Social Security’s website. Below, please find an explanation as to each type of benefit you can apply for if you have asthma that prevents you from working for more than one year:
Social Security Disability Insurance (SSDI):
SSDI benefits are for those who have worked in the recent past and can no longer work at any job due to their medical condition. The amount of the monthly payment you will receive from SSDI benefits is based on how much Social Security tax you paid during your work history. To qualify for SSDI, you must have earned enough “work credits” to qualify. A work credit is an amount of taxable income. You can earn up to 4 work credits per year. The amount of work credits you will need will depend on how old you are when you apply. If you haven’t earned enough work credits for your age at the time you apply, you may only qualify for Supplemental Security Income benefits.
Supplemental Security Income (SSI):
SSI is a needs based benefit and it is for those people with little to no income, such as children and the elderly. Anyone who makes more than a certain amount of money per month cannot receive SSI benefits. The SSA counts the income of those in your house, not just your income. If you have a spouse who earns more than $5000 a month, for example, then that income will prevent you from being paid SSI benefits. You cannot qualify for SSI benefits, no matter how severe your asthma, if you do not meet the income and asset rules for SSI.
WHAT IS AN ASTHMA ATTACK?
An asthma attack occurs when the muscles around your airways tighten and create bronchospasm. When this happens, then the lining of your lung airways become inflamed and produce too much mucus. This mucus is also thicker than normal. Due to the combination of these factors, an asthma attack occurs and you have trouble breathing.
Symptoms of a severe asthma attack include:
- Severe wheezing
- Coughing that you cannot stop
- Rapid attempts to breathe
- Chest pain or a tight chest. This may feel like something is sitting on your chest or you make think you are having a heart attack.
- Some people who have asthma say they can’t catch their breath or they feel like they can’t get air out of their lungs.
- Trouble talking
- Anxiety and panic because you cannot breathe
- Blue lips and blue fingernails
Usually, when symptoms like this occur, you will need immediate treatment. For example, if you have trouble breathing, you should quickly use an asthma inhaler or bronchodilator. An asthma inhaler puts medicine into your lungs that opens up the airways. Then, you will be able to breathe. If you cannot breathe after using your inhaler, then you need to go to a hospital right away.
HOW MANY PEOPLE HAVE ASTHMA?
According to the CDC, almost 25 million Americans have asthma. This means that about 1 in 13 Americans, about 8 percent of adults and 7 percent of children, have asthma. Centers for Disease Control and Prevention. (2020). 2019 National Health Interview Survey data. Review CDC asthma information.
Additionally, the Asthma and Allergy Foundation of America did a study that reports the highest rates of asthma deaths and hospital visits occur in Black, Hispanic, and Native American populations. The study found that Black Americans are nearly 1.5 times more likely to have asthma. Puerto Rican Americans are nearly 2 times more likely to have asthma.
Moreover, Black Americans were 5 times more likely to visit the emergency room due to asthma and they were 3 times more likely to die from an asthma attack. When the study looked at gender as a factor, it found that Black women had the highest rates of death due to asthma. Read about asthma and the medical profession.
WHAT CAUSES ASTHMA?
Doctors do not yet understand the cause of asthma. However, they know that asthma symptoms are often the result of a strong immune response to something in the lungs.
For example, asthma attacks can start because of irritants, allergies, exercise, cold air, cold viruses, and even emotional upset. Likewise, it is also possible for asthma attacks to occur for no apparent reason. For instance, many people file for asthma benefits due to all of the asthma triggers that exist at work.
Your asthma doctor will help you find out which things trigger your asthma to flare up. For example, some common triggers are:
- Irritants such as cigarette smoke, air pollution, or man made chemicals in the work environment. Sometimes, even products such as perfume can cause an asthma attack.
- Allergens from animal fur, dust, mold, and tree, grass and flower pollen.
- Viral colds.
- Physical activity, including exercise.
Asthma symptoms are different for each person. For example, some of the triggers on the above list may not bother you. However, you may have other triggers that are not on the list. If you believe you have asthma symptoms that are causing you to be unable to work, then talk to your doctor about possible treatment options.
DOES ASTHMA QUALIFY FOR SSD BENEFITS?
To determine if you should be paid asthma benefits, the Social Security Administration will first check to make sure you are not working. In order to win SSD benefits you cannot be working and you must be unable to work for over 12 months. Work has a specific meaning for the SSA. Learn about the SSA’s definition of work.
In order to qualify for asthma SSD benefits, you will need to have a spirometry test. This test measures how much air you breathe in and out. Additionally, it will also measure at what rate you breathe. In short, the spirometry test measures how much air you can force out of your lungs in one second. This end result of the test shows your FEV1.
To qualify for benefits based on asthma, you will also need to provide them with at least 12 consecutive months of medical records that show how often and how long you were in the hospital because of your asthma attacks.
Your medical records will also need to show your history of asthma treatment. Likewise, the records need to show you have been compliant with the treatment plan from your doctor. Find out about the importance of medical records in your SSDI and SSI case.
SSA’S LISTING 3.03 FOR ASTHMA BENEFITS
SSA has a listing that you need to meet in order to win asthma benefits. Below, you will find the listing, which includes a table that shows what your FEV1 must be in order to meet the listing. The table is also divided by height, age, and gender.
3.03 Asthma with both A and B:
A. FEV1 less than or equal to the value in Table VI-A or VI-B for your age, gender, and height without shoes measured within the same 12 month period as the hospitalizations in 3.03B.
Table VI: FEV1 Criteria for 3.03A
|
Height
without shoes (centimeters) < means less than |
Height
without shoes (inches) < means
less than |
Table VI-A
|
Table VI-B
|
||
|
Age 18
to attainment of age 20 |
Age 20
or older |
||||
|
Females
FEV1 less than or equal to (L, BTPS) |
Males
FEV1 less than or equal to (L, BTPS) |
Females
FEV1 less than or equal to (L, BTPS) |
Males
FEV1 less than or equal to (L, BTPS) |
||
|
<153.0
|
<60.25
|
1.65
|
1.90
|
1.45
|
1.60
|
|
153.0 to <159.0
|
60.25 to <62.50
|
1.75
|
2.05
|
1.55
|
1.75
|
|
159.0 to <164.0
|
62.50 to <64.50
|
1.85
|
2.15
|
1.65
|
1.90
|
|
164.0 to <169.0
|
64.50 to <66.50
|
1.95
|
2.30
|
1.75
|
2.00
|
|
169.0 to <174.0
|
66.50 to <68.50
|
2.05
|
2.45
|
1.85
|
2.15
|
|
174.0 to <180.0
|
68.50 to <70.75
|
2.20
|
2.60
|
2.00
|
2.30
|
|
180.0 to <185.0
|
70.75 to <72.75
|
2.35
|
2.75
|
2.10
|
2.45
|
|
185.0 or more
|
72.75 or more
|
2.40
|
2.85
|
2.20
|
2.55
|
AND
B. Exacerbations requiring three visits to the hospital within a 12 month period and at least 30 days apart (the 12 month period must occur within the period we are considering in connection with your application). Each visit to the hospital must last at least 48 hours, including hours in a hospital emergency department immediately before the hospitalization.
The SSA will consider you under a disability for 1 year from the discharge date of your last hospital visit. After that, they will look at your residual impairments under listing 3.03 or another similar listing.
HOW DOES SSA EVALUATE ASTHMA?
Asthma SSD benefits are hard to obtain. Typically, people win benefits when they have more than one medical condition along with asthma. However, SSA states that under the asthma listing 3.03, they will look at the following three factors:
-
- Evidence showing that you have listing level (see Table VI in 3.03A) airflow obstruction at baseline while you are stable.
- The phrase “consider under a disability for 1 year” in 3.03B does not refer to the date on which your disability began, only to the date on which the SSA must decide whether your asthma continues to meet a listing or falls under SSA’s other rules.
- The SSA determines the onset of your benefits based on the facts of your case. But, the onset date will be no later than the admission date of your first of three visits to the hospital that satisfy the listing 3.03B.
WHAT MEDICAL EVIDENCE DOES SSA NEED?
In order to understand your asthma, the SSA needs medical evidence that documents how severe your symptoms are. Medical evidence that documents your asthma includes a number of items.
For example, the medical evidence should include your medical history. Additionally, the records should include the physical exam findings from your doctor. Also, you will want to send in the results of chest x-ray imaging.
Additionally, the SSA requires pulmonary function tests, including descriptions of any medical treatment and your response to it.
They also state the following:
- If you use supplemental oxygen, then we still need medical evidence to show the severity of your respiratory disorder.
- Imaging refers to medical imaging techniques, such as x-ray and ct scan. The imaging must be consistent with the current state of medical knowledge and medical practice as the proper technique to support the evaluation of your asthma.
- Pulmonary function tests include:
- spirometry (which measures ventilation of the lungs),
- DLCO tests (which measure gas diffusion in the lungs),
- ABG tests (which measure the partial pressure of oxygen, PaO2, and carbon dioxide, PaCO2, in the arterial blood),
- pulse oximetry (which measures oxygen saturation, SpO2, of peripheral blood hemoglobin).
If you do not have these tests, then it is possible for the SSA to send to you to see one of their doctors for an asthma exam. Find out about the SSA doctor exam.
OBTAIN MEDICAL EVIDENCE FOR FREE OR LOW COST
If you are missing medical information, then you can make an appointment with your doctor. Your primary care doctor can refer you to a pulmonologist, who can order tests like a pulmonary function test. Spirometry is the most common type of breathing test. This test measures how much air you can breathe in and out of your lungs. It also tests how easily and how fast you can the blow the air out of your lungs. Your doctor should order a spirometry test if you have asthma.
This type of medical evidence helps you win your case. However, if you can’t afford to see a doctor, then you still have options.
For example, for those who live in Utah, we have a list of free and low cost health resources you can contact for asthma treatment. Likewise, if you live in Nevada, we provide a list of Nevada’s free and low cost health resources to help you find a doctor. Additionally, we have a list of free health resources for those who live in Colorado.
Additionally, if you cannot afford treatment, you can request that SSA send you to one of their doctors. You can visit one of SSA’s doctors for free. They will write a report about your asthma and any of your other physical issues. Learn about your free SSA doctor exam.
OBESITY CAN CONTRIBUTE TO YOUR ASTHMA CASE
The SSA states that obesity is a medical condition that often occurs along with breathing conditions such as asthma. Obesity makes it harder for the chest and lungs to expand. Therefore, obesity impairs the ability of your lungs to supply oxygen to your body. If you have both obesity and asthma, then find out more about obesity and SSD benefits.
The effects of obesity along with asthma can be greater than the effects of each of the medical conditions alone. As a result, the SSA considers any effects of your obesity when they decide whether you can be paid SSD benefits for asthma.
SSA also considers whether you have asthma and a combination of other medical conditions that might equal a listing. If you do not meet or equal a listing, then the SSA will also assess your RFC. You can learn about winning benefits by reviewing information about your residual functional capacity.
CHRONIC OBSTRUCTIVE PULMONARY DISEASE AND DISABILITY
Chronic obstructive pulmonary disease (COPD) includes several lung diseases that damage your lungs. These diseases block airflow and affect your ability to breathe.
Typically, when a doctor refers to COPD, they mean lung diseases such as emphysema, chronic bronchitis, and sometimes asthma. Just like asthma, these lung conditions cause coughing, wheezing, and shortness of breath. Therefore, COPD like asthma, can keep you from working.
The most common cause of COPD is smoking. If you quit smoking, then your lung symptoms may improve. However, that is not always true. Like asthma, COPD is diagnosed through a spirometry test. Asthma can also be partly diagnosed by a pre and post bronchodilator spirometry test.
However, unlike asthma, the SSA looks at COPD under listing 3.02 for chronic pulmonary insufficiency. If you need additional information, then you should review COPD and SSD benefits. Additionally, you can learn about Black Lung benefits. Smoking is also the most common cause of lung cancer. Learn about SSD benefits for lung cancer.
WHAT EVIDENCE PROVES YOUR RESIDUAL FUNCTIONAL CAPACITY?
If you cannot meet listing 3.03, then the SSA will examine your medical records to determine your RFC. They will take into account what your doctor states about your asthma in progress notes. Also, the SSA will review any statements from your doctors. They will also review any medical opinions from the SSA doctors.
Other medical conditions beyond asthma, like obesity and COPD, can impair your RFC. Your RFC determines your ability to work and perform all the activities of work at a particular level. The different types of work are sedentary, light, medium, heavy, and very heavy. Each job level is defined in terms of the strength demands for the job. Strength demands include sitting, standing, and walking. It also includes lifting, carrying, pushing, and pulling. Each job has physical demands and those are what makes up the RFC.
If you asthma impairs your RFC, it will prevent you from doing certain types of jobs. Consider, for example, having asthma and having a job in a dusty mine or at a construction site. That would not be possible because of the air quality at those job sites.
The SSA will also consider descriptions about your asthma from you, your family and friends. For example, your family or friends could write a statement about the impact and effects of your chronic lung symptoms and trouble breathing. Find out about RFC and how it along with age can prove you cannot work. Also, review SSA’s Medical Vocational Guidelines.
TREATING DOCTOR STATEMENT ABOUT ASTHMA
Your medical records should document your asthma symptoms. If you doctor has treated you for some time, then they might be willing to write about your RFC. They should do so. Because chances are good that your medical records do not contain your RFC.
In order to prove your RFC, you should ask you doctor to fill out an RFC form about your asthma. For example, your doctor could state you should avoid dusty or dirty air at a job. You also might need to avoid extreme temperatures or perfumes, fumes, or smoke. Additionally, you may be prone to allergies that can make your asthma worse.
The RFC states how much you can lift and how many minutes you can sit at one time before you need to stand up. Also, your doctor should explain how many minutes you can stand at one time before you need to sit down. If you need to lay down during the day, your doctor should include that information. Also, many people with asthma need oxygen. If you are using oxygen 24/7, have your doctor document why you need the oxygen and how it impacts your ability to work.
OUR FIRM CAN HELP YOU WIN YOUR ASTHMA CASE
If you have asthma, then you may need to hire an attorney to help you win your SSDI case. In order to hire us, all you need to do is call. Or, you can contact us. We offer a free review of your case over the phone. And, it doesn’t cost anything to call us. Better yet, it also doesn’t cost you any upfront money to hire us.
Why? Because you only pay us an attorney fee if we win your asthma case. If we win your SSD case, then you pay the attorney fee out of your back benefits. There is a cap on the amount of the attorney fee, which is $9200. This is the most you will need to pay. If you do not win, then there is no attorney fee to pay.
If there are costs in your case, then you pay those costs. Usually, those costs are less than $100. Once we win, you pay your attorney free from your back benefit. For instance, to hire most lawyers, you have to pay upfront. We don’t work like that. You don’t have a job. Therefore, the only way to pay us, is for us to win your case. That is our goal. We want to win your asthma benefits case.
OUR EXPERT LAWYERS AND STAFF
If you want to hire us to help you win your asthma benefits, then you may want to learn more about the attorneys at our law firm. You can learn about our lawyers and staff on our About Us page.
For example, you will learn that Dianna Cannon has been helping her clients win Social Security benefits for thirty years. Likewise, Brett Bunkall and Andria Summers have also won thousands of SSD clams. Many of those cases have been asthma cases. Together, we have won over 20,000 SSDI and SSI cases for our clients.
Above all, in order to win your asthma case, you need the support of your doctor. For example, you need a good relationship with your doctor. Also, you need to ask your doctor for help in your case. If you don’t have a doctor, then we will do our best to help you find a free or low cost health clinic where you live. Because the burden of proof is on you to prove you deserve benefits, you need a statement about your asthma from your doctor. We have lists of free health clinics in Utah.
You can also learn about filing for SSD benefits in Utah. Additionally, you can learn about filing for benefits in Nevada. We also have information on free Idaho clinics.
HIRE OUR LAW FIRM TO WIN YOUR SSD BENEFITS
When you hire our firm, you have an experienced lawyer proving your asthma problems to the judge. In the past 30 years, our attorneys have won thousands of cases at the hearing level. It isn’t easy to be a witness at your own hearing. However, when you have an attorney, they can help you understand what kinds of questions you will need to answer.
Additionally, at the hearing you attorney can question the vocational expert (VE). We can also question the medical expert. Learn about the VE at the SSA hearing.
If we don’t win cases at the hearing level, then we often appeal ALJ decisions to the Appeals Council. We can also appeal any SSA decision to Federal District Court. Because we work with our clients as part of a team effort, we are usually successful in our cases. Learn what to do if you already lost your hearing. You do have options. For example, you may be able to apply again. Filing a new application is possible if you do not have a date last insured issue. Learn information about your date last insured.
We are also members of NOSSCR, which is an organization of SSD attorneys. We attend NOSSCR conferences every year to make sure we are up to date on Social Security law. Also, as NOSSCR members, we talk to Congress and ask them to change the law to be in favor of our clients.
HOW WE HELP YOU WIN YOUR ASTHMA BENEFITS
Additionally, our application experts can help you apply for SSD and SSI benefits using SSA’s website. For instance, we can also help you collect medical evidence about your asthma. You do not have to obtain benefits for asthma on your own. We can help file your SSDI and SSI application. Also, we can help you through the appeal stages of the Social Security appeal process.
When you leave that up to us, you can focus on your health. For example, our attorneys and staff can:
- Help you file your application for SSD and SSI benefits on Social Security’s website
- File an appeal if you receive a denial from DDS
- Collect your medical records
- Help you confirm your SSA doctor exam
- Request a Hearing with an Administrative Law Judge (ALJ)
- Prepare you to testify at your ALJ hearing
- Represent you at your hearing and question the expert witnesses
- Read about job expert testimony at your hearing
- Learn about medical expert testimony
- Request review of an SSA decision with the Appeals Council
- Request review of an Appeals Council denial in Federal Court
Cannon Disability represents clients in many states. For example, we have clients in Nevada, Utah, and Idaho. You can find out about Nevada SSD benefits. Likewise, you can learn about Utah SSDI benefits. California SSD and SSI benefits information is also available.
Additionally, we have clients in Idaho and Colorado. Learn about Idaho SSD benefits. No matter where you live, we want to be your legal team. Call now. We will answer your questions about winning your asthma benefits. Contact us today. Put our experience to work for you.
