COPD DISABILITY BENEFITS

WHAT IS COPD?

Chronic obstructive pulmonary disease (COPD) is a group of progressive lung diseases. However, it is different than asthma. If you need information about asthma, then learn about asthma benefits. The most common COPD diseases are emphysema and chronic bronchitis. Emphysema destroys air sacs in your lungs and this interferes with outward air flow. Chronic bronchitis, however, causes inflammation of the bronchial tubes, which allows mucus to build up in the lungs. Many people with COPD have both of these conditions.

Your lungs are a complex machine. For example, your windpipe connects to your lungs, where it divides into multiple smaller branches. These branches end in small air sacs called alveoli. The alveoli have tiny blood vessels known as capillaries running along their walls. This is where oxygen passes from the sacs into the capillaries and carbon dioxide passes from the capillaries into the sacs. Breathing involves this exchange of gases. It also brings oxygen to your body.

If you have healthy lungs, then the airways and air sacs are stretchy. Therefore, this elasticity permits the sacs to inflate when a person breathes in and deflate when they breathe out. If you have COPD, however, you lose this elasticity.

IS COPD A DISABILITY?

COPD benefits are available if you cannot work due to your severe COPD symptoms. In order to receive SSDI and SSI benefits, your COPD symptoms must be so severe that you cannot work for more than 12 months. This article discusses COPD and how to apply and win COPD benefits from the Social Security Administration (SSA).

THE TWO TYPES OF COPD SOCIAL SECURITY BENEFITS

There are two types of COPD  benefits. The first is Social Security Disability Insurance (SSDI) benefits. SSDI benefits are for those who have a full time work history for five out of the last 10 years. The amount of your SSDI benefit depends on the amount of your previous salary.

In addition to SSDI benefits, you can win Supplemental Security Income (SSI) benefits. SSI benefits are a supplement. Therefore, they are for people with very limited resources and low income. In 2024, the maximum monthly SSI benefit is $943 per individual.

SSD BENEFITS ARE FOR THOSE WHO CANNOT WORK

If you have COPD and you are “working,” then you do not qualify for SSDI or SSI benefits. The SSA defines work using the term “substantial gainful activity.” This term describes a specific level of work activity and earnings. In 2024, the SGA amount is $1550 per month before taxes.

Work is “substantial” if it involves doing significant physical or mental activities or a combination of both. For work activity to be substantial, it does not need to be performed on a full time basis. For example, part time work may also be SGA or “work.” Because you can still earn over SGA if you work part time.

Many people think they can do part time work and still get SSDI benefits. This is not true. If you can work part time, then the SSA will believe this is evidence that you can do full time work. Likewise, many people do not realize that even part time work can make them ineligible to receive an SSI benefit and an SSDI benefit.

HOW DOES THE SSA DEFINE WORK?

The SSA generally uses earnings guidelines to evaluate whether your work activity is SGA. The amount of monthly earnings the SSA considers to be SGA depends on the nature of your disability. For example, the Social Security Act specifies a higher SGA amount for persons who meet the definition of blindness. For more information about SSA rules on working and blindness, refer to SSA’s guide Working While Disabled: How We Can Help.

EMPHYSEMA, CHRONIC BRONCHITIS, AND COPD 

If you have emphysema, then your lungs airways and sacs have lost their elasticity. In turn, this leads to alveolar destruction. As a result of this damage, the sacs lose their shape and ability to recoil when you exhale. Therefore, air gets trapped in your lungs. Trapped air continues to distend the alveoli, causing a cycle of airway obstruction when you try to breathe.

These changes eventually result in the lungs becoming hyperinflated, which reduces the exchange of gases. This makes it difficult for people to breathe and oxygenate their blood. It also impairs the ability to breathe out carbon dioxide from the blood.

If you have chronic bronchitis, then the airway walls in your lungs are inflamed. As a result, the inflammation produces mucus. Excess mucus in the lungs reduces your ability to breathe. The main difference between emphysema and chronic bronchitis, is that chronic bronchitis produces a frequent cough with mucus. By contrast, the main symptom of emphysema is shortness of breath.

CAUSES OF COPD

The most common cause of COPD is smoking. If you quit smoking, then your lung symptoms might improve. The problem with smoking is that it causes your COPD condition to progress. Emphysema, for example, is irreversible. People with severe emphysema may need a lung reduction surgery. This surgery removes the diseased area of the lung in order to allow the healthier part of the lung to work better.

Over time, COPD symptoms can become so severe that you become too short of breath to perform normal activities, such as cleaning the house and working a job. COPD symptoms include coughing, phlegm, and also trouble breathing deeply. Additionally, COPD can lead to the progression of other diseases, like heart problems and respiratory infections. You can learn about other breathing problems, like sleep apnea.

COPD SYMPTOMS

It’s estimated that about 30 million people in the US have COPD. However, half of those people may not know that they have COPD. Some people simply don’t recognize their COPD symptoms until the later stages of the disease. Sometimes, people assume they have COPD, when in fact their symptoms may be from lung cancer. Learn about SSDI and SSI benefits for lung cancer.

For example, people may think they are short of breath because they are getting older. Or, because they are overweight. However, being short of breath could also be a symptom of severe lung disease.

If you experience any of the following symptoms, then talk to your doctor about whether or not you have COPD and need SSI and SSDI benefits.

• Chronic cough
• Shortness of breath while doing normal activities
• Respiratory infections
• Blue fingernail beds or blue lips
• Fatigue
• Coughing up phlegm or mucus
• Wheezing

If you have these symptoms, then call your doctor. Early treatment of COPD can help you with your breathing symptoms. In addition, the symptoms of COPD can impact your daily activities and lead to other problems. These problems include:

• Limitations on walking or climbing stairs
• Needing an oxygen tank in order to breathe
• Depression and anxiety
• Confusion and memory loss
• Frequent hospital visits for breathing problems

Make sure to explain any problems you experience from COPD to your doctor. If you do not have a doctor for COPD, then we have a list of free and low cost doctors in Utah. Similarly, we have a free and low cost list of Nevada doctors.

In order to diagnose chronic obstructive pulmonary disease, which includes chronic bronchitis and emphysema, your doctor will first evaluate your symptoms. After that, your doctor will ask for your complete health history. Finally, your doctor will conduct a health exam and possibly perform certain tests.

Next, in order to determine COPD, your doctor will usually ask you questions about your health history. For example, she may want to know if you:

• Smoke or have a history of smoking
• Are exposed to smoke, air pollution, chemicals or dust
• Have symptoms such as shortness of breath or chronic cough
• Have family members with COPD

TESTS TO DIAGNOSE COPD

SPIROMETRY

In order to determine if you have COPD, your doctor will probably perform a spirometry test. A spirometry test shows the doctor how well your lungs function. The test requires you to blow air into tubing attached to a machine. The machine then measures the amount of air you blow out and also, how fast you can blow the air. Spirometry results will show if you have a COPD.

CHEST X-RAY

Your doctor may also have you undergo a chest X-ray. The chest X-ray will show any damage to your lungs. In order to take a chest X-ray, you will stand still in front of an X-ray machine. Then, the doctor will ask you to hold your breath, so the X-ray machine can take an image of your lungs.

ARTERIAL BLOOD GAS TEST

Another test that your doctor can perform is an arterial blood gas test. This test, for example, requires your doctor to draw blood from an artery. Then, they test the blood for your oxygen and carbon dioxide levels.

WHAT IS SLEEP APNEA?

Although sleep apnea is not the same as COPD, people who have breathing problems may suffer from sleep apnea. Sleep apnea occurs when breathing stops repeatedly while you are asleep. For example, in a regular six to eight hour period of sleep, a person with sleep apnea will stop breathing for up to a minute. This is due to air passages becoming blocked. Which usually occurs from the collapse of the tissue in the back of the throat.

After a while, breathing will start again, often with loud snoring. While the brain tries to get air flowing again, the body is deprived of oxygen and the person may wake up or have trouble sleeping.

Because the poor quality of sleep, if you have sleep apnea, then you may still feel tired after a night’s sleep. In addition, you might fall asleep during at work as a result of not getting rest at night. If you have obesity, then you are also more likely to have sleep apnea. Find out about obesity and SSDI benefits.

THE THREE TYPES OF SLEEP APNEA

If you have a COPD, you may also have sleep apnea. There are three major types of sleep apnea:

• Obstructive sleep apnea. Muscles in the back of the throat relax and block the air passage, causing snoring.
• Central sleep apnea. The brain stops sending messages to breathe during sleep.
• Complex sleep apnea. This is a combination of obstructive and central sleep apneas.

Additionally, two of the most common symptoms of sleep apnea are snoring and not feeling rested after a night of sleep. As with COPD, other common symptoms are shortness of breath, insomnia, and headaches. Sleep apnea is a serious breathing problem. Therefore, seek medical treatment if you can. Additionally, these medical conditions can cause depression. Learn about depression and SSD benefits.

SSA’S LISTING FOR COPD BENEFITS

The SSA uses listing 3.02 to determine if you are can be paid benefits for your COPD. Below you will find tables that outline COPD:

3.02 Chronic respiratory disorders due to any cause except CF (for CF, see 3.04) with A, B, C, or D:

A. FEV₁ (see 3.00E) less than or equal to the value in Table I-A or I-B for your age, gender, and height without shoes (see 3.00E3a).

Table I: FEV₁ Criteria for 3.02A

OR PART B

B. FVC (see 3.00E) less than or equal to the value in Table II-A or II-B for your age, gender, and height without shoes (see 3.00E3a).

Table II: FVC Criteria for 3.02B

OR PART C

C. Chronic impairment of gas exchange demonstrated by 1, 2, or 3:

1. Average of two unadjusted, single-breath DLCO measurements less than or equal to the value in Table III for your gender and height without shoes; or

Table III: DLCO Criteria for 3.02C1

2. Arterial PaO₂ and PaCO₂ measured concurrently by an ABG test, while at rest or during steady state exercise, breathing room air, less than or equal to the applicable values in Table IV-A, IV-B, or IV-C; or

Table IV-A – ABG Criteria for 3.02C2

Table IV-B – ABG Criteria for 3.02C2

 Table IV-C – ABG Criteria for 3.02C2

3. SpO₂ measured by pulse oximetry (see 3.00H2) either at rest, during a 6MWT, or after a 6MWT, less than or equal to the value in Table V.

Table V: SpO₂ Criteria for 3.02C3

OR PART D

D. Exacerbations or complications requiring three hospitalizations 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 or continuing disability review). Each hospitalization must last at least 48 hours, including hours in a hospital emergency department immediately before the hospitalization.

At your hearing, the ALJ may invite a medical expert to testify about your COPD. The medical expert talks about  whether your COPD meets or equals listing 3.02. If that is the case, then you need an attorney to question the medical expert. Find out about the medical expert at your hearing.

Furthermore, we can appeal your case to the Appeals Council. The Appeals Council is an appeal board that reviews cases throughout the entire country. If you already lost your case at the hearing, then you have 60 days to appeal to the Appeals Council. Find out about your Appeals Council options.

Likewise, we file appeals in Federal Court. We don’t often take cases to Federal Court, because it can result in bad law for everyone. So, just because we can appeal does not mean we will appeal your case. Lawyers must be very careful in what they appeal. However, we can represent you no matter where you live. For example, we can represent you if need an attorney in Utah, Nevada, California, and Idaho.

Moreover, your ability to receive Medicaid benefits and Medicare depends upon the success of your SSDI and SSI claim. You are going to need health insurance to care for your COPD. Find out about Medicare benefits.

THE VOCATIONAL EXPERT AT YOUR COPD HEARING

If your COPD does not meet or equal the listing under step three, then your RFC becomes important at your hearing. Learn about your residual functional capacity. If you appear at a Social Security hearing before a judge, then a VE might testify at your hearing.

VE’s are at your hearing to testify about the kinds of jobs you can perform. Also, they testify about the number of jobs available to someone with your medical condition. Learn about the role of the VE at the SSA hearing.

At the hearing, the ALJ asks questions of the VE. Then, the VE testifies if you can work with the physical or mental issues found by the ALJ. Likewise, your attorney also asks questions of the VE. Those question are based upon your testimony and your medical conditions.

At our law firm, we have the legal experience to question the VE. While your testimony and medical records are crucial to proving your COPD prevents you from working, you still need an attorney on your side. It is important, because the burden to prove the SSA should pay you benefits is on you. Therefore, you may need an attorney to question the VE. Learn about proving you deserve SSD benefits.

THE MEDICAL EXPERT CAN TESTIFY ABOUT COPD

Medical Experts (ME) often testify at Social Security hearings. The ALJ calls them to review your medical records for COPD. Also, they explain your other medical conditions to the judge. Your attorney can request that an ME testify in court. This is, however, mostly done in complex medical cases.

The medical expert who appears at the hearing is not your treating doctor. The doctor at the hearing must have never met you before. Because, the ME is there to give testimony about your medical records.  They cannot examine you. Additionally, the doctor should not favor either side of the case.

Usually, the medical expert comes to the hearing. However, they can also testify by video or by telephone. It is also possible for an ME to answer written questions after the hearing. The judge sends written questions to the expert. The ME’s answers require review and possibly filing objections. If you do not know how to do this, then hire an attorney. Do not make the mistake of not preparing for the medical expert.

OUR LAW FIRM CAN HELP YOU WIN COPD BENEFITS

In order to fight the SSA’s denials, you need a lawyer with experience. Dianna Cannon has been helping her clients win SSDI benefits for over thirty years. Likewise, Brett Bunkall and Andria Summers have years of legal experience. Together, we have won over 20,000 Social Security hearings.

When you have COPD, it is hard to trust your future to a lawyer. We understand. That is why we include information about our attorneys on our About Us page.

At Cannon Disability Law, we can help you apply for benefits. Our experts who will help you complete your application. Usually, we help you file your application on Social Security’s website. If you receive a denial, then we can help you appeal it.

Likewise, if your case is set for a hearing, then we represent you before the judge. One of the things we do is prepare you testify at your hearing. For example, we meet with your before the hearing. At the meeting, we talk about how to answer questions. We also let you know what kind of questions you will be asked. Learn what questions the judge will ask at your Social Security hearing.

WE CAN HELP YOU WITH YOUR COPD CASE NO MATTER WHERE YOU LIVE 

If you cannot work due to your COPD, then your SSDI benefits will dictate your future finances. You need to hire a law firm that cares about your future. Our lawyers and staff care. Better yet, we are one of the best Social Security law firms in the country.

Likewise, we are one of the best Social Security firms in Las Vegas, Nevada. Nevada SSDI and SSI Information is also available for you.

Additionally, we are the best Social Security law firm in Utah. Learn about Utah SSD benefits. If you are from California, then review California SSDI information. However, we can represent you in your COPD case no matter where you live.

There are many law firms that claim they practice Social Security law. However, most of those firms do other types of cases. For example, some firms practice personal injury or Worker’s Compensation law. We don’t do that. Our law firm only takes Social Security cases. We believe it is important to focus on your COPD benefits and not other areas of law.

Finally, we will use our skills to help you through the Social Security benefit process. Obviously, it is our goal to win your COPD case. But, it also our goal to make filing for SSDI and SSI benefits easier for you. As a result, we offer a free review of your case.

If you call, then there is no pressure to become our client. You can also simply ask us questions. We will answer. Even if you don’t want us to represent you, we will try to answer your questions about your COPD benefits.