LUNG TRANSPLANT WINS SSD BENEFITS

WHAT IS A LUNG TRANSPLANT?

A lung transplant is a critical procedure for those who have exhausted all other treatment options. They are usually done only after all other treatment options—such as medications, oxygen therapy, or less invasive surgeries—have failed. Candidates for a lung transplant must meet strict medical criteria to ensure  success.

A lung transplant involves replacing one or both damaged lungs with healthy ones from a donor. The need for a lung transplant usually arises from severe, irreversible damage caused by chronic conditions. For example, lung transplants occur when people have damage from chronic obstructive pulmonary disease (COPD), idiopathic pulmonary fibrosis, cystic fibrosis, or pulmonary hypertension. These diseases impair lung function, making it difficult for the body to receive enough oxygen to survive. For some, complications from illnesses like COVID-19 can also require a transplant when the lungs are unable to recover naturally.

Lung transplants can be done on people of almost all ages from newborns to adults up to age 65 and sometimes even later. While a lung transplant can improve quality of life, it is not without risks. These risks include infection, organ rejection, or complications from lifelong immunosuppressive therapy. If you need a lung transplant, then you must weight the risks. But for most patients, a transplant can mean the difference between life and death.

HOW MANY PEOPLE HAVE LUNG TRANSPLANTS IN THE USA?

In 2022, a record 2,692 lung transplants were performed in the United States, which is an increase from previous years. This upward trend continued into 2023. Lung transplant increased by 16 percent in 2023, as did organ transplants. In 2023, there were a total of 46,632 organ transplants throughout the country, which represents an 8.7% increase over 2022. Results are not yet available for 2024.

A lung transplant is a complex procedure. Survival rates vary based on factors such as your overall health and age. Even more important is the severity of the underlying condition that caused the lung transplant in the first place. However, on average, almost 85% of patients survive the first year after a lung transplant. The figure is less for five years after the transplant. Approximately 59% survive five years after their lung transplant.

Another interesting factor is that survival rates differ between medical centers. For instance, Stanford Health Care reports a one year survival rate of 96.86% for their lung transplant patients. That is much higher than the national average.

WHAT ARE THE REASONS FOR A LUNG TRANSPLANT?

Most lung transplants are performed to treat end stage lung diseases that cannot be managed with other treatments. The most common reasons include:

1. Chronic Obstructive Pulmonary Disease (COPD): This group of diseases, which includes emphysema, is the leading reason for lung transplants. COPD damages the lungs over time, making it harder to breathe.
2. Idiopathic Pulmonary Fibrosis (IPF): IPF is a condition that causes scarring of the lung tissue, leading to severe breathing problems. The damage is irreversible, and many patients eventually require a transplant to survive.
3. Cystic Fibrosis (CF): A genetic condition that causes thick, sticky mucus to build up in the lungs, leading to infections and respiratory failure. A lung transplant can improve quality of life and extend survival for individuals with advanced CF.
4. Pulmonary Hypertension: This refers to high blood pressure in the lungs’ arteries, which can cause severe strain on the heart and lungs. When medications and other treatments fail, a lung transplant may be the only option.
5. Heart disease: Heart disease or heart defects that affect the lungs may need a heart and lung transplant.
6. Other diseases: Other conditions that can cause severe lung damage include sarcoidosis, chronic lung infections and lymphangioleiomyomatosis. Also, certain hereditary conditions can affect the lungs.

While these conditions are the most common reasons, other diseases or certain rare conditions may also lead to the need for a lung transplant.

WHAT ARE THE RISKS OF A LUNG TRANSPLANT?

Undergoing a lung transplant is a major surgery.  Therefore, like any big medical procedure, it comes with risks. One of the biggest concerns is organ rejection. Organ rejection occurs when your body’s immune system attacks the new lung, thinking it’s a threat. Doctors will give you medications called immunosuppressants to prevent this. But, these drugs can weaken your immune system. In turn, that makes it easier for you to get infections. These infections can be serious, especially in the months right after surgery when your body is still healing.

Other risks include complications from the surgery itself, like bleeding or blood clots. There is also a chance that the new lung may not work as well as expected. For example, you could experience a condition known as primary graft dysfunction, which can occur shortly after the transplant. Additionally, some patients may develop a condition called chronic lung allograft dysfunction. This condition can gradually reduce the function of the transplanted lung.

Despite these risks, many people who receive a lung transplant find it improves their quality of life and gives them more time to spend with loved ones.

CAN YOU GET DISABILITY BENEFITS FOR A LUNG TRANSPLANT ?

If you’ve had a lung transplant, then you probably qualify for Social Security Disability (SSD) benefits. The Social Security Administration (SSA) considers a lung transplant to be a severe medical condition that automatically meets the requirements for benefits. According to SSA’s Blue Book, those who have had a lung transplant are disabled. You are considered disabled for three years following a lung transplant, not just one year.

You can find this rule under Listing 3.11 in SSA’s Blue Book. Unlike many other serious conditions, the SSA actually recognizes the serious impact of a lung transplant on your ability to work. After the three year period, the SSA reviews your health to determine if you still meet their disability criteria.

When filing an application for SSD benefits, you need to submit medical records proving your lung disease. Obviously, you will also need to submit the records which show you need a lung transplant. The will also require a copy of the lung transplant surgery. After the three year period, your ongoing ability to receive SSD benefits will depend on your other health issues. For example, have you had complications from the lung transplant? Are you experiencing chronic organ rejection? What is your lung function?

For many, the recovery from a lung transplant involves managing medications, infections, and other health issues. Such issues can make it difficult to return to work.

SSA LISTING 3.11 FOR LUNG TRANSPLANT

The SSA listing for lung transplants is as follows:

3.11 Lung transplantation (see 3.00M). Consider under a disability for 3 years from the date of the transplant; after that, evaluate the residual impairments.

If you receive a lung transplant (or a lung transplant simultaneously with other organs, such as the heart), then the SSA considers you to be disabled under 3.11 for 3 years from the date of the transplant.

After that, the SSA will evaluate your residual function by considering your health post transplant. They will also consider the frequency and severity of any rejection episodes, problems with other body systems, and adverse treatment effects.

People who receive organ transplants generally have medical conditions that meet the SSA’s definition of disability. The phrase “consider under a disability for 3 years” in 3.11 does not refer to the date on which your disability began. It only refers to the date on which the SSA must evaluate whether your condition continues to meet a listing or otherwise prevents you from working. The SSA determines the onset of your disability based on the facts of your case.

YOUR RESIDUAL FUNCTIONAL CAPACITY ON REVIEW

If you have a lung condition that does not meet or equal a listing, then your RFC can help you win benefits. Residual Functional Capacity (RFC) is one of the most important concepts in your case. You can use your RFC to prove that you cannot work. So, what is your RFC?

The RFC is the medical assessment of what you can physically and mentally do in a work setting. Step four of the SSA review process defines your RFC after taking into account all of your symptoms.

When you have a lung transplant, in order to figure out your physical RFC the SSA will examine your medical records. They will take into account what your doctor says about your ability to work. Also, the SSA will review any statements from your doctors. They will also review records from SSA’s doctors.

The SSA will also consider descriptions about your physical limits from your family, neighbors and friends. For example, your family or friends could write a statement about your chronic pain or breathing problems. Find out how your RFC combines with age to eliminate work. Also, learn about SSA’s Medical Vocational Guidelines.

Your medical records should contain information about your lung transplant and your underlying disease. Likewise, your records should also document your symptoms. Make sure that you continue to go to the doctor even after your lung transplant. It is your job to make sure the medical record is complete.

WHAT WE DO TO HELP YOU WIN YOUR SSD BENEFITS

You do not need to obtain SSD benefits on your own. Our law firm can help file your SSD application. Also, we can help you file an appeal after every SSA denial. That way, you can focus on getting better after a lung transplant. Our attorneys and staff can:

• Send you the forms and paperwork you need to become our client
• Help you file your application for SSD and SSI benefits
• Inform the SSA that your cancer is a Compassionate Allowance
• Request an appeal if you receive an initial denial
• Help you confirm your SSA doctor exam
• Request a Hearing with an Administrative Law Judge
• Prepare you to testify at your ALJ hearing
• Represent you at your hearing and question the expert witnesses
• Read about job experts and their hearing testimony
• 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

If you file your application for SSD benefits on Social Security’s website, then you have 6 months to complete it. Once you submit your application, the SSA sends you an application summary in the mail. You must sign the summary and mail it back. Additionally, once you receive a denial from the SSA, you have 60 days to file an appeal. You must file an appeal within 60 days. If you don’t, then you will have to start the process over again. That means you will lose any benefits you could receive on the prior application.

HIRE OUR LEGAL TEAM TO WIN YOUR SSDI BENEFITS

In the past 30 years, we have won millions of dollars in ongoing and past due SSD benefits for our clients. If you want to win benefits for lung transplant, then you may need to hire an attorney with the experience to win your case. If the SSA doesn’t grant your case, then hire a lawyer to prove to the SSA they should pay you SSD benefits. Contact us.

If you want to learn more about our lawyers and staff, then review our About Us page. For instance, Andria Summers can help you with your Medicare plan. She has also won thousands of SSD cases. Dianna Cannon has been helping clients win SSD benefits for thirty years. Brett Bunkall also has years of experience helping people obtain their SSI and SSDI benefits. We are experts. You can trust us to help you win SSDI and SSI benefits.

In the past 30 years, we have won over 20,000 SSDI and SSI cases for our clients. Also, we help our clients with their Medicare benefits. Our legal experts can help you apply for SSDI and SSI benefits using the SSA’s website.

Likewise, if you need an appeal, we can help you do that too. There are also many forms you will need to fill out. But, don’t worry. If you have questions about the SSA forms, then we will answer them. You can learn how to complete SSA’s appeal forms. Call us for a free review of your benefits and lung transplant case.