PULMONARY EMBOLISM & DISABILITY

WHAT IS A PULMONARY EMBOLISM (PE)?

A pulmonary embolism (PE) is a blood clot in the lungs. This can occur when the blood vessels that supply blood to the lungs become blocked. First, the blood clot forms in the legs or the pelvic area. Next, the clot travels to your lungs.

When a blood clot forms or gets stuck inside a blood vessel, it can block the blood vessel and prevent blood from moving through the body. When a pulmonary embolism occurs it may be difficult to breathe, the lungs can become damaged. And, it can even lead to death.

A pulmonary embolism when left untreated can result in death. If you have a PE, then you have a 30% chance of dying. However, if your PE is treated quickly, the mortality rate drops to 8%. Unfortunately, having a pulmonary embolism can lead to other health issues which can also result in death. Within 3 months of diagnosis, about 23% of people with PE die. Similarly, there is a 37% death rate one year after being having a PE.

Additionally, about 2% to 4% of patients with PE will have ongoing damage to the lungs. This condition is called pulmonary hypertension. Pulmonary hypertension symptoms include shortness of breath and fatigue when you exercise. If you do not treat it, then pulmonary hypertension can lead to heart failure.

SIGN AND SYMPTOMS OF A PULMONARY EMBOLISM 

How do you know if you are having a pulmonary embolism? This is a hard question to answer. Because, the symptoms vary for each person. Knowing that a pulmonary embolism is the cause of your symptoms may not be possible. You may only know it is PE if you have felt the symptoms before.

The symptoms of a PE are dramatic enough that they should send you to the hospital.

Symptoms of a pulmonary embolism include:

• Changes in the color of one or both legs. Usually, the limb turns a shade of blue or purple.
• Chest pain when you breath in
• Cough
• Coughing up blood
• Difficulty breathing
• Fatigue
• Fever
• Panting
• Rapid heartbeat
• Shortness of breath
• Swelling and pain in the arm or leg
• Throbbing pain

If you experience these symptoms, then go to the ER. You need medication attention immediately. Additionally, you should be on the alert for a pulmonary embolism if you have any of the causes below.

CAUSES OF A PULMONARY EMBOLISM

While it is not always possible to know the cause of a pulmonary embolism, there are certain genetic factors that should put you on the alert for a PE. For example, the following genetic issues can raise your risk of having a pulmonary embolism:

• Hereditary factors
  • Antithrombin III deficiency
  • Factor V Leiden (genetic risk factor)
  • Protein C deficiency
  • Protein S deficiency
  • Plasminogen abnormality
  • Plasminogen activator abnormality
  • Fibrinogen abnormality
  • Resistance to activated protein C
• AIDS
• Behçet disease (a rare disorder disorder that causes blood vessel inflammation)
• Cancer, especially:
  • Pancreatic carcinoma
  • Bronchogenic carcinoma
  • Carcinomas of the genitourinary tract
  • Colon cancer
  • Stomach cancer
  • Breast cancer
• Congestive heart failure (CHF)
• Deep vein thrombosis
• Estrogen replacement
• Heart attack
• Immobilization as in lengthy periods of bed rest
• Loss of vein function
• Oral contraceptives
• Polycythemia (increased red blood cell production)
• Pregnancy
• Surgery
• Systemic lupus erythematosus
• Ulcerative colitis

PREVENTING A PULMONARY EMBOLISM

You cannot predict a pulmonary embolism. However, you can take steps to prevent clots in the deep veins of your legs. If you have a clot in the deep veins of your legs, then it may break off and move to your lungs or heart. Avoiding deep vein thrombosis (DVT) will help prevent a pulmonary embolism.

There are many ways to prevent a pulmonary embolism. Most of them involve taking care of yourself by making sure there is good circulation in your legs. For example, you can use the following:

• Blood thinners. Blood thinners can prevent clots both before and after surgery. Additionally, if you are in the hospital with a heart attack or stroke, then you might take a blood thinner.
• Compression stockings. Compression stockings are longer than a sock. They compress your legs. This helps your veins and leg muscles move the blood in your legs. Compression stockings are safe and they don’t cost a lot of money. Usually, you wear compression stockings after a surgery. This helps the blood flow in your legs while you are laying down.
• Elevating your legs. Elevating your legs during the day and at night is also a good way to help the blood flow in your legs. Put your legs up the wall or on the headboard of your bed.
• Pneumatic compression. This is a form of treatment that uses a machine attached to cuffs that go around your thighs or calves. The machine inflates the cuffs with air. Then it deflates every few minutes. When it does this it massages the veins in your legs and improves blood flow.
• Walking. Walking as soon as you can after an operation can help prevent a pulmonary embolism.

SOCIAL SECURITY DISABILITY & SSI BENEFITS

Social Security Disability benefits are available to you if you cannot work due to a PE. In order to qualify for SSDI benefits you must have enough work credits. For example, if you are over the age of 30, then you must have worked at least 20 quarters within the ten year period just prior to the start of your disability. The Social Security Administration often calls this rule the “20/40 rule.” Review the definition of work and substantial gainful activity. SSDI benefits come with Medicare benefits.

Please note that if you do not have enough work credits to qualify for SSDI benefits, then you can apply for SSI benefits. However, Supplemental Security Income (“SSI”) benefits are different than Social Security Disability Insurance (“SSDI”) benefits. You can qualify for SSI benefits if your monthly SSDI benefit is a low amount of money.

It is also a benefit you can receive if you have never had a job or if you have only worked for a short period of time. In order to qualify for SSI you must meet income and asset rules. For example, you cannot have more than $2000 in the bank in order to qualify for SSI. The financial asset rules that govern SSI are complex. Therefore, you may need the help of an SSI benefits attorney to see if you qualify. SSI benefits also come with Medicaid benefits. Medicaid is a form of health insurance.

FILING A CONCURRENT CLAIM FOR BOTH SSDI AND SSI BENEFITS

If you have worked 40 hours a week and earned a low wage, then you could qualify for a combination of both SSI and SSDI benefits.  The SSA calls this “concurrent benefits.” SSI benefits add onto SSDI benefits, but only if the SSDI amount is below $943 in 2024.

Together, the two benefits can bring you to a higher monthly benefit amount than one benefit alone. However, in order to win SSI benefits, you must have a severe disability that prevents work work for 12 months or longer. Additionally, you must meet the income and asset requirements.

Many people think that once they receive SSI benefits, they also qualify for SSDI benefits. But this is not true. The SSA pays you all of the benefits you qualify for. SSDI benefits are only for those who have enough work credits. Therefore, if you are already getting SSI benefits, then you probably do not qualify for SSDI benefits. The most common reason you do not qualify for SSDI benefits is because you do not have enough work credits.

PULMONARY EMBOLISM & MEETING LISTING 7.08

In order to meet SSA’s listing for pulmonary embolism, the SSA focuses on the problems that occur after your PE. As an example, this blog will focus on thrombosis. Once you have a pulmonary embolism, you may also have blood clots in your legs or arms.

You can also have multiple lobes of your lungs filled with blood clots. If this occurs, then you will need a series of surgeries to remove the clots. You may also have a pulmonary embolism and months later experience more issues with thrombosis.

SSDI & SSI benefits are for those who cannot work for over 12 months. They are also for those who will never work again. If you have a pulmonary embolism, then you may be able to return to work after a period of recovery. If you return to work 8 months after your PE, then you will not qualify for benefits. However, if you have further problems that prevent you from working for one year, then you qualify for benefits. Especially if you require multiple hospital stays.

SSA’s listing for pulmonary embolism focuses on ongoing issues with thrombosis. For example, the listing requires you to be in the hospital for thrombosis. You need to be in the hospital three times within a twelve month period. Also, there must be 30 days in between each hospital stay. And each hospital visit must last at least 48 hours. Below, you will find SSA listing 7.08.

Listing 7.08 – Disorders of thrombosis and hemostasis:

Including hemophilia and thrombocytopenia, with complications that require at least three hospital stays within a 12 month period that occur at least 30 days apart prior to a determination. Each hospital stay must last at least 48 hours, which can include hours in the hospital emergency department or comprehensive hemophilia treatment center immediately before the hospitalization.

D. What are disorders of thrombosis and hemostasis, and how does SSA evaluate them under 7.08?

1. Disorders of thrombosis and hemostasis include both clotting and bleeding conditions, and may be congenital. These disorders are characterized by abnormalities in blood clotting that result in hypercoagulation (excessive blood clotting) or hypocoagulation (inadequate blood clotting). The diagnosis of a thrombosis or hemostasis disorder is based on evaluation of plasma clotting factor proteins and platelets. Protein C or protein S deficiency and Factor V Leiden are examples of hypercoagulation disorders. Hemophilia, von Willebrand disease, and thrombocytopenia are examples of the same thing. Acquired excessive blood clotting may result from blood protein defects and acquired inadequate blood clotting.
2. The hospital stays in 7.08 do not all have to be for the same complication of thrombosis and hemostasis. They may be for three different complications of the disorder. Examples of issues that may result in hospitalization include anemias, thromboses, embolisms, and uncontrolled bleeding that requires multiple factor concentrate infusions or platelet transfusions. The SSA will also consider any surgery that you have had. They will consider it even if it is not related to your hematological disorder.
3. The SSA believes it is a complication of thrombosis and hemostasis if you require treatment with clotting factor proteins (for example, factor VIII or factor IX) or anticoagulant medication to control bleeding or coagulation in connection with your surgery. Also, the SSA will count the hours you receive emergency treatment in a comprehensive hemophilia treatment center immediately before a hospital stay if this treatment is comparable to the treatment provided in a hospital emergency department.

EXAMPLES OF COMPLICATIONS REQUIRING HOSPITALIZATION

If you have thrombosis in your legs, then a doctor will probably need to operate and remove the blood clots. This operation is a thrombectomy. It requires the surgeon to cut open your leg and remove the blood clots from inside your artery or vein. Most patients spend three to four days in the hospital before going home to recover. Recovery can last up to 12 weeks.

If a blood clot in your leg stops the blood flow to the foot long enough, then you may have further problems, such as nerve damage. If you have nerve damage, then you may not be able to feel your foot. Also, you may experience leg ulcers or gangrene in your foot. If you have gangrene, then you might need amputation of your toes or a part of your foot. If these issues occur, then your attorney will obtain the medical records. That way, your attorney can document each of your hospital stays and argue that your PE meets listing 7.08.

Each year in the United States, about 3 in every 1,000 adults develop a DVT or pulmonary embolism. Likewise, almost 300,000 people die each year as a result of DVT/PE. It is the third most common vascular disease, after heart attacks and strokes.

IF YOU DON’T MEET LISTING 7.08, THEN YOU CAN STILL WIN SSD BENEFITS 

If you don’t meet listing 7.08, then you can still win SSD benefits if you can’t work due to your severe symptoms. The SSA looks to the mental and physical symptoms that occur after a pulmonary embolism. Once they determine the impact of those symptoms, they will know your residual functional capacity (RFC).

The SSA determines your RFC by reading your medical records. They also ask you questions about your ability to do certain tasks. For example, the SSA will look at how your symptoms impact your ability to do tasks, such as sit, stand, and walk. They will also look at your fatigue and determine if you need to lie down during the day.

If your RFC is limited, then it can prevent you from working. For example, if you have leg surgery following a pulmonary embolism it may impair your ability to walk. Likewise, you may not be able to sit for 8 hours a day in an office chair. Or, it may require you to lay down during the day with your legs above your heart. If so, then this could prevent you from working.

Additionally, the SSA will decide whether or not the impact of your pulmonary embolism effects you mentally. For example, does your pain make you unable to concentrate. Or, if you have a stroke, are you struggling to communicate? The SSA develops a RFC assessment to determine if you can work.

WHAT WE DO TO HELP YOUR PULMONARY EMBOLISM CASE

You do not have to obtain SSD benefits for a pulmonary embolism on your own. Our law firm can help you file your SSD application. Also, we can help you through the stages of appeal during the SSA process. That way, you can focus on your health. Our attorneys and staff can:

• Help you file your application for SSD and SSI benefits
• Request an appeal if you receive an initial denial from DDS
• Help you confirm your attendance at a free SSA doctor exam
• Request a Hearing with an Administrative Law Judge (ALJ)
• Prepare you to testify witness at your ALJ hearing
• Represent you at your hearing and question the expert witnesses
• Read about job expert testimony at the SSA 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

If you file your application for SSD benefits online at Social Security’s website, then you only have 6 months to complete it. After you submit your online application, the SSA sends you a summary of it in the mail. In order for your application to be complete, 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 of SSA’s decision. You must file an appeal within the 60 day time limit set by the SSA.

HIRE US FOR OUR YEARS OF EXPERIENCE

In the past 30 years, we have won millions of dollars in ongoing and past due SSDI benefits for our clients. If you want to win benefits, then you need to hire an attorney with experience. Also, you need a lawyer to help you through the appeal process. Contact us today. We can help you win benefits for your pulmonary embolism.

If you want to learn about our attorneys, then you can review our About Us page. For example, Andria Summers can help you with your Medicare advantage 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 benefits.

In the past 30 years, we have won over 20,000 SSDI and SSI cases for our clients. Also, we help our clients get the best plan with their Medicare benefits. Our lawyers and staff can help you apply for SSD 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 these forms, then we will answer them. You can learn how to fill out SSA’s appeal forms. Call us for free today.

IF YOU DON’T WIN BENEFITS, THEN THERE IS NO ATTORNEY FEE 

If you have a pulmonary embolism and cannot work, then you should hire an attorney. An attorney can help you win your SSD benefits. In order to hire us, all you need to do is contact us. We offer a free review of your case over the phone. Furthermore, it doesn’t cost anything to call us.

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 case. This means if we win your SSD case, then you pay the attorney fee out of your back benefits. If you do not win, then there is no attorney fee for you to pay. You can learn how attorney fees work in disability cases.

The attorney fee has a cap or a limit. The SSA sets the limit of the attorney fee at 25% of the back benefit. Or, the maximum attorney fee cap. You pay whatever is less and only if you win.

If there are costs in your case, then you pay those. But usually those costs are less than $100. Once we win your case, the attorney fee comes from your past due benefit. To hire most lawyers, you have to pay upfront. We don’t work like that. You don’t have a job. So, the only way to pay us, is for us to win your case. That is our goal. Call and see what we can do for you.

WE WORK FOR YOU NO MATTER WHERE YOU LIVE

Additionally, we represent clients in many states. These states include Nevada, Utah, and Idaho. Learn more about filing an application for SSD benefits in Idaho. We also have clients in Colorado and California. Find out about Nevada SSD benefits. Also, learn about Utah SSD and SSI benefits and Colorado SSD benefits.

You can also review information about California disability benefits. No matter where you live, we will answer your questions. Hire our team to help you win SSD benefits for pulmonary embolism. Learn about other blood disorders, like hemophilia.

When you are searching for an attorney, make sure you understand their legal experience. Many law firms claim they practice Social Security Disability law. But, in reality, it may just be a small part of their overall practice. Don’t hire them. Instead, hire a law firm whose only focus is SSDI and SSI claims. Also, hire a lawyer that you get along with. The wait for SSD benefits can be up to two years. During that time, you want to get along with your lawyer and their staff.

We want to be your legal team. Contact us if you cannot work due to a pulmonary embolism.