COPD, or chronic obstructive pulmonary disease, is a condition that affects the lungs and makes it difficult to breathe. It can develop slowly and worsen over time. If you have COPD and your symptoms have progressed, could be fatal, or will cause you to miss work for more than 12 months, you may qualify for disability benefits.
This article discusses the stages of COPD, when it may become disabling, and the testing and documentation required to apply for COPD disability through the Social Security Administration (SSA).
When Does COPD Become Disabling?
As the disease progresses, symptoms can escalate from mild shortness of breath to being too breathless to leave the house. Other symptoms of COPD could include coughing, producing phlegm, or having difficulty breathing deeply.
A person’s ability to work will vary based on the severity of symptoms and the nature of their work. Some employers may make reasonable accommodations, such as job restructuring, providing leave time, modifying your schedule or offering you a part-time schedule, modifying workplace policies, or reassigning you to allow you to continue working within reasonable constraints of the job.
However, if you are concerned that your symptoms are becoming too severe for you to work, you could qualify for disability. Before applying for COPD disability benefits through the SSA, you’ll need to be evaluated by your healthcare provider to determine just how severe your illness is.
According to the Global Initiative for Chronic Obstructive Lung Disease (GOLD), there are four stages of COPD, ranging from mild to very severe.
Stages of COPD
Stage 1: Mild COPD
Stage 2: Moderate COPD
Stage 3: Severe COPD
Stage 4: Very Severe COPD
Your primary care physician (PCP) may be able to assess your symptoms to determine which stage you are in. Your PCP can also refer you to a pulmonologist, a doctor who specializes in the lungs and respiratory tract. They will make their assessment using a spirometry test to see how well your lungs work.
A spirometer measures the amount of air an individual can exhale with force in one second. Your provider will measure the results of the spirometry test against a baseline measurement of forced expiratory volume in one second (FEV1) to determine the severity of illness.
COPD affects around 16.4 million Americans. Women have higher morbidity and mortality rates related to the disease than men, but COPD often goes undiagnosed in women until the disease is severe, which could contribute to the poor outcomes for women with COPD.
The symptoms of COPD can impact a person’s daily activities and lead to additional complications. These can include:
- Limitations on regular activities like walking or climbing stairs
- Reliance on portable oxygen tanks
- Disconnection from social or community activities
- Depression and anxiety
- Confusion and memory loss
- More frequent visits to the hospital emergency room (ER) and overnight hospital stays
Qualifying for COPD Disability
Before you can start collecting a COPD disability allowance, the SSA will require you to provide specific evidence of the severity of your illness. This is done by submitting medical records that include any COPD testing and results, as well as any medications and treatments you have taken for your COPD.
It’s also helpful to provide documentation that supports the effect COPD has had on other areas of your health and quality of life. The more details you can provide, the better.
Working With a Pulmonologist
The SSA gives more weight to the opinion of medical specialists when reviewing applications, so working with a pulmonologist is recommended.
Required Medical Documentation
The SSA requires a high level of detail when it comes to your health history. Work with your primary healthcare provider or pulmonologist to gather documentation of any COPD treatments you’ve had and their efficacy, as well as any additional health history related to the disease. Make sure to include:
- Medications you are taking for COPD
- Any medical therapies you are receiving for your disease, like respiratory therapy or pulmonary rehabilitation
- Supplemental oxygen needs
- Records of surgeries or procedures you’ve undergone as a result of COPD
- Any additional complications of COPD
While COPD mainly affects the lungs, it can also affect other systems of the body. The decreased flow of oxygen can affect your heart health. It can also affect your ability to participate in regular activities of daily life, which can then affect your mental health. Be sure to provide documentation around every area of your health that has been affected by COPD.
It’s important to be your own advocate. Have an open dialogue with your provider and make sure to ask questions if you think that any documentation you need is missing.
COPD can be diagnosed by using a variety of tests, all of which should be documented in your medical records and submitted with your COPD disability application. These tests include:
- Arterial blood gas (ABG)
- Pulse oximetry levels
- Imaging tests that may show evidence of COPD, such as a chest X-ray or computed tomography (CT) scan
- Pulmonary (lung) function tests
- Spirometry test results
- Pulse oximetry
You will also want to include records of any hospitalizations and documentation of any supplemental oxygen use, including flow rate.
Waiting for Approval
If you are considering applying for COPD disability benefits, note that it can take anywhere from a few months to nearly a year to start collecting benefits if you’re approved. The approval process can take three to five months, and once you’re approved it could take even longer to begin receiving your benefits.
Waiting for approval can be difficult. If you want to check your disability claim status, you can create an account on the SSA website and monitor your application online. If you prefer not to create an account, you can call the SSA’s toll-free number or visit your local Social Security office.
If You’re Approved
The SSA offers two different types of disability options for someone with COPD.
The first is called Social Security Disability Insurance (SSDI). This is based off of your work history and salary. It requires that you have worked full-time for five of the last 10 years. This option will provide you benefits based on your previous salary.
The agency also offers Supplemental Security Income (SSI), which is designed for people with very limited finances and resources. The maximum monthly benefit as of 2020 was $783 per individual.
If You’re Denied
Not everyone who submits a COPD disability claim is approved.
If you’re denied, it doesn’t mean you can never be approved. You can file an appeal, but be prepared to provide more details about your disease and how it’s affecting your ability to work.
There are lawyers who specialize in Social Security issues who may be able to help you obtain these benefits in the future.
COPD is a chronic lung disease that impacts the ability to breathe. It can also affect other areas, including heart health and mental health. People with COPD can apply for disability benefits from the Social Security Administration. This requires documentation about the disease, its severity, and how it impacts a person’s ability to work.
A Word From Get Meds Info
The process of applying for COPD disability benefits can feel like a job itself. It is a time-consuming process that requires high attention to detail. It can become especially stressful when you have other people relying on you and your income for support. Collecting the proper documentation and paying attention to the small details within the application can be challenging, but it will be worth it in the end if you’re approved.
Frequently Asked Questions
Is it safe to work with COPD?
Your ability to safely work with COPD depends on the severity of your disease as well as the nature of your work.
Which COPD complications could affect a disability claim?
COPD can affect various systems of your body as well as your quality of life. If this disease has had an impact on your heart health, mental health, social interactions, memory, or has led to additional ER visits, this could support your disability claim.
Can a doctor help with SSA requirements for COPD?
You should work with your primary care provider or pulmonologist to gather the necessary documentation for your COPD disability application.