An estimated eight percent — or one out of every 12 — people in the U.S. have asthma, reports the American Academy of Allergy, Asthma & Immunology (AAAAI). Asthma can cause relatively mild symptoms and infrequent asthma attacks, or can be so severe that sufferers cannot function and often miss school or work.
For asthma suffers in latter group, disability benefits may be option. If you have asthma that meets the Social Security Administration’s (SSA) severity requirements, you may be entitled to a monthly disability benefit. Below is a general overview of the requirements, but for case-specific information or for help getting Social Security disability for asthma in Pittsburgh, call Berger and Green to schedule a free consultation with a disability lawyer: 412-661-1400.
What are the criteria for disability under the asthma listing?
The SSA maintains a list of commonly disabling impairments and their criteria. Asthma is one of the conditions listed in Section 3.00 — Respiratory Disorders.
If your asthma meets both of the following criteria, the SSA will likely determine you disabled:
- Your FEV1, the measure of the volume of air you can exhale, is less than or equal to a certain value that is provided in the SSA’s charts for your age, gender, and height. For instance, a 5’10” 19-year-old male must have a FEV1 of 2.75 or less to qualify. A 5’4” 55-year-old female would need a FEV1 of 1.65 or less.
- You have experienced “exacerbations or complications requiring three hospitalizations within a 12-month period and at least 30 days apart. Each hospitalization must last at least 48 hours.”
The SSA explains the gist of what they are looking for: “We need evidence showing that you have listing-level airflow obstruction at baseline while you are medically stable.”
The SSA details listing levels in Table VI in Section 3.03A of the Blue Book, but they are quite complex and technical. You might consider having your doctor review the listing requirements for asthma to see if you qualify.
Note: If you meet both criteria above, the SSA will consider you as disabled for one year after your discharge date of you your last hospitalization, regardless of how much you improve. After that, it will reevaluate you.
What if my asthma does not match the listing criteria?
Not quite meeting the above criteria regarding FEV1 and hospitalizations will not automatically disqualify you from benefits. The SSA will review your application and perform a residual functional capacity (RFC) assessment that looks at what, if any, basic skills (e.g., walking, lifting, ability to converse) that you still have, despite your asthma.
The claims examiner will use your RFC to determine whether or not you are capable of doing any jobs. They will take your age and educational background into consideration, too. If the SSA determines that your asthma prevents you from doing any type of work, it may still determine you as disabled.
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What are the other requirements to collect disability benefits?
There are several basic criteria you must meet in order to meet the SSA’s definition of disabled and collect benefits. These include the following:
- You have an impairment, or combination of impairments, that the SSA deems as totally disabling. To meet the definition of disabled, you must either meet the severity requirements under the listing for asthma, or prove to the SSA that your condition is so severe that you cannot work.
- Your asthma must have lasted or is expected to last a year or longer or result in death.
- Given your age, background, and symptoms, there is no work you can adjust to.
- You are not engaged in substantial gainful activity (SGA), which means that your income is less than a certain amount. (In 2016, having a monthly income of $1,130 or more means you are engaged in SGA.)
You will also have to meet certain work history or financial requirements. If you are applying for Social Security Disability Insurance (SSDI) benefits, you must have sufficient work credits on your record. If you have not worked long or recent enough to qualify for SSDI or the claimant is a child, you can instead apply for Supplemental Security Income (SSI). To be eligible for SSI, your income and the value of assets must fall under a certain amount.
Determining whether you are eligible for SSI or SSDI is not always straightforward. A disability attorney with SSI and SSDI claims experience can examine your medical, work, and financial records to determine eligibility.
How do I substantiate my asthma disability claim?
You will need to gather all your medical records and other pertinent records regarding your condition to prove your impairment to the SSA. You may also submit input from non-medical sources about how your condition is affecting your ability to work, such as from your spouse, employer, and social workers.
The more supportive evidence you have that clearly shows the extent of your condition and the effect it is having on your life, the better.
To increase your chances of obtaining benefits, consider speaking to a lawyer prior to filing. If you have already filed and recently received a letter of denial in the mail from the SSA, our disability lawyer can help you appeal your case.
We can manage your claim, all the way from reconsideration to federal court. We regularly work with medical experts to help prove that our clients are unable to engage in substantial gainful employment.
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Our disability lawyers provide free, no-obligation consultations to disabled and injured persons in Pittsburgh. Call Berger and Green today at 412-661-1400 to see how we can help you with your disability claim.