Every day, thousands of Americans battle health conditions affecting their lungs. Many of these people require lung transplants. If they need a transplant, they may seek Social Security disability benefits to pay for medical expenses and cover lost wages. Unfortunately, recovering the benefits you need is rarely easy.
For help obtaining Social Security disability for a lung transplant in Pittsburgh, call Berger and Green: 412-661-1400.
How can I recover disability benefits for a lung transplant?
It can take a person six months to recover from a lung transplant. For this reason, the SSA will consider you disabled for three years from the date of your transplant (if you meet the other criteria). After that time, the SSA will evaluate you based on:
- Your post-transplant residuals (e.g., breathing capacity)
- Work history (i.e., ability to do past job effectively)
- Physical and mental ability to do another job despite the lung transplant
- Severity of medical condition
Can I recover benefits while waiting for a lung transplant?
According to the U.S. Department of Health and Human Services, there are over 1,000 people waiting for a lung transplant at this moment. Unfortunately, that means most people have to wait quite a long time for a transplant.
Fortunately, you may be eligible to recover benefits while you wait.
How to Qualify for Benefits While Waiting
If you are waiting for a lung transplant, you may be unable to work and support your family. You might be entitled to benefits if your need for a lung transplant is the result of certain medical conditions.
To determine whether you qualify, the Social Security Administration (SSA) will first consider the following:
- If you are working and, if so, how much you are earning: If you are earning less than $1,170 per month, you may be eligible for Social Security Disability Insurance (SSDI) benefits.
- If you have enough work credits: The number of work credits required for SSDI will depend on your age, how many years you have worked, and the amount of money you have put into the Social Security system over time.
- If you meet the SSI criteria: Those who do not have enough work credits may qualify for disability benefits through the Supplemental Security Income (SSI) program. The SSI program helps individuals who have a low income and less than $2,000 in assets.
Once you have qualified for benefits based on your employment history, the SSA will consider your medical condition.
Blue Book List of Impairments
To determine whether you qualify for benefits, the SSA will consult its Blue Book. If your condition meets a listing’s severity criteria, you may be entitled to benefits. The following are conditions, listed in the Blue Book, that might require a lung transplant.
To qualify under the chronic pulmonary insufficiency listing, you must have:
- A certain FEV1 (the volume of air you can exhale) dependent on your age, gender, and height
- A certain FVC (the total amount of air you can exhale during an FEV test) dependent on your age, gender, and height
- Chronic impairment of gas exchange (i.e., your body cannot take in enough oxygen or dispense enough carbon dioxide)
- “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”
In order to qualify under the asthma listing, you must suffer from persistent asthma attacks. Your condition must meet the following criteria:
- Attacks must occur at least three times a year with a minimum of 30 days between each attack.
- Each attack must last a minimum of 48 hours.
- The attacks must require hospitalization.
- You must have a certain FEV1 dependent on your age, gender, and height.
In order to qualify under the Blue Book listing for cystic fibrosis, you must show:
- Spirometry test results that show that your lung function is within the required range.
- Pulmonary exacerbations where you have frequent episodes involving bronchitis and other respiratory issues.
- Chronic infections that require treatment at least once every six months.
- Respiratory failure
- You require vascular embolization to control pulmonary hemorrhaging.
If you qualify under a respiratory condition listed in the Blue Book, you will be able to receive disability benefits.
What if I do not meet the Blue Book criteria?
Even if your medical condition is not in the Blue Book, you can still qualify for disability benefits based on a “medical vocational allowance.” A medical vocational allowance will take the following factors into account when determining whether you are able to work:
- Work history and experience
- Residual Functional Capacity (RFC): A claims examiner will determine your RFC based on your physical and mental abilities and limitations. The SSA will determine whether you can do sedentary, light duty, medium duty, or heavy duty work.
What should I include with my application?
The SSA rejects a majority of the applications for SSD benefits. Receiving benefits if you need a lung transplant surgery may prove to be difficult. You will need to include as much information as possible to help the SSA make its decision. You should include:
- Treatment information (duration, type, etc.)
- Test results
- Dosage of medications
- Effects of the treatment
Make sure your application has the best chance of success by consulting with an attorney at Berger and Green. The attorneys on staff know how difficult it is to work if you need a lung transplant and understand your financial struggles.
To file your Social Security Disability case for benefits or helping appealing a decision, contact Berger and Green today: 412-661-1400.