Obtaining Social Security Disability Benefits for Asthma

November 21,2016
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The U.S. Centers for Disease Control and Prevention estimates that as many as 25 million Americans (about 8 percent of the population) have asthma. Obtaining Social Security disability benefits for asthma can be difficult; most cases of asthma are controllable. However, a small percentage of people with asthma are unable to work because of their condition. If you are one of them, you may be eligible for benefits.

What Is Asthma?

Asthma is a chronic disease that affects millions of people. It causes the airways to become inflamed and the muscles around the airways can tighten when an attack is triggered. Muscle tightness and uncontrollable inflammation may result in coughing, wheezing, and shortness of breath. In severe cases, it can cause a person to faint and may even be fatal.

Asthma can be extremely painful. It can cause prolonged irritation and inflammation. It can result in chest tightness that may be confused for a heart attack. The pain caused by asthma can make it difficult to move and perform activities of daily living, including working.

People who have asthma must do what they can to prevent an attack, which can have devastating results. Allergies, exercise, and stress can all provoke an asthma attack. Frequent attacks and inability to prevent the symptoms can lead to disability.

Asthma can also cause an increased susceptibility to other lung infections and breathing disorders. The Social Security Administration (SSA) considers complications of asthma as contributors of disability.

Qualifying for Social Security Disability Benefits for Asthma on the Basis of Your Medical History and Records

Asthma is included on the Adult Listing of Impairments in Category 3.00 Respiratory System. Section 3.03 describes when asthma is severe enough to qualify you for benefits based on your medical history and records.

Asthma may result in disability when:

  1. Chronic asthma results in frequent bronchitis, which is evaluated as a chronic obstructive pulmonary disease.
  2. Asthma attacks continue despite prescribed treatment and require physician intervention at least once every two months or at least six times a year. If in-patient hospitalization is needed for longer than 24 hours to control asthma, that hospitalization counts as two attacks.

Even if your asthma does not exactly match this description, you may still qualify for disability benefits if your asthma has reduced your ability to function to such a low level that you are not capable of working. (See below.)

Verifiable Medical Evidence Is Important

You must have verifiable medical evidence from reliable medical sources to prove the existence and severity of your asthma. Your subjective account of your condition is not enough to prove that you are disabled.

Verifiable medical evidence may include any of the following:

  • X-rays or other radiological imaging.
  • Lung function tests.
  • Allergy tests.
  • ER records.
  • Doctor’s office notes.

Although doctor’s office notes are acceptable as medical evidence, they must include specific information. Your treating physician must document the onset date of your condition and any verified attacks. Office notes should detail your symptoms from an objective medical viewpoint.

Qualifying for Social Security Disability Benefits for Asthma on the Basis of Low Residual Functional Capacity (RFC)

If your asthma does not match the description in the Listing of Impairments, you must prove that your RFC (the most you are able to do despite your asthma) is so reduced that you are unable to perform substantial gainful activity (i.e., a full time job).

Your treating physician can complete a Physical Residual Functional Capacity Assessment that details your abilities and proves that you are unable to perform work on a sustained basis.

An RFC Assessment asks your physician to evaluate the following:

  • Exertional limitations – how much you can lift, stand, walk, sit, push, and/or pull.
  • Postural limitations – your ability to climb, balance, stoop, kneel, crouch, and/or crawl.
  • Manipulative limitations – your ability to reach, manipulate objects, and/or feel.
  • Visual limitations – including near acuity, far acuity, depth perception, accommodation, color vision, and/or field of vision.
  • Communicative limitations – your ability to hear and speak.
  • Environmental limitations – your ability to tolerate extreme cold, heat, wetness, humidity, noise, vibration, poor ventilation, and/or hazards.

People with asthma typically have limitations in multiple areas, including exertional and environmental limitations.

A Seasoned Social Security Attorney Can Help You

It is possible to obtain Social Security disability benefits for asthma.  The Social Security Administration recognizes asthma as a condition that can cause severe impairments. If your medical records show that you meet requirements in the Listing of Impairments, you will be automatically qualified. However, even if you do not have the required number of attacks in one year, if your condition causes significant limitations, you may still be eligible.

If your asthma attacks are making it difficult or impossible to work, call the Hermann Law Group at 914-286-3030 for a no cost, no obligation evaluation of your case.