Does COPD Qualify for Disability Benefits?

Chronic obstructive pulmonary disease (COPD) affects over 16 million people in the U.S., making it one of the more common respiratory disorders. If you suffer from COPD and it impacts your ability to work, even though you’ve received treatment for months, then you could qualify for disability benefits from the Social Security Administration (SSA).

Is COPD A Disability?

The Social Security Administration (SSA) recognizes Chronic Obstructive Pulmonary Disease (COPD) as a disability. It will be possible only when its symptoms or the treatment required significantly impair your ability to maintain employment or carry out daily tasks independently.

What is Chronic Obstructive Pulmonary Disease (COPD)?

COPD is a progressive and chronic respiratory condition primarily affecting the lungs and airways. It encompasses a group of lung diseases, including chronic bronchitis and emphysema, which cause breathing difficulties. 

Can You Get Disability Benefits For COPD?

Yes, it is possible to get disability benefits for Chronic Obstructive Pulmonary Disease (COPD). To qualify, you must demonstrate that your COPD is severe and significantly impairs your ability to work. The specific eligibility criteria and application process may vary by the disability benefits program, such as SSDI or SSI, that the applicant is applying for. 

Common Stages of COPD

Chronic Obstructive Pulmonary Disease (COPD) is typically classified into four standard stages based on the severity of the condition. These stages are often determined using the GOLD (Global Initiative for Chronic Obstructive Lung Disease) staging system:

Stage 1: Mild COPD (Mild Obstruction): Individuals may have mild symptoms such as a chronic cough and increased mucus production in this stage.

Stage 2: Moderate COPD (Moderate Obstruction): At this stage, symptoms become more noticeable and may include increased breathlessness, particularly during physical activity. 

Stage 3: Severe COPD (Severe Obstruction): Severe COPD is characterized by significantly reduced lung function, causing frequent and severe breathlessness even during minimal physical exertion. 

Stage 4: Very Severe COPD (Very Severe Obstruction): This stage represents the most advanced form of COPD. Lung function is severely compromised, and individuals may experience severe and persistent symptoms even at rest.

Symptoms of COPD

Symptoms of Chronic Obstructive Pulmonary Disease (COPD) include:

• Chronic Cough: A persistent cough that may produce mucus.
• Shortness of Breath: Difficulty breathing, especially during physical activity.
• Wheezing: A high-pitched whistling sound when breathing.
• Chest Tightness: A sensation of pressure or constriction in the chest.
• Increased Mucus: Production of excess mucus in the airways.
• Frequent Respiratory Infections: Such as bronchitis or pneumonia.
• Fatigue: Feeling tired or lacking energy due to the effort required to breathe.
• Reduced Exercise Tolerance: Difficulty engaging in physical activities due to breathlessness.
• Cyanosis: Bluish or grayish discoloration of the lips and nails due to low oxygen levels.
• Weight Loss: Unintended weight loss is often related to the increased effort of breathing.

Your COPD may trigger other disorders such as insomnia, anxiety, depression, or other panic attacks.

Criteria for Getting Disability with COPD

COPD criteria for Social Security disability benefits typically involve demonstrating the following:

• Medical Documentation: You must provide medical evidence of a formal diagnosis of COPD from a qualified healthcare professional, such as a pulmonologist.
• Severity of Impairment: You need to show that your COPD is severe enough to significantly impair your ability to work and perform substantial gainful activity (SGA). 
• Duration: Your COPD must last at least 12 continuous months or be expected to result in death.
• Compliance with Treatment: Compliance with prescribed treatments and therapies and evidence of limited improvement despite these interventions are often considered.
• Work History: For Social Security Disability Insurance (SSDI), you must have a work history and be insured for benefits based on your work credits. Supplemental Security Income (SSI) is available to individuals with limited income and resources.
• Age: Certain age-related criteria may apply, especially for SSDI.
• Income and Resource Limits: In the case of SSI, income and resource limits need to be met.

How Much Is The Average Disability Check For COPD?

The Social Security Administration (SSA) does not specify payments for COPD. The average COPD disability check for COPD and other respiratory diseases is approximately $1,384. For SSDI, the maximum disability payment is $3,600 per month in 2023; for SSI, the payment is $914.  

What Is The Application Process For COPD?

The application process for Social Security Disability benefits due to Chronic Obstructive Pulmonary Disease (COPD) in the United States typically involves the following steps:

• Prepare: Gather all necessary documentation, including medical records, test results, and work history information.
• Complete the Application: Provide detailed information about your medical condition, work history, and other relevant details. Be thorough and accurate in your responses. If a claimant does not have enough work credits, they can still apply for the benefits by having knowledge of social security 5-year rules. 
• Medical Evidence: Submit all relevant medical records and documentation that support your COPD diagnosis.
• Notification: You will receive a decision letter from the SSA regarding your application.

What if my COPD Does Not Meet The SSA’s Eligibility Criteria?

If your Chronic Obstructive Pulmonary Disease (COPD) does not meet the Social Security Administration’s (SSA) eligibility criteria for disability benefits, there are still steps you can take:

• Appeal the Decision: You can appeal if your initial application is denied. The appeals process includes several stages, such as reconsideration and, if necessary, an administrative law judge (ALJ) hearing.
• Be Persistent: The disability claims process can be lengthy, and many applicants are initially denied. Persistence and determination can be essential to ultimately securing the benefits you deserve.
• Explore Other Options: If you do not qualify for disability benefits, you may still be eligible for other forms of assistance, such as vocational rehabilitation, unemployment benefits, or help from charitable organizations.

Need Legal Help? Contact a Disability Lawyer

An experienced Social Security Disability lawyer can assist in obtaining COPD disability benefits by understanding the specific requirements for disability claims ensuring your application is comprehensive and well-documented.

If you want to apply for benefits without the help of a lawyer, you can choose to do so. However, having legal guidance is beneficial owing to their experience increases your chances of a successful claim, helping you access the financial support needed for COPD-related medical and living expenses.

FAQs on COPD disability