Social Security Disability Benefits For Asthma

SSDI Asthma Eligibility Guidelines

1. Determine if an individual is working (engaging in substantial gainful activity) according to the SSA definition. Earning more than $1,470 a month as an employee is enough to be disqualified from receiving Social Security disability benefits.

2. Conclude the asthma disability must be severe enough to significantly limit one’s ability to perform basic work activities needed to do most jobs. For example:

• Walking, standing, sitting, lifting, pushing, pulling, reaching, carrying or handling.
• Seeing, hearing and speaking.
• Understanding/carrying out and remembering simple instructions.
• Responding appropriately to supervision, co-workers and usual work situations.
• Dealing with changes in a routine work setting.

3. Asthma is listed under the category of impairments known as the Respiratory System – Medical Listing 3.03. When a respiratory impairment is episodic in nature, as can occur with exacerbations of asthma or chronic asthmatic bronchitis, the frequency and intensity of episodes that occur despite prescribed treatment are often the major criteria for determining the level of impairment. If any of the following are present, the individual will be found to be disabled:

Attacks of asthma that in spite of prescribed treatment and requiring physician intervention, occurring at least once every two months or at least six times a year. Each in-patient hospitalization for longer than 24 hours for control of asthma counts as two attacks, and an evaluation period of at least 12 consecutive months must be used to determine the frequency of attacks. Attacks of asthma are defined as prolonged symptomatic episodes lasting one or more days and requiring intensive treatment, such as intravenous bronchodilator or antibiotic administration or prolonged inhalational bronchodilator therapy in a hospital, emergency room or equivalent setting. The medical evidence should include spirometric results obtained between attacks that document the presence of baseline airflow obstruction.

Chronic asthmatic bronchitis is assessed under the criteria for chronic obstructive pulmonary disease, which generally produces irreversible loss of pulmonary function due to ventilatory impairments, gas exchange abnormalities or a combination of both. A thorough medical history, physical examination, and chest x-ray or other appropriate imaging techniques are required. More sophisticated pulmonary function testing may then be necessary to determine if gas exchange abnormalities contribute to the severity of a respiratory impairment. Spirometric results and measurements such as one-second forced expiratory volume (FEV1) and forced vital capacity (FVC)are required to evaluate severity. Additional testing might include measurement of diffusing capacity of the lungs for carbon monoxide or resting arterial blood gases.

4. Explore the ability of an individual to perform work they have done in the past despite their asthma. If the SSA finds that a person can do his or her past work, benefits are denied. If the person cannot, then the process proceeds to the fifth and final step.

5. Review age, education, work experience and physical/mental condition to determine what other work, if any, the person can perform. To determine asthma disability, the SSA enlists medical-vocational rules, which vary according to age.

For example, if a person is:

Under age 50 and, as a result of the symptoms of asthma, unable to perform what the SSA calls sedentary work, then the SSA will reach a determination of disabled. Sedentary work requires the ability to lift a maximum of 10 pounds at a time, sit six hours and occasionally walk and stand two hours per eight-hour day.

Age 50 or older and, due to asthma, limited to performing sedentary work, but has no work-related skills that allow the person to do so, the SSA will reach a determination of disabled.

Age 55 or older and, due to the disability, limited to performing light work, but has no work-related skills that allow the person to do so, the SSA will reach a determination of disabled.

Over age 60 and, due to asthma, unable to perform any of the jobs he or she performed in the last 15 years, the SSA likely will reach a determination of disabled.

Any age and, because of asthma, has a psychological impairment that prevents even simple, unskilled work, the SSA will reach a determination of disabled.