Can you get Social Security disability for COPD?

Does a breathing disorder keep you from working a full-time job? It is possible to receive Social Security disability benefits for chronic obstructive pulmonary disease (COPD) and other breathing disorders. With a well-documented medical history showing how your COPD affects your ability to work, a good claim can be made.

A diagnosis on its own is not enough. In my practice, I find that COPD is disabling to my clients in two ways: either their symptoms are so severe on their own that they cannot work, or their COPD combines with symptoms from other impairments to keep them from working.

What COPD is

COPD is an obstructive lung disease characterized by very poor airflow. Many people who have COPD have emphysema, chronic bronchitis, or both. There is no cure for COPD, and it usually worsens over time. Most treatments aim to slow the progression of the disease rather than reverse it. It is important for people with COPD to avoid other lung and airway infections, which can be seriously detrimental.

COPD can be caused by:

• Smoking
• Air pollution
• Occupational exposure to dust, chemicals, and fumes
• Genetics, including alpha-1 antitrypsin deficiency

The most common symptoms include:

• Shortness of breath, particularly on exertion
• Constant coughing
• Sputum or mucus production
• Wheezing
• Fatigue
• Chest pain or tightness
• Frequent respiratory infections

Because these symptoms are common to a number of diseases, a thorough medical examination and medical history are the starting point, and chest imaging is often used to rule other causes out. The diagnosis itself is established by spirometry, which measures airflow obstruction directly, and that is also the test Social Security will be looking for in your records.

How Social Security evaluates COPD: listing 3.02

Social Security examines pulmonary disorders in its Listing of Impairments at Section 3.00, Respiratory Disorders. COPD falls under listing 3.02, chronic respiratory disorders due to any cause other than cystic fibrosis.

If you have COPD, Social Security will almost certainly want a pulmonary function test to measure objectively how obstructed your airways are. If you are already treated by a pulmonologist you may have had several. Social Security will request records from your doctor, including those test results along with the diagnoses and clinical impressions.

There are four separate ways to meet listing 3.02, and you only need one:

• 3.02A, FEV1. Your forced expiratory volume in one second must be at or below the value in Social Security’s table for your age, sex, and height without shoes. FEV1 is the measurement most closely tied to the severity of COPD.
• 3.02B, FVC. Your forced vital capacity, the total amount of air you can exhale after your deepest breath, must be at or below the table value for your age, sex, and height without shoes.
• 3.02C, impaired gas exchange. Shown through a low diffusing capacity of the lungs for carbon monoxide (DLCO), arterial blood gas results, or oxygen saturation measured by pulse oximetry at rest, during, or after a six-minute walk test.
• 3.02D, exacerbations. Three hospitalizations within a 12-month period, at least 30 days apart, each lasting at least 48 hours including time in the emergency department immediately before admission.

Why the timing of your breathing test matters

This is the detail that costs people claims, and it is worth understanding before you are tested.

Social Security will not accept spirometry taken when you are not medically stable. The agency specifically does not consider you stable within two weeks of a change in your prescribed respiratory medication, while you are experiencing or within 30 days of finishing treatment for a lower respiratory tract infection, or while you are experiencing or within 30 days of finishing treatment for an acute exacerbation of your COPD.

The practical effect runs both ways. A test done during a flare-up may show your worst numbers but will not count. A test done shortly after starting a new inhaler may not count either. If your only recent spirometry was taken during a hospitalization, it may not be usable, and getting a properly timed test before your hearing can matter more than any argument made at it.

Social Security uses your highest FEV1 value and your highest FVC value, even if they come from different attempts during the test.

Other respiratory listings in Section 3.00

Section 3.00 covers a number of other respiratory impairments, and it is worth knowing which one applies to you:

• 3.03 Asthma, which has its own criteria and is evaluated differently from COPD
• 3.04 Cystic fibrosis
• 3.07 Bronchiectasis
• 3.09 Chronic pulmonary hypertension
• 3.11 Lung transplantation
• 3.14 Respiratory failure

If you have both COPD and asthma, which is common, Social Security will consider your condition under whichever listing fits the evidence, and the two sets of criteria work quite differently.

If your test results do not meet the listing

Even when test results fall short of listing levels, you may still meet Social Security’s definition of disabled based on the functional limitations your COPD causes. Many of my clients do not have test results or frequent enough hospitalizations to meet the listings, and their symptoms still seriously interfere with their ability to work. As with any claim, your condition also has to have lasted, or be expected to last, at least twelve months, which for COPD is rarely in dispute.

They are often unable to stand or walk for extended periods. Sometimes symptoms are severe enough that they become short of breath talking on the phone or performing sedentary activities. Some of my clients use inhalers, nebulizers, or supplemental oxygen. Portable oxygen tanks in particular hinder many types of work. Severe fatigue while performing even simple tasks is a common complaint, and fatigue is a real factor in whether someone can sustain an eight-hour workday.

Sometimes a breathing problem is apparent just from talking with someone. Other times it only becomes obvious when they exert themselves, which is exactly the situation an eight-hour workday creates and a twenty-minute medical appointment does not.

Your age, education, and work history matter at this stage too. A claimant of 50 or older with no transferable skills is in a considerably stronger position than a younger claimant with identical limitations, and at 55 the vocational rules shift again in the claimant’s favor. Since June 22, 2024, Social Security also looks only at work performed in the previous five years rather than fifteen.

Let Social Security know you have breathing problems even if that is not your primary reason for filing. The agency must consider all of your impairments in combination when deciding whether you can maintain full-time employment, and breathing problems frequently combine with other conditions to tip a claim.

The medical evidence your claim needs

Useful evidence for a COPD claim includes:

• Spirometry results, taken during a period of medical stability
• DLCO testing, arterial blood gas results, or pulse oximetry readings
• Chest X-rays or other imaging
• Hospital admission and discharge records for any exacerbations, with dates and lengths of stay
• Documentation of prescribed oxygen, including how many hours per day
• Treatment notes describing what you can and cannot do

Receiving the correct treatment can be the key to a successful appeal, and a qualified pulmonologist is often best placed to provide the documentation Social Security needs. Seek medical attention, take your prescribed medications, and keep detailed records.

Filing and appealing

If you are unable to work due to COPD or any other disabling condition, you can start the process by filing an initial application. If your application is denied, as most are, appeal rather than starting again. Filing a Request for Reconsideration protects your original filing date and the back pay attached to it, and you generally have sixty days from the date on the denial notice, so do not set the letter aside. Most people have to attend an administrative hearing before they have a real chance at benefits.

The process can be lengthy and confusing, but persistence and good treatment records are often the keys to a successful outcome.

Talk with an Indiana disability attorney

If COPD is keeping you from working, contact my office for a free consultation.

The one thing worth sorting out early is your spirometry. If the only recent test in your file was done in the hospital or just after a medication change, it may not count, and that is fixable before a hearing rather than after one.

I represent Indiana residents at every stage, from the initial application through a hearing before an Administrative Law Judge.