Can I Get Social Security Disability Benefits If I Am On Oxygen?

Not automatically. Needing oxygen is strong evidence, but it is not a listing on its own, and there is a rule that catches people out: Social Security requires the oxygen saturation testing that matters to be recorded while you are breathing room air, without your supplemental oxygen. If every reading in your file was taken on your prescribed flow, none of it can be used to meet the gas exchange criteria at listing 3.02C. Most oxygen claims are won instead on residual functional capacity, and in my experience many judges do find people disabled when they are on oxygen 24 hours a day, 7 days a week,even without listing-level evidence.

Is being on oxygen a sure winner in Social Security disability cases?

In my experience with Social Security disability in Indianapolis, there are several variables involved in determining a person’s need for oxygen and their ability to work.

The thought of dragging around an oxygen tank in the workplace may sound far fetched to some, but at times a Vocational Expert, meaning the job expert who testifies at a hearing, may say there are occupations a person can do while still needing the aid of oxygen.

Eligibility for disability benefits while using oxygen

If you are attempting to get Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) benefits because you need the aid of oxygen, you should first look at whether your medical condition meets one of the listings in the Social Security Administration’s (SSA’s) Listing of Impairments.

There is no listing for being on oxygen. Oxygen is a treatment, not a diagnosis, so your claim will be evaluated under the listing for whatever condition made the oxygen necessary. For most people that means Section 3.00, the respiratory system, and in particular listing 3.02, chronic respiratory disorders. Depending on your diagnosis it could instead be pulmonary hypertension at 3.09, or one of the cardiovascular listings if your oxygen need stems from your heart rather than your lungs.

The gas exchange criteria are usually the ones that matter

Listing 3.02 can be met four different ways, and you only need one of them. Most discussions of this listing focus on the spirometry tables that compare your FEV1 against your age, sex, and height without shoes. Those tables are real, but if you are on oxygen, they are often not the route that fits your situation.

The route that usually matters is 3.02C, impaired gas exchange. Gas exchange is measured three ways:

• Diffusing capacity of the lungs for carbon monoxide, known as DLCO
• Arterial blood gas testing
• Oxygen saturation, or SpO2, measured by pulse oximetry, either at rest, during a six minute walk test, or after one

If your doctor has prescribed continuous oxygen, there is a reasonable chance your gas exchange numbers are the strongest evidence in your file. It is worth asking whether that testing has actually been done and is in your records, rather than assuming spirometry is the only thing Social Security will look at.

The room air rule

Here is the detail that surprises nearly everyone, and it is the single most important thing on this page.

Social Security requires that your pulse oximetry measurement be recorded while you are breathing room air, meaning without oxygen supplementation. Your prescribed oxygen has to be off for the reading to count.

The practical consequence is significant. If you wear oxygen continuously, most of the SpO2 readings in your chart were probably taken while you were using it, because that is how your doctors monitor you. Those readings show the treatment working, which is good medicine and useless for this listing. A file full of readings in the mid-nineties on four liters tells Social Security nothing about your gas exchange.

If you think your claim may turn on 3.02C, ask your treating physician whether an appropriate room air measurement has been documented.

A few related requirements are worth knowing:

• The reading has to be stable. Social Security requires that the range of SpO2 values during any 15 second interval not exceed 2 percentage points.
• You must be medically stable when tested. Testing during a flare-up, within 30 days of treatment for a chest infection or an acute exacerbation, or within two weeks of a change in your respiratory medication, generally will not be accepted.
• The lowest value is the one used. If you have had more than one measurement, such as at rest and after a walk test, Social Security uses the measurement with the lowest SpO2 value. This works in your favor, and it is the opposite of how the agency treats spirometry, where it uses your highest FEV1.
• A walk test can help. Social Security may arrange pulse oximetry during and after a six minute walk test if your resting value is above the threshold. Many people with significant lung disease have acceptable numbers sitting still and desaturate badly on exertion, which is exactly what a workday requires and a resting reading conceals.

Much of the material in the Listing of Impairments can be confusing, and you may find it in your best interest to talk it through with your physician or a qualified Social Security disability lawyer.

Your physical condition determines your eligibility

If you do not meet or equal a listing, will you lose your Indiana Social Security disability appeal? Not always.

It may depend on how often you are short of breath, experience chest pain, find yourself fatigued, and many other factors. Your inability to complete a full workday because of those problems may persuade an Administrative Law Judge (ALJ) that you deserve SSDI or SSI benefits.

This is your physical residual functional capacity, or in other words what you can and cannot do once all of your physical limitations are taken into consideration.

Oxygen use creates limitations that go beyond the breathing itself. Tubing is a trip hazard in most workplaces. Portable concentrators and tanks have to be carried, which limits lifting and rules out work requiring free use of both hands. Tanks run down and need swapping or recharging on a schedule an employer does not set. Many workplaces prohibit oxygen near heat, sparks, or open flame outright. None of these appear on a spirometry report, and all of them are worth describing plainly to your doctor so they end up in the record.

While some job experts may say jobs exist for individuals dragging around an oxygen tank, most qualified job experts also acknowledge it would be considerably harder for such a person to be hired compared with someone not on oxygen.

In Indianapolis Social Security attorney Scott Lewis’s experience, many ALJs find individuals disabled when they are on oxygen 24 hours a day, 7 days a week, even when there is no evidence that they meet a listing.

The condition behind the oxygen matters too

Because oxygen is a treatment rather than a diagnosis, your claim is only as strong as the documentation of the underlying condition. It is worth making sure Social Security has the full picture of what you are being treated for, whether that is COPD, pulmonary fibrosis, pulmonary hypertension, heart failure, or something else, along with every other impairment you have. The agency is required to consider all of your impairments in combination.

In summary

Just being on oxygen is not a sure thing when it comes to Social Security disability benefits. Many factors come into play, including your age, education, prior work experience, and residual functional capacity.

What it is, though, is significant evidence, provided the right testing exists in your file and the practical limitations are described rather than assumed.

If you have any further questions, please don’t hesitate to reach out to us. We’re here to help!