Sleep Apnea and Social Security Disability

Sleep Apnea and Social Security Disability

Sleep apnea is a very common medical condition, with roughly 22 million Americans suffering from some form of the condition. This is according to the American Sleep Apnea Association. However, there is a broad range of severity, and no two cases are exactly the same. The U.S. Social Security Administration (SSA) no longer recognizes sleep apnea, which was previously listed under Section 3.10 of the SSA Regulations. However, SSA does still allow a potential claimant to receive disability for respiratory conditions under the same Section of the regulations, provided the condition is severe enough to warrant such a disability finding. Here is what you need to know about sleep apnea and social security disability.

Understanding Sleep Apnea

There are generally three types of sleep apnea: Central, Obstructive, and Mixed:

  • Obstructive Sleep Apnea. OSA is caused by an actual physical blockage or tissue obstruction in the airway. This occurs when the throat muscles relax during sleep, allowing the tongue or neck tissue to partially obstruct the airway, making the person gasp for air and wake up.
  • Central Sleep Apnea. Central Sleep Apnea (CSA) is a neurological condition, where the brain stops telling the person to breathe. Regardless of the type of apnea, the result is typically the same—the person feels fatigued, begins to suffer a host of daytime complications, and the condition can affect other organ systems, leading to long-term health problems.
  • Mixed Sleep Apnea. Mixed Sleep Apnea (or complex) is just that—a patient is experiencing both an obstruction of the airway and a neurological condition that results in the brain failing to send the message to breathe.

Qualifying For Other Respiratory Conditions Under Regulations

If you qualify based on the criteria listed under Section 3.00 of the SSA Regulations, you automatically meet the qualification for compensation for disability. If your apnea is causing any of the following, you may meet the criteria for disability:

  • Severe cognitive deficits
  • Mood disturbances
  • Behavioral problems
  • Chronic pulmonary hypertension
  • Chronic heart failure

Other Ways To Qualify For Sleep Apnea Social Security Benefits

It can be very difficult to qualify for disability compensation purely for sleep apnea. That said, there is another option for those who suffer from moderate to severe sleep apnea. It’s called “residual functional capacity.”

Residual Functional Capacity

Those who are diagnosed with one or more forms of sleep apnea but do not meet the requirements of the impairments listed in Section 3.00, SSA can review your Residual Functional Capacity (“RFC”). This is essentially your remaining ability to maintain gainful employment, despite your medical impairments.

Under Section 416.945 of the SSA Regulations, RFC is a careful determination of just how much ability or functionality you retain, after accounting for your limitations. Many things can be used to prove your limitations.

  • How tired do you get during the day?
  • Do you fall asleep at work?
  • Have you suffered a heart attack or cardiac problems due to sleep apnea?
  • Does your career require tasks that are limited by your treatment?
  • Are you unsafe to operate a motor vehicle (especially commercial vehicles)?
  • Does your daytime fatigue limit your work involving heavy machinery?
  • Is your memory affected?

Presenting Your Case To SSA

Social Security hearings are supposed to be fairly informal and non-adversarial, but sadly this is not the case. At a hearing, you will have to answer questions from an experienced Administrative Law Judge (ALJ), and there will probably be a vocational expert present. That expert’s job is to provide an unbiased look at your limitations in light of potential work opportunities. Unfortunately, in many cases, that person becomes more an adversary than unbiased expert. This can lead to having two highly trained and experienced government employees looking for ways that you could still earn a living and arguing that your condition does not limit your employability, even if the evidence strongly suggests otherwise.

Get Help Today

If you believe you qualify for SSA benefits due to a disability, contact an experienced disability lawyer who can prepare your case and fight to get you the disability compensation you deserve. Contact our office to speak with one of the skilled attorneys of Klok Law Firm LLC today.