Updates to Disability Claims for Respiratory Disorders

Updates to Disability Claims for Respiratory Disorders

Many individuals who apply for disability benefits suffer from a type of respiratory disorder. Common respiratory disorders include COPD, Cystic Fibrosis, Sleep Apnea, Pneumoconiosis, Asthma, Pulmonary Hypertension, and Respiratory Failure. When evaluating a disability benefits claim, the Social Security Administration (SSA) uses their promulgated regulations to determine whether that particular claimant should be entitled to receive benefits. In June 2016, the SSA updated their regulations regarding respiratory disorders by publishing their Revised Medical Criteria for Evaluating Respiratory Disorders. This update provides further detail as to how the SSA will evaluate disability benefits claims for individuals with respiratory disorders. The revised rules became effective on October 7, 2016 and will be used by the SSA in evaluating respiratory disorder benefits claims moving forward.

Background for the New Rule

As part of their revised regulations, the SSA explained that these new updates reflect advances in medical knowledge and comments they had received from medical experts since the previous overhaul of the regulations for respiratory disorders. The SSA then released a Notice for Proposed Rulemaking (NPRM) proposing changes to the previous regulations and opening the proposed rules for public comment. Once taking into consideration the concerns raised via public comment, the SSA issued its final regulations.

Evaluating Respiratory Disorders Using the Revised Regulations

There are several key updates addressed in the revised criteria that individuals seeking to claim disability benefits should bear in mind when filing a claim for benefits:

  • COPD: An applicant will be able to meet the requirements for COPD if they have taken a spirometry test that yielded results that the applicant’s FEV1 (volume of air exhaled in one second) is equal or less than a given amount depending on your height. Alternatively, if an applicant has been hospitalized for at least two days three times within a year due to your breathing problems, they will be approved for disability benefits.
  • Asthma: In order to receive benefits for asthma, the disease must be persistent, defined as requiring hospitalization three times a year. The regulations further require that the asthma attacks must occur at least 30 days apart and must last for at least 48 hours. The applicant must also show that he or she is otherwise following a doctor’s prescribed treatment for the disease.
  • Cystic Fibrosis: Like Asthma, an applicant with cystic fibrosis must show their disease causes persistent pulmonary infection. Additionally, the applicant must suffer from recurrent episodes of infection at least once every six months and require physician intervention at least six times a year.

Get Help With Your Disability Claim

When someone applies for disability benefits due to a respiratory disorder, the SSA will look to the newly released regulations to determine whether the claimant should be entitled to receive benefits. You should hire lawyers who understand the new rules as well as the application and appeals processes for disability benefits. The experienced Mount Pleasant, South Carolina attorneys at Klok Law Firm LLC can help you receive the disability benefits you are entitled to receive.

Contact us today for a free consultation.