Breathing shouldn’t feel like a daily struggle, but for many Americans with COPD, it does. This progressive lung disease affects nearly 16 million people in the U.S., and can make simple tasks like walking or climbing stairs exhausting.
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If your condition makes it hard to work or handle everyday activities, you might be asking: Is COPD a disability? The answer depends on how severe your symptoms are and whether they meet the Social Security Administration’s criteria.
In this article, we’ll discuss COPD, how the Social Security Administration evaluates it, and how you can build a strong case for the benefits you deserve.
Key Takeaways
- COPD may qualify as a disability if your symptoms are severe enough to keep you from working.
- Medical evidence is critical for SSDI approval. Pulmonary function tests and hospitalization records can help prove your COPD meets SSA requirements.
- Many claims are denied initially, but appealing with strong evidence or legal support can improve your chances.
In this article about if COPD is a disability:
What is COPD?
Chronic obstructive pulmonary disease (COPD) refers to a group of chronic lung conditions that cause permanent damage and make it difficult to breathe. The damage leads to swelling and irritation inside the airways, which block airflow in and out of the lungs (known as obstruction). The two most common types of COPD are emphysema and chronic bronchitis.
The leading cause of COPD is long-term exposure to irritants, especially cigarette smoke. Other causes include breathing in fumes, dust, or chemicals over time.
COPD symptoms usually don’t show up until significant lung damage has occurred, and they tend to worsen over time, especially if exposure to irritants continues. Common symptoms include:
- Shortness of breath
- Wheezing
- Chest tightness or heaviness
- Frequent lung infections
- Persistent cough (often producing mucus)
- Swelling in the ankles, feet, or legs
People with COPD often experience flare-ups, or periods when symptoms are worse than usual. These flare-ups can last from a few days to several weeks and may be triggered by things like strong smells, cold air, air pollution, or infections such as colds or the flu.
COPD is a progressive disease, meaning it gets worse over time. Flare-ups often become more severe and frequent as the disease advances. While this progression usually takes years or even decades, for some people, the condition can develop more rapidly.
Is COPD a disability?
The Social Security Administration (SSA) recognizes COPD as a serious medical condition that can qualify you for Social Security Disability Insurance (SSDI) benefits. Additionally, COPD is typically covered under the Americans with Disabilities Act (ADA). However, neither of these facts guarantees you will receive disability benefits for the condition.
Therefore, if you’ve been diagnosed with COPD, you may qualify for disability benefits. However, the SSA considers specific criteria when evaluating COPD SSDI claims, which can make approval challenging for many applicants.
To be eligible for SSDI for COPD, your symptoms must make it impossible to continue working gainfully and interfere with your ability to support yourself.
Your condition must also meet other medical requirements listed in the SSA’s Blue Book. We explain these requirements in more detail below.
How to qualify for SSDI with COPD
COPD is classified as a respiratory disorder in the SSA’s list of qualifying impairments, also called the Blue Book, and is listed under Section 3.02.
To qualify for disability benefits, you must show your condition is severe, long-lasting, and prevents you from doing any substantially gainful work. Additionally, you must show severe chronic respiratory impairment through medical evidence and pulmonary function test results and/or a history of frequent COPD exacerbations or complications requiring hospitalization.
The SSA may also consider whether your COPD has led to three hospitalizations within a 12-month period, with each hospitalization occurring at least 30 days apart and lasting at least 48 hours. This includes time spent in the emergency department immediately before admission. These hospitalizations must fall within the time period the SSA is reviewing for your disability claim.
Pulmonary function tests help the SSA understand how severe your COPD is. Some specific pulmonary function tests the SSA looks for include:
- Spirometry (FEV1): Measures how much air you can breathe in and out, and how fast you can do it
- DLCO test: Measures how well oxygen passes from your lungs into your blood
- ABG test (arterial blood gas): Measures the levels of oxygen and carbon dioxide in your blood
- Pulse oximetry: Uses a small device on your finger to measure the oxygen level in your blood
Your chances of approval may improve if you have additional qualifying conditions related to COPD, such as diabetes, heart disease, or anxiety, or if your condition stems from an event that also caused long-term injuries that limit your ability to work.
Submitting a complete and detailed application with all the necessary records can help prevent delays, as the approval process can take several months or longer.
What evidence can help your claim?
To build a strong case to support your COPD disability application, you can start by reviewing the SSA’s specific criteria and directly linking your symptoms to the requirements listed in the Blue Book. Then you’ll want to gather extensive evidence showing your symptoms meet the SSA’s criteria.
Medical evidence can include:
- Medical history reports
- Clinical findings (such as the results of physical or mental status exams)
- Lab results or test results
- Imaging (such as CT scans, x-rays, and MRIs)
- Emergency room visit summaries
- Diagnosis
- Treatment prescribed based on response and prognosis
- A statement from a medical professional on what work activities they believe you are capable of doing despite your condition
- Any treatment information
- Info about your daily activities and capabilities
Submitting thorough medical evidence to support your diagnosis and keeping a personal log detailing how your symptoms impact your daily life and ability to work can also help support your claim. These details add valuable context and make your claim more compelling.
How long does it take to get a disability decision?
When considering how long a disability claim can take, it’s important to keep in mind that there is no one-size-fits-all answer.
The time it takes to get a disability decision depends on several factors, like whether the SSA needs more information to process your claim. On average, the wait for an initial SSDI decision is about 6.3 months, or roughly 193 days.
According to the SSA’s 2023 Annual Report, about 20% of applications were approved at this stage, meaning nearly three out of four claims were denied.
Don’t get discouraged if you’re denied. You can appeal, but be aware that the appeals process can add another six months or more to your wait.
How do I appeal a decision if I was denied?
If your SSDI application is denied, you have the right to appeal the decision. According to the SSA, approximately 80% of SSDI claims are rejected at the initial level, often due to insufficient medical evidence, limited work history, or other technical issues. Because the appeals process can take time, it’s important to act quickly – you only have 60 days to file your appeal.
While appealing a denial is always worthwhile, it doesn’t guarantee approval, as many applicants are denied even after multiple appeals. However, working with an experienced disability lawyer can help strengthen your case and improve your chances of success.
How Woods & Woods can help
Having a disability shouldn’t mean losing your peace of mind. At Woods & Woods, we help individuals with disabilities connect with legal help. If you’re seeking SSDI benefits, call us today for a free case evaluation.
Don’t face Social Security alone.
Frequently asked questions
Yes, the Social Security Administration considers COPD a disability if your symptoms or treatment prevent you from working or handling daily activities.
The time it takes to receive an initial decision can vary depending on many different factors; however, the average wait for an initial SSDI decision is about 6.3 months, or roughly 193 days.
Lori Underwood
Lori Underwood received her law degree from Northern Kentucky University. She previously practiced Social Security disability and personal injury law and was a juvenile court attorney.
She has been an attorney at
Woods & Woods since 2014.
