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Getting Disability Benefits for Pulmonary Fibrosis

If your pulmonary fibrosis severely affects your physical abilities, you should be able to get disability benefits.

Pulmonary fibrosis is a condition where your lungs create scar tissue (known as fibrosis) that interferes with the lungs' ability to supply oxygen. Symptoms include difficulty breathing (dyspnea), coughing, tiredness, and lack of appetite. Pulmonary fibrosis is a condition that will likely worsen over time.

Pulmonary fibrosis can occur from many different causes. If your doctor is uncertain of how your pulmonary fibrosis began, the term used is idiopathic pulmonary fibrosis. Your doctor may confirm a diagnosis of pulmonary fibrosis by ordering a chest x-ray, a computerized tomography or CT scan, or by using a spirometer (measuring your lung flow) or oximeter (measuring the amount of oxygen in your blood).

Receiving Disability Benefits for Pulmonary Fibrosis

If a doctor has diagnosed you with pulmonary fibrosis and you have been unable to work for at least one year (or you are fairly certain you won't be able to work for at least a year), you should consider applying for disability benefits through the Social Security Administration (SSA). Based on your past work history, you could apply for Social Security Disability Insurance (SSDI) and/or Supplemental Security Income (SSI) benefits.

If you have idiopathic pulmonary fibrosis (no known cause), you may be eligible for a fast-tracked decision through Social Security's compassionate allowance program.

Whether Your Pulmonary Fibrosis Meets or Equals a Disability Listing

When reviewing your medical file, the SSA will first consider whether your medical evidence meets a disability listing found in the SSA's Listing of Impairments. Pulmonary fibrosis would be considered in Section 3.00, Respiratory System. There is no separate listing for pulmonary fibrosis; instead, Social Security would consider whether your claim satisfies the requirements for such listings as 3.02 Chronic Pulmonary Insufficiency or 3.03 Asthma.

A common way to meet Listing 3.02 for pulmonary insufficiency is by presenting evidence at or below a certain value of FEV (forced expiratory volume) or FVC (forced vital capacity). You would need to undergo a spirometer test to gather an FEV or FVC value. To find the values that qualify you for disability, see our article on disability for chronic pulmonary problems.

To meet Listing 3.03 for asthma, you would need to show you had an “attack” or difficulty breathing at least six times in the last year or once every 2 months. Each attack would need to last at least one day and require serious treatment, such as a bronchodilator.

Even if you don’t quite meet the requirements of these listings, you should consider arguing to SSA that your pulmonary fibrosis “equals” a disability listing. For example, if your FEV value is a bit too high to qualify for disability through listing 3.02, you could argue that your obesity and pulmonary fibrosis considered together are equivalent to the required FEV value. Since the SSA has strict requirements in the area of respiratory listings, you should contact a disability attorney for guidance.

Consideration of Your Residual Functional Capacity

If the SSA finds that your condition does not meet or equal a disability listing (few do), the SSA will assess your residual functional capacity (RFC). Your RFC is an explanation of what type of work activities you can and cannot perform. In creating your RFC, the SSA will consider your ability to perform a variety of tasks during an eight-hour workday, including sitting, standing, walking, using your arms, bending, stooping, concentrating on tasks, and following instructions.

To be found disabled, your RFC will need to show that you are unable to perform the jobs you held in the last fifteen years and any other jobs in the national economy.

When you have severe pulmonary fibrosis, your RFC might look like the following: significant fatigue that makes you unable to stand or walk for more than two-hours in an eight-hour day, no exposure to irritants or fumes, and episodes of shortness of breath that would cause you to miss work more than two days in a month. With such an RFC, you would be found disabled.

What You Can Do to Help Your Disability Case

Since pulmonary fibrosis can affect individuals differently, it is important that you clearly describe to the SSA why you are unable to work. Quite often, when assessing your RFC, the SSA will include a limitation on your exposure to fumes and chemicals but will overlook whether your pulmonary fibrosis also affects your ability to sit, stand, walk, lift, and carry. If possible, you should submit a letter from your doctor describing the limitations you have in these functional areas, what activities cause shortness of breath, and whether you have tried medication or other treatments to help control your pulmonary fibrosis.

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