Getting Disability for Pneumonia or Other Lung Infections

Lung infections, such as pneumonia, have a number of causes. Viruses, bacteria, or fungi can irritate the lungs, making them inflamed. Related medical conditions like cystic fibrosis and bronchiectasis are often comorbid (occurring at the same time) with lung infections.

Symptoms of lung infections—like chest pain, fever, shortness of breath, weight loss, and fatigue—can make it really difficult to work. If you have a chronic lung infection that has kept you from working full-time for at least 12 months, you may qualify for benefits from the Social Security Administration (SSA).

Can You Get Disability for Pneumonia?

Pneumonia and other lung infections that go away in a few weeks or months won't qualify for Social Security disability benefits. One of the basic requirements for disability is that your medical condition must prevent you from doing a substantial amount of work—earning about $1,600 or more per month—for at least a year. Because even severe lung infections can usually be treated effectively within a few months' time, it can be difficult to meet this one-year requirement.

If you do have medical records showing that you have a chronic lung infection that's lasted (or is expected to last) for at least one year and prevents you from engaging in "substantial gainful activity," you could be eligible to receive Social Security disability benefits. You'll need to establish that you either meet the requirements of a respiratory disorder listing in the Blue Book, or that your functional limitations rule out all work.

How Do You Meet a Disability Listing for Pneumonia?

The Blue Book is a category of medical conditions that the SSA considers especially severe. You can qualify for disability automatically if you have medical evidence that your lung infection meets the requirements of a "listed impairment" (or simply "a listing").

If you have difficulty breathing and severely limited airflow, you might qualify under listing 3.02 for chronic respiratory disorders. Pneumonia and tuberculosis are examples of lung infections that the SSA can evaluate for automatic approval.

To meet listing 3.02, you'll need to have spirometry results. A spirometry test measures how much air you inhale and exhale and at what rate you breathe. The results of the test will show the SSA how badly your lungs have been damaged by the infection. You can find more detailed information on which spirometry results meet the listing requirements in our article on chronic pulmonary disease.

Can You Get Disability for Pneumonia If You Don't Meet a Listing?

You can still get benefits even if you don't meet a disability listing—for example, your spirometry results aren't quite low enough—if Social Security finds that your lung functioning is so poor that it prevents you from doing not only your past work, but all other less demanding jobs. To determine what types of jobs you can and can't do, the agency will assess your residual functional capacity (RFC).

What's Your RFC?

Your RFC is a set of limitations that reflects the most you can do in a work environment on a regular and sustained basis. Social Security reviews your medical records and daily activities to determine how your condition affects your ability to perform job tasks.

Some limitations may be physical, such as restrictions on how long you can sit, stand, and walk, or how much weight you can lift and carry. These strength-related limitations will determine the exertional level of jobs you can do. Other limitations can be non-exertional, such as whether you need to avoid dusty workplaces or must take additional breaks throughout the day to use an inhaler. The more severe your symptoms are, the more limitations you'll have in your RFC.

How Does Social Security Use Your RFC?

Social Security compares the restrictions in your current RFC with the job demands of your past work to see if you could still do those jobs today. If you can't, the agency will determine whether other jobs exist that you could perform, given your RFC, age, education, and skills. Here are some examples of how Social Security determines whether you can work.

Applicants 50 years of age or older may qualify for benefits under the "medical-vocational grid rules"—as in the above example—while applicants younger than 50 generally need to be able to show that they can't do any sit-down jobs in order to get disability.

Showing that you can't do sit-down jobs can be challenging. Social Security has to consider the combined effects of all your impairments in your RFC, however, so if you have additional limitations from another medical condition, make sure the agency includes them in your RFC. Being unable to sustain a constant work pace or manipulate small objects are common RFC restrictions that can rule out most jobs, even sit-down jobs.

Does Pneumonia Have a VA Disability Rating?

Veterans may qualify for disability benefits from the VA if they have a "service-connected" respiratory disorder. Unlike the SSA—where you're either disabled or you aren't—the VA assigns disability percentage ratings based on how severe your symptoms are. The percentage ratings determine the monthly amount of VA disability compensation you can receive.

The VA uses the Schedule for Rating Disabilities (38 CFR Book C) to assign a percentage rating to your condition. Respiratory disorders are evaluated under Section 4.97. While pneumonia isn't one of the diagnoses available for a rating, related impairments like chronic bronchitis and mucormycosis (a fungal infection) can be assigned disability ratings of up to 100%.

How to Apply for Disability Benefits

The SSA has several methods for you to start your disability application:

• File online through Social Security's website.
• Call 800-772-1213 (if you're deaf or hard of hearing, the TTY number is 800-325-0778) between 8 a.m. and 7 p.m., Monday through Friday, to speak with a representative.
• Go in person to your local Social Security field office.

Once you file for benefits, a representative or claims examiner will make sure that you're legally eligible to receive benefits from one of the disability programs administered by Social Security.

• Social Security Disability Insurance (SSDI) is available to people with qualifying work histories based on their payroll or self-employment taxes.
• Supplemental Security Income (SSI) is a needs-based benefit available to people below a certain income and asset threshold.

If you want to apply for VA benefits, you'll need to submit Form 21-526EZ, Application for Disability Compensation and Related Compensation Benefits, to your regional VA office. You can also submit this form online at the VA's website. For more information, see our article on filing for VA disability benefits.