Can Asthma Qualify for Social Security Disability?

Yes, asthma can qualify you for Social Security Disability benefits if it is severe enough to prevent you from performing substantial gainful activity (SGA), which typically means the ability to earn over a certain income level. To qualify for SSDI (Social Security Disability Insurance) or SSI (Supplemental Security Income), you must demonstrate that your asthma is disabling and has lasted or is expected to last for at least 12 months or result in death.

The SSA evaluates asthma based on its severity, how well it’s controlled with medication, and how much it limits your ability to function.

SSA’s Criteria for Asthma

The SSA has specific guidelines for respiratory conditions, including asthma, in its Listing of Impairments. Asthma is evaluated under Listing 3.03 – Asthma (Chronic Obstructive Pulmonary Disease or COPD). To meet the SSA’s criteria for asthma, you must show the following:

Frequent Asthma Attacks
The SSA considers the frequency and severity of your asthma attacks. To qualify under this listing, you need to show that you experience severe asthma attacks at least once every two months (or at least six times a year). These attacks should require intensive medical treatment, such as emergency room visits, hospitalizations, or the use of medications that aren’t enough to control your symptoms.

Difficulty Breathing Despite Treatment
If your asthma attacks are frequent and severe, but not necessarily requiring hospitalization or emergency treatment, you may still qualify if you can show that your condition severely limits your ability to breathe. The SSA looks for:

• Low forced expiratory volume (FEV1), which measures how much air you can exhale in one second.
• Low peak flow readings: A test that measures how fast you can exhale air.

If these lung function tests show significant limitations, the SSA may consider you disabled, even if you don’t have frequent hospital visits.

Restrictions in Daily Activities
You will also need to show that your asthma significantly limits your ability to perform basic work activities. This could include issues like:

• Difficulty walking or standing for long periods of time.
• Inability to carry out normal activities due to shortness of breath or fatigue.
• Need for rest breaks frequently throughout the day.

How the SSA Evaluates Asthma Beyond the Listings

If your asthma doesn’t meet the SSA’s exact criteria under Listing 3.03, you may still be able to qualify for Social Security Disability benefits based on the residual functional capacity (RFC) evaluation. The SSA uses your RFC to determine how much work you can still do despite your asthma. If your asthma prevents you from doing your job or any other job, you could be eligible for benefits.

In determining your RFC, the SSA will consider:

• The severity of your symptoms: How often do you have attacks? How severe are they?
• Your treatment history: Have you followed prescribed treatments, and have they been effective?
• The impact of asthma on your daily life and ability to work: How often do you miss work or are unable to perform basic tasks due to asthma symptoms?

Gathering Medical Evidence for Your Asthma Claim

The key to qualifying for Social Security Disability benefits with asthma is providing strong medical evidence. This includes:

• Medical records showing a history of asthma and any hospitalizations, emergency visits, or doctor visits for asthma attacks.
• Pulmonary function tests: These may include spirometry, FEV1, and peak flow readings that measure how well your lungs are functioning.
• Doctor’s opinions: Your treating physician should provide a letter describing how asthma impacts your ability to work and engage in daily activities. A detailed letter about your limitations can be very helpful in making your case.

The Application Process for SSDI with Asthma

To apply for Social Security Disability benefits due to asthma, you need to follow these steps:

• Determine Which Program You Qualify For
  If you have worked and paid into Social Security, you may qualify for SSDI. If you have limited income and resources, you may qualify for SSI. The eligibility requirements for each program are different, so make sure you understand which program is right for you.
• Complete the Application
  You can apply for SSDI or SSI benefits online at www.ssa.gov, by phone at 1-800-772-1213, or in person at your local Social Security office. Be sure to provide complete and accurate information, including medical records and details about your work history.
• Submit Supporting Medical Evidence
  Include your doctor’s notes, test results, and any other relevant documentation to show that your asthma is severe and prevents you from working. The more detailed your medical evidence, the stronger your claim will be.
• Follow Up
  After submitting your application, stay on top of any requests for additional information from the SSA. You can track your claim online through your SSA online account or call the SSA at 1-800-772-1213 for updates.

What Happens If Your SSDI or SSI Claim is Denied?

It’s not uncommon for SSDI claims to be denied on the first attempt, even if you have a valid case. If your claim is denied, you have the right to appeal the decision. The appeals process includes:

• Request for Reconsideration: If your claim is denied, you can request a reconsideration, where a different examiner will review your case.
• Hearing Before an Administrative Law Judge (ALJ): If reconsideration is denied, you can request a hearing where you can present your case in person before an ALJ.
• Further Appeals: If the ALJ denies your claim, you can appeal to the SSA’s Appeals Council or take your case to federal court.