COPD and Long Term Disability

COPD and Long Term Disability

Chronic obstructive pulmonary disease, often called COPD for short, is a general term for several lung diseases, including chronic bronchitis and emphysema. These diseases are typically evidenced by obstructed airflow through the airways in and out of the lungs. Chronic bronchitis and emphysema cause excessive inflammatory processes leading to abnormalities in lung structure and limited airflow. Both medical conditions are progressive in nature and worsen over time.

Cigarette smoking is the primary cause of COPD. A small number of COPD sufferers have alpha-1-antitrypsin (AAT) deficiency, also called familial emphysema. Air pollution and occupational fumes, dusts and other allergens may also contribute to COPD, especially if the individual exposed to these substances is a smoker. Adults with asthma are also as much as 12 times more likely to develop COPD than those who do not have the condition.

COPD symptoms include gasping, wheezing, shortness of breath, and coughing. In addition, COPD makes the heart work harder and can cause pulmonary heart disease, or cor pulmonale. Treatment for COPD includes oxygen therapy, pulmonary rehabilitation, and various medications and inhalers such as Advair.

Qualifying for Long Term Disability Benefits for COPD

You may qualify for Long Term Disability benefits if you are able to prove that your COPD reduces your capacity to breathe and exert yourself so much that you can no longer work at any type of job.

Evidence to Support Disability for COPD

To qualify for long term disability benefits, you should produce evidence such as a lung function test performed by a consulting doctor to show very limited airflow. Specifically, a spirometry test documenting your FEV1 value (your forced expiratory volume in one second, meaning the amount of air you can exhale in one second) should show significant limitations.

Alternatively, if you do not have a problem with air flowing in or out of your lungs (in other words, your FEV1 value is too high), but your lungs still have a problem oxygenating your blood, you may qualify for benefits with a poor DLCO (diffusing capacity of the lung for carbon monoxide) score or ABG (arterial blood gas values of oxygen and carbon dioxide) test score. A sample low DLCO score is one that is less than 10.5 ml/min/mm Hg or less than 40% of the predicted normal value for your race. Or, your ABG test values may be low (at rest or exercising).

Reduced Capacity for Work

You may qualify for long term disability benefits if you can show that your COPD has reduced your breathing capacity to such an extent that you cannot hold down a job. To show that your breathing capacity and ability to exert yourself are so low that you cannot work, you should ask your doctor to provide a medical opinion on what kinds of activities you can and cannot do (such as lifting no more than 10 pounds, walking no more than one-half hour at a time, and no exposure to dust or fumes).

The insurance company will give you an Attending Physician’s Statement (APS), also called a residual functional capacity (RFC) assessment, stating the type of work you can do (sedentary work, light work, medium work, or heavy work) based on your breathing test results and your doctors’ restrictions.

Having Multiple Medical Problems

The vast majority of patients with COPD have other serious medical problems as well. For example, many people with COPD suffer from coronary artery disease, high blood pressure, diabetes, and obesity, as well as suffering from mental issues such as depression. When you have multiple medical conditions that limit your ability to work, you have a better chance of qualifying for benefits.