Get Social Security Disability & SSI: Pulmonary Fibrosis

Winning Your Case

With pulmonary fibrosis or pneumoconiosis, Social Security will render a favorable ruling for either you or your child if you meet the following two regulations:

1. Non-Medical Criteria, and
2. Disability Criteria.

Regarding the disability criteria, you should understand –

1. How Social Security evaluates pulmonary fibrosis (reviewed on this page),
2. You satisfy Social Security Listing related to pulmonary fibrosis (also reviewed on this page) or you have disabling Functional Limitations, and
3. You Submit Winning Evidence.

When Social Security Examines Your Pulmonary Fibrosis Medical Evidence

You can be victorious in a Social Security and SSI disability case with pulmonary fibrosis or pneumoconiosis which is a severe lung disease where the air sacs (alveoli) of the lungs become irreversibly scarred. The most common causes include exposure to toxins, other medication conditions, or radiation therapy. Common symptoms of pulmonary fibrosis include the following:

1. Breathing dysfunction,
2. Fatigue,
3. Chest pain,
4. Dizziness,
5. Coughing,
6. Illness, and
7. Weight loss.

Whether you are disabled according to Social Security’s rules is largely dependent on your medical care. It is important you are diagnosed and treated by a pulmonologist. A diagnosis is made by one of the following:

1. Lung testing;
   1. Spirometry/pulmonary function test,
   2. Pulse oximetry,
   3. Arterial blood gas test,
   4. Diffusing capacity (DLCO) test,
2. CT lung scan;
3. X-ray;
4. Exercise stress test;
5. Echocardiogram; and
6. Blood tests or a biopsy may be performed.

Whatever medical treatment you receive, Social Security will want to review it. Treatment for pulmonary fibrosis usually includes the following:

1. Antibiotics;
2. Medications (bronchodilators and steriods);
3. Airway therapy – inhalers, nebulizers, supplemental oxygen (oxygen tank), and in severe cases, a mechanical ventilator; and
4. Surgeries are rare and include the removal of damaged lung tissue and lung transplants.

Most Important Evidence Tip. The most important piece of evidence in your Social Security and SSI disability case with pulmonary fibrosis is a spirometry/pulmonary function test. Social Security generally equates disability with spirometry testing scores close to, or at, the listing level. The second most important piece of evidence is whether you are using some type of airway therapy. Social Security generally finds that such treatment is an indication of a severe condition.

Pulmonary Fibrosis Social Security & SSI Listing

The Adult Listing 3.02 is satisfied in one of four ways – an adult undergoes pulmonary testing showing severely diminished 1) FEV, 2) FVC, or 3) gas exchange scores, or 4) an adult suffers ongoing pulmonary complications causing multiple medical center admissions. The Child Listing 103.02 is satisfied in one of five ways – a child undergoes pulmonary testing showing severely diminished 1) FEV, or 2) FVC scores; 3) hypoxemia with oxygen use; 4) a tracheostomy; or 5) for a child younger than age two, CLD (lung scarring) necessitating multiple medical center admissions.

If your pulmonary fibrosis results in respiratory failure, you will satisfy Adult Listing 3.14 if you are prescribed mechanical ventilation or noninvasive ventilation with a BiPAP.

If your pulmonary fibrosis results in lung transplantation, Adult Listing 3.11 is met for three years after which Social Security will reassess you to determine if your disability continues.

TERI: Terminal Disease Case

Social Security can deem a severe pulmonary fibrosis or pneumoconiosis disability claim as a compassionate allowance claim and a TERI claim. In either case, this means Social Security will speed up the case for a determination – Expedited Cases.