As anyone who suffers from cystic fibrosis knows, this hereditary disease can create debilitating side effects that make it impossible to earn a living. Cystic fibrosis causes excessive thick mucus to form in the lungs and the pancreas. This mucus leads to lung infections and breathing difficulties. In the worst cases, patients may die of acute respiratory failure or heart failure. The Social Security Administration recognizes the severity of this condition and therefore grants automatic approval of disability benefits in certain cases.
Conditions for Automatic Approval of Benefits for Cystic Fibrosis Patients
Cystic fibrosis is a disease that typically worsens with age. Adult sufferers will automatically qualify for disability benefits if they can demonstrate frequent infections or poor lung function. Showing any one of the following will lead to automatic qualification for benefits:
- Poor breathing test. Applicants for Social Security disability benefits can submit to a spirometry test in order to qualify automatically. This test measures something called FEV1, which is a reading of how much air the patient can exhale in one second. Depending on the applicant’s height, if the results show an FEV1 that ranges between 1.45 and 2.05, automatic qualification for benefits will apply.
- Pulmonary exacerbations. If an applicant suffers from recurring episodes of coughing up blood, pneumonia, bronchitis, or respiratory failure requiring medical attention, benefits will be granted automatically. To qualify, however, these episodes must occur every other month or six times during a year.
- Chronic infections. Cystic fibrosis patients who suffer from chronic lung infections involving increased bacterial infections that occur at least once every six months and require antibacterial treatment intravenously or by nebulizer may also qualify automatically for disability benefits.
Qualifying for Social Security Disability Based on Doctor’s Restrictions
When cystic fibrosis sufferers do not automatically qualify for disability benefits based on one of the three criteria set forth by the Social Security Administration, they may still qualify based on doctor’s restrictions. Applicants for disability benefits fall into this category when their respiratory infections are not as frequent as those that occur for applicants who receive automatic approval. Similarly, the lung function for these applicants has not deteriorated to 2.05 or below on a spirometry test.
To qualify based on doctor’s orders, an applicant must show that the doctor imposed one of the following restrictions:
- Frequent rest breaks
- Limits on the amount of weight that can be lifted
- Avoidance of temperature extremes
- Avoidance of dust and fumes
- Daily or weekly percussion therapy or nebulization
These restrictions must also limit the type of work the applicant can do. The Social Security Administration claims examiner handling the case will compare these restrictions to the residual functional capacity assessment to make a disability benefit determination.
Since cystic fibrosis is such a serious condition, it is crucial to seek the guidance of an experienced attorney when seeking Social Security disability benefits. Contact us today via this website for more information.
by Paul B. Burkhalter Managing Partner of Morgan & Weisbrod, Board Certified in Social Security Disability Law.