COPD and Disability Benefits: The Pros, Cons, and Step-by-Step Guide to SSDI

This article was written by Arnelle Konde, MPH, CHES.

Severe COPD affects more than just your physical health. It can also make it harder to earn a living and pay for the care you need. If you find yourself in this position, you may qualify for federal disability benefits.

This month marks the 36th anniversary of the Americans with Disabilities Act (ADA), which became law on July 26, 1990.¹ The ADA helps protect the rights of people with physical, mental, or cognitive disabilities.¹ It gives them equal access to jobs, public accommodations, and government services.¹

While the ADA protects your rights, other federal programs can help protect your income. If you are living with severe COPD or another chronic lung disease, you may qualify for Social Security Disability Insurance (SSDI).² In honor of this important anniversary, we will break down the pros, cons, and how to apply for these benefits.

What is SSDI?

Social Security Disability Insurance (SSDI) is a federal program. It provides monthly payments and health insurance to people who cannot work because of a severe medical condition.² You may qualify if you meet these requirements:

• Medical: You have a disability or blindness that meets the Social Security Administrations (SSA) rules.^3,4
• Work History: You earned enough work credits through jobs where you paid Social Security taxes. Most people need 40 work credits, and 20 of them must be earned in the last 10 years.4 Younger workers may qualify with fewer credits.⁴

One important thing to know is that SSDI is an earned benefit. If you qualify, it is because you paid Social Security taxes while you worked.⁴

The Pros and Cons of SSDI for People With COPD

SSDI benefits can ease a lot of stress if working can make it hard to breathe. But it's important to know that the system has some challenges.

• The Pros (The Benefits):
  • Steady Income: It provides a monthly check to help cover living expenses when you can no longer earn a salary.²
  • Medicare Eligibility: Once you have received SSDI for 24 months, you become eligible for Medicare health insurance. This coverage can greatly lower the cost of expensive daily COPD medicines and oxygen treatments.^2,6
  • Family Benefits: Family members of people who receive SSDI, such as children under 18 or spouses age 62 and older, may also qualify for benefits. This can provide extra financial support.⁴
• The Cons (The Challenges):
  • Strict Income Limits: You cannot earn a lot of other substantial income while receiving SSDI benefits.⁵
  • The Waiting Game: It takes months—sometimes over a year—to get approved for SSDI benefits. Once you're approved, there is a mandatory 5-month waiting period before payments begin.⁶
  • High Denial Rates: Most (an estimated 67%) first-time SSDI applications are denied, requiring a lengthy appeals process.^6,7

How the Social Security Administration (SSA) Evaluates COPD

When applying for disability benefits, you must provide the SSA with medical proof that your COPD makes it impossible for you to work.

The SSA uses a guide called the Blue Book. It lists medical conditions that may qualify for disability benefits.⁸ COPD is listed under Section 3.02, which covers chronic respiratory disorders.8 To qualify based on COPD, doctors look at lung function testing data.⁸ These tests include:

• Spirometry: This test measures how easily you can move air in and out of your lungs.⁸
• Diffusing capacity of the lungs for carbon monoxide (DLCO) Test: This measures how well your lungs transfer oxygen from the air into your blood.^8,9
• ABG (Arterial Blood Gas) or Pulse Oximetry: These tests measure the oxygen levels in your blood.^8,9

If your numbers don't perfectly match the Blue Book requirements, you can still qualify another way. The SSA will look at your Residual Functional Capacity (RFC).⁸ This evaluates what you can still do at work with your medical condition.^8,9 If you can prove your breathlessness and fatigue are so severe that they prevent you from working, you can still be approved.

How to Apply for SSDI Benefits

• Step 1: Check Your Eligibility. Visit the SSA website to verify you have enough work credits to qualify and that you meet the basic eligibility requirements.
• Step 2: Gather Your Medical Evidence. Collect everything: pulmonary function test (PFT) results, oxygen prescriptions, hospitalization records, and a detailed letter from your doctor outlining your physical limitations.⁸
• Step 3: Apply Online or In Person. Fill out the forms honestly and accurately. Describe how your condition affects your daily life, including on your more difficult days.
• Step 4: The Initial Decision. Wait for the Disability Determination Services to review your file. Note that this typically takes up to 7 to 8 months.⁸
• Step 5: Appeal (If Denied). If you are denied on the first try, you have 60 days to ask for a reconsideration, where a new reviewer looks at your file. If that is also denied you can request a hearing before an Administrative Law Judge.^10,11 While approval is never guaranteed, many people have a better chance of getting approved during the appeals process.^10,11

Living with severe COPD is hard, but you do not have to handle the costs alone. The Americans with Disabilities Act reminds us that you have a legal right to seek the financial help and health care support you deserve.¹

Take the first step today. Talk to your doctor or care team about gathering your medical records. You can also visit SSA.gov to create an account, check your work credits, and start your application.