Asthma is a medical condition that affects the airways in the lungs, which carry air in and out of the lungs. With asthma, the airways become inflamed and narrowed, making it harder to breathe. Asthma can cause episodes of wheezing, breathlessness, chest tightness, and coughing.
Asthma symptoms can vary from mild to severe and may occur frequently or infrequently. Mild symptoms may only last a few minutes, while more severe asthma symptoms can last hours or days. Common signs and symptoms of asthma range from chest tightness or pain to shortness of breath to wheezing to coughing.
Asthma can significantly affect a person’s quality of life, limiting physical activities. Severe asthma can lead to sleep disturbances, missed work, and frequent visits to the hospital.
Is Asthma a Disability?
Asthma can be classified as a disability under certain legal frameworks, such as the Americans with Disabilities Act (ADA) if it significantly hinders major life activities. Your asthma may also qualify as a disability under the Social Security Disability (SSD) program if it is severe and chronic, and cannot be controlled by medication.
The severity of asthma and the frequency of attacks play a major role in its classification as a disability. Chronic and severe asthma that requires frequent hospitalization may be more likely to be considered a disability under the Social Security Administration’s (SSA) definitions of disability.
Can People with Asthma Qualify for Social Security Disability Insurance (SSDI)?
The Social Security Administration defines disability as an inability to work due to a medically determinable physical or mental impairment that is either expected to result in death or has lasted or is expected to last for at least 12 months. The process to determine if you are disabled involves five questions:
1. Are you working?
If you are working at substantial gainful activity levels, generally, you will not be considered to be disabled. Substantial gainful activity (SGA) is a level of work activity and earnings. A person who is earning more than a certain monthly amount is working at substantial gainful activity levels. In 2023, for a non-blind individual, the monthly SGA amount is $1,470.
If you have been diagnosed with asthma but continue to do work at substantial gainful activity levels, you may not be eligible for disability benefits.
2. Is your condition severe?
Your condition is severe if it significantly limits your ability to do basic work activities. Basic work activities include activities such as walking, sitting, seeing, and remembering.
If your asthma impacts your ability to stand, walk, or do other basic work activities, the Social Security Administration will go on to the next step of the disability determination.
3. Is your condition on the list of disabling impairments?
The SSA has a list of impairments for each of the major body systems. These listed impairments are so severe that they automatically meet the definition of disability. If the condition is not on the list, the SSA will decide if it is of equal severity of an impairment on the list. If it is, the claim will be approved.
Being diagnosed with a listed condition does not automatically equate to a finding of disability. The SSA’s listed impairments define the detailed symptoms, test results, or other data that show the conditions severe enough to be disabling.
Asthma and other chronic respiratory disorders are listed in SSA’s listings of impairments. The definition of asthma is as follows:
3.03 Asthma. with both A and B:
- A. FEV1 less than or equal to the value in Table VI-A or VI-B for your age, gender, and height without shoes measured within the same 12-month period as the hospitalizations in 3.03B.
Table VI: FEV1 Criteria for 3.03A
Height |
Height < means | Table VI-A | Table VI-B | ||
Age 18 | Age 20 | ||||
Females | Males | Females | Males | ||
<153.0 | <60.25 | 1.65 | 1.90 | 1.45 | 1.60 |
153.0 to <159.0 | 60.25 to <62.50 | 1.75 | 2.05 | 1.55 | 1.75 |
159.0 to <164.0 | 62.50 to <64.50 | 1.85 | 2.15 | 1.65 | 1.90 |
164.0 to <169.0 | 64.50 to <66.50 | 1.95 | 2.30 | 1.75 | 2.00 |
169.0 to <174.0 | 66.50 to <68.50 | 2.05 | 2.45 | 1.85 | 2.15 |
174.0 to <180.0 | 68.50 to <70.75 | 2.20 | 2.60 | 2.00 | 2.30 |
180.0 to <185.0 | 70.75 to <72.75 | 2.35 | 2.75 | 2.10 | 2.45 |
185.0 or more | 72.75 or more | 2.40 | 2.85 | 2.20 | 2.55 |
AND
- B. Exacerbations or complications requiring three hospitalizations within a 12-month period and at least 30 days apart (the 12-month period must occur within the period we are considering in connection with your application or continuing disability review). Each hospitalization must last at least 48 hours, including hours in a hospital emergency department immediately before the hospitalization. Consider under a disability for 1 year from the discharge date of the last hospitalization; after that, evaluate the residual impairment(s) under 3.03 or another appropriate listing.
If your asthma condition meets the defined values and has resulted in the required number of hospitalizations under the SSA’s definitions, your condition meets the definition of a listed impairment and you will be found disabled. If your impairments do not meet or equal a listed impairment, the Social Security Administration will go on to the next step of the disability determination.
4. Can you perform your past relevant work?
If your impairment does not meet or equal the listing of impairment, the Social Security Administration will determine your residual functional capacity. The residual functional capacity assessment is a determination of the maximum ability to do sustained work activity on a regular and continuous basis despite the limitations and restrictions of the claimant’s medical impairments. If you have been diagnosed with asthma or another serious respiratory condition and the SSA considers it to be a severe impairment, the residual functional capacity assessment is an accounting of your abilities, despite the limitations and restrictions that stem from a severe asthma case.
At step four of the sequential evaluation, after taking into consideration your residual functional capacity assessment, the SSA will determine if you can perform your past relevant work. Your past relevant work is work performed at the substantial gainful activity level in the last 15 years.
If your asthma prevents you from performing your past work or you have no relevant past work, the SSA will go on to the next step of the disability determination.
5. Can you do any other type of work?
At step five of the sequential evaluation, the Social Security Administration will determine if there is any other work that exists that the claimant can perform. When considering if the claimant can perform any other work, the adjudicator will consider the limiting effects of asthma as well as the claimant’s age, education, and work experience.
To be found disabled, your asthma has to be severe enough to prevent you from performing your past work or transferring your skills to any other full-time work.
Applying for SSDI with Asthma
Before you apply for SSDI benefits, gather the necessary information and documentation. The SSDI application requires information and your past work history and information about the medical treatment you receive for your condition. Here is a brief overview of the information and documents needed:
- Personal information: You’ll need your Social Security number, contact information, and information about your family members, including your spouse and children.
- Medical information: Include records and test results related to your asthma diagnosis, treatments, and medications. Also include details of all medical professionals who have treated you since your disability began.
- Work history: Provide detailed information about the work you’ve done over the last 15 years.
Tips for Strengthening Your Application
Following these tips can help ensure that your claim gets approved by the SSA:
- Respond to requests from the SSA. Throughout this process, the SSA will send out forms or questionnaires for you to complete. Some forms only require your signature. Other questionnaires require that you answer questions about your prior work history or your disability. Please make sure that you respond to all requests from the SSA promptly. If you have any questions about the correspondence that you receive, please reach out to our office and our representatives will help you complete these forms.
- Provide proof of disability. If your asthma significantly limits your activities of daily living, it is important to visit a doctor. The doctor will likely perform a physical exam and order a series of tests. These tests can measure lung function to assess the seriousness of your condition. These objective tests provide supportive evidence of your disability.
- Be a compliant patient. Do everything that you can to follow your doctor’s recommendations. The support of your doctor is invaluable during the disability application and appeals process. The SSA often reviews claims to evaluate whether an individual is doing everything reasonably possible to improve their health problem, so it is important that you follow your doctor’s orders and treatment recommendations.
- Include a Residual Functional Capacity (RFC) assessment. The opinion from a treating provider can help to strengthen your case. This form completed by your doctor can provide evidence of your limitations and inability to work.
- Seek legal assistance. An attorney experienced in SSDI applications can help ensure your application is as strong as possible.
