Cystic fibrosis (CF) is a life-threatening disorder that causes normally thin and slippery fluids like sweat, mucus, and digestive juices to become thicker and stickier. The fluid then build up in important areas of your body such as your digestive tract and – quite commonly – the lungs. Too much buildup and you won’t be able to breathe.
CF is a disabling condition that necessitates daily care and makes it a lot harder to do things that most of us take for granted, such as going to school or work.
The vast majority of people diagnosed with cystic fibrosis today now live into their 20’s or 30’s, and some even live to their 40’s or 50’s. It is serious enough that the SSA offers disability benefits for those who qualify under the Social Security Disability Insurance program.
So how do you go about qualifying? Use one of two methods:
Meet the criteria. In order to make the disability benefit application process go more smoothly, the SSA has put together a compendium of recognized conditions called the Listings of Impairments that both defines each disorder and lists specific qualifying criteria. Meet the criteria for a particular listing and you’ll automatically qualify for benefits.
Go through the Five Step Process. Not everyone can meet the specific criteria, but that doesn’t necessarily mean you can’t receive benefits. The SSA understands this, so they have created a secondary method by which you can qualify – prove that your medical condition is equivalent to a different issue they have already recognized.
First, let’s look at meeting the criteria in the listing for cystic fibrosis.
Disability Benefit Criteria for Cystic Fibrosis SSA Listing 3.04
Simply having cystic fibrosis isn’t enough to earn you benefits. You also have to meet one of the following requirements:
You have an FEV1 (a measure of the volume of air you are able to push out of your lungs in one second) is less than or equal to a value specified in the SSA’s tables for your age, gender, and height without shoes.
OR
You experience Incidents or complications involving three hospitalizations of any length within one year and at least 30 days apart.
OR
You experience spontaneous pneumothorax, secondary to CF, requiring chest tube placement.
OR
You have respiratory failure treated with invasive mechanical ventilation, noninvasive ventilation with BiPAP, or a combination of both treatments – lasting for at least 48 hours, or for at least 72 hours if postoperatively – and,
You suffer pulmonary hemorrhage requiring vascular embolization to control bleeding.
OR
Your SpO2 (peripheral capillary oxygen saturation) measures less than or equal to the value set forth in SSA’s table twice within a year and at least 30 days apart.
OR
You experience two of the following episodes or complications within one year:
- Irritation / complications requiring 10 continuous days of IV antibiotic treatment.
- Pulmonary hemorrhage (hemoptysis with more than blood-streaked sputum but not requiring vascular embolization) requiring hospitalization of any length.
- Weight loss requiring daily supplemental enteral nutrition via feeding tube for at least 90 consecutive days – or – parenteral (IV) nutrition via a central venous catheter for at least 90 consecutive days.
- Cystic fibrosis–related diabetes (CFRD) needing daily insulin therapy for at least 90 consecutive days.
Accepted SSA tests that can benefit your case include:
- Arterial Blood Gas Study (Resting)
- Chest X-Ray
- Polymerase Chain Reaction
- Sputum Collection
- Bronchoscopy
- Spirometry
- Computerized Tomographic Scanning of the Chest
- Pulse Oximetry
- Sweat Chloride Test
A positive result on any of these tests can serve as great support to your claim.
For a free legal consultation, call 800-562-9830
If you cannot meet SSA’s listing for cystic fibrosis? Prove equivalency!
As mentioned above, not everyone who ultimately receives benefits is able to meet the criteria for their specific disability in the Listings of Impairments. They need to prove their issue is equivalent to a listed impairment by using the Five Step Sequential Evaluation Process.
Because arguing equivalency is not as straightforward as matching a listing, you’re going to want to work with a social security disability attorney that you trust. Ultimately, your goal will be to prove that your medical condition has prevented you from being able to work for 12 months or more. Do this, and you’ll receive the benefits that you need.
Questions?
Learn even more about the claims process by reading our Social Security Disability eBook for free or call us today at (800) 562-9830 to schedule a free consultation.
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