Why this listing matters
Bronchiectasis—permanent dilation and scarring of the bronchi—produces chronic infection, copious sputum, and repeated “tune-up” admissions for IV antibiotics or airway clearance. Social Security grants an automatic Step-3 allowance when those flare-ups become so frequent or so severe that they mirror cystic-fibrosis-level disability. Practitioners who can document the required pattern of hospitalizations—or the tell-tale CT evidence paired with low lung-function numbers—can win without ever reaching a vocational step.
Regulatory text
“3.07 Bronchiectasis (including non-cystic fibrosis bronchiectasis) — With either:
- Imaging evidence of bronchiectasis (e.g., CT scan) and sputum production or expectoration persisting for at least one year, documented at least once every 2 months, and requiring antibiotic therapy at least once every 6 months; OR
- Exacerbations or complications requiring three hospitalizations within a 12-month period, occurring at least 30 days apart, and each hospitalization lasting at least 48 hours (including emergency-department hours).”
Elements to prove
| Requirement | What meets it | Best proof sources |
|---|---|---|
| 1. Objective diagnosis | HRCT or chest CT showing cylindrical, varicose, or cystic bronchiectasis | Radiology report with images; pulmonologist summary |
| 2. Chronic, productive cough | Daily purulent sputum/hemoptysis entries ≥ 6 times / year across at least 12 months | Clinic progress notes, airway-clearance logs, patient diary, pulmonology letters |
| 3. Regular antibiotic therapy (Path A) | Oral or IV antibiotics prescribed ≥ 2 courses / year | Pharmacy fill history, hospital infusion records |
| 4. OR frequent hospitalizations (Path B) | ≥ 3 in-patient stays for pulmonary exacerbations in any 12-month window, each ≥ 48 h and ≥ 30 days apart | Admission/discharge summaries with ICD-10 J47.*, ER timestamps |
| 5. Treatment adherence | Use of nebulized saline, airway-clearance device, macrolide prophylaxis | Durable-medical-equipment invoices, refill logs, RT notes |
Practice playbook for a winning 3.07 claim
- Secure a high-resolution CT report
Radiologist must use the word “bronchiectasis.” Supply images if DDS radiology consultant balks. - Create a “sputum calendar.”
Ask claimant to keep a daily airway-clearance log; scan into ERE every quarter to demonstrate persistent production. - Print antibiotic-fill ledger
Azithromycin, levofloxacin, IV cefepime admissions—plot dates to show ≥ 2 courses per year (Path A) or to verify 3 hospitalizations (Path B). - Chart hospitalizations
One-page table: admit date, discharge date/time, diagnosis, length of stay. Remember ER hours count toward the 48-hour rule. - Submit RT & pulmonary-rehab notes
They confirm daily vest therapy, flutter valve, or nebulizer use—evidence of adherence and severity. - Collect lab cultures
Multiple Pseudomonas or MRSA isolates bolster the “severity” story even when FEV₁ not listing-level. - Address overlap with COPD or CF.
If claimant also meets 3.02 (FEV₁) or 3.04 (CF), cite both. Duplicate evidence strengthens the narrative. - RFC fallback strategy
If one hospitalization short of Path B, emphasize need for unscheduled chest-physiotherapy breaks, infection-control absences, and environmental limits—VE will have trouble finding jobs.
Pearls & pitfalls
- Document spacing. Admissions must be 30 days apart; a 10-day readmission won’t count twice—highlight gaps.
- 48-hour rule. Include nursing-triage time; attach ED printout if discharge occurs on day two.
- Proof of “persistent” sputum. DDS often argues cough resolves—counter with serial objective notes.
- Long-COVID overlap. Post-COVID bronchiectasis on CT qualifies if it meets the same sputum/antibiotic or hospitalization criteria—cite SSA’s EM-21032-Q3 on COVID sequelae.
Bottom line: Listing 3.07 rewards meticulous chronology. Pair a definitive HRCT with either (a) documented, year-long sputum plus regular antibiotics or (b) a triad of well-spaced hospitalizations, and you hand the ALJ a ready-made checklist for an immediate, step-3 win.
Under Listing 3.07, a Social Security Disability Lawyer can help compile CT imaging, treatment history, and hospitalization records to meet SSA requirements. Strong, well-documented evidence of chronic infections and repeated flare-ups is essential to support a Step 3 approval.