Is Asthma Considered a Disability?
Asthma is a chronic respiratory condition affecting over 25 million Americans. It causes swelling and narrowing of the airways, leading to coughing, wheezing, tightness in the chest, and difficulty breathing.
For most people, asthma is manageable with proper treatment and avoidance of triggers. But for some, asthma symptoms and attacks disrupt daily life and work. This leads many to wonder - is asthma considered a disability?
While asthma alone may not necessarily constitute a disability, severe and poorly controlled asthma can potentially qualify you for Social Security disability benefits and legal protections against discrimination under certain circumstances.
What Constitutes a Disability?
For asthma to be considered disabling, it must meet the criteria for disability set forth by the Social Security Administration (SSA) and the Americans with Disabilities Act (ADA).
The SSA defines disability as a physical or mental condition severe enough to prevent someone from engaging in "substantial gainful activity" for at least 12 months. Substantial work is defined as earning over a certain monthly amount set by the SSA.
Meanwhile, the ADA considers a disability a physical or mental impairment that substantially limits one or more major life activities, such as breathing, walking, seeing, hearing, or working.
So for asthma to qualify as a disability, it must severely restrict your ability to work and earn an income or limit major bodily functions and life activities.
Factors That Determine Disability
The SSA and ADA look at several factors when evaluating if a health condition constitutes a disability. For asthma, they consider:
Severity of Symptoms
How severe are your asthma symptoms? Do you suffer frequent asthma attacks and breathing problems despite treatment?
Frequency of Exacerbations
How often do your asthma flares or attacks occur that require oral steroids, ER visits or hospitalizations?
Response to Treatment
How well is your asthma controlled by medications and avoidance of triggers? Are you still quite symptomatic despite following treatment plans?
Impact on Work and Daily Living
How much does asthma limit your capacity to work and engage in normal daily activities? Do you require many sick days?
Pulmonary Function Test Results
Pulmonary function tests measure how much air you can exhale. Results under a certain percentage often indicate severe respiratory impairment.
If your asthma is poorly controlled and severely restricting despite adherent treatment efforts, it may qualify you for Social Security disability benefits.
Types of Disability Benefits for Asthma
If your asthma meets disability criteria, you may qualify for two types of Social Security benefits:
SSDI - Social Security Disability Insurance
SSDI provides income replacement for those with a severe disability who have worked for years and paid Social Security taxes through their paycheck. Your work history determines your benefit amount. SSDI also covers certain family members.
SSI - Supplemental Security Income
SSI offers income support for disabled adults and children with limited work histories and income/resources. It has strict financial criteria to qualify. SSI also requires U.S. citizenship or lawful alien status.
In addition, those on disability for asthma may qualify for publicly provided medical insurance under Medicare (for SSDI) or Medicaid (for SSI).
Asthma and Anti-Discrimination Laws
Beyond Social Security benefits, having asthma designated as a disability also protects you from discrimination under the Americans with Disabilities Act (ADA) and other laws.
This means employers, government agencies, schools, housing authorities, and other organizations must provide reasonable accommodations to allow you equal participation. Accommodations may include:
- Permitting work from home options
- Providing breaks to take breathing treatments
- Making sure work/housing environments are asthma trigger free
- Allowing time off for medical care
- Supplying air filtration devices
- Allowing students to carry inhalers
Having your asthma documented as a disability enables you to request the adaptations needed to manage it while going about normal life activities.
Qualifying as an Asthma Disability with Social Security
To have your asthma deemed a disability by the SSA, detailed medical documentation is required. Your doctor must provide records substantiating:
- Objective lung function test results confirming poor airflow/respiratory impairment
- The frequency and severity of your asthma attacks and exacerbations
- A list of all asthma medications you take, including oral steroids
- The type and frequency of treatments needed
- All specialist referrals and hospitalizations
- Opinions on how asthma impairs basic work and activities
In addition, you will be asked to describe how asthma affects your capacity to function and work during disability application forms and interviews.
The SSA will combine your reported symptoms, your doctor’s notes, and the medical evidence to assess if your asthma meets the threshold to be considered disabling.
Can Children Qualify for Asthma Disability Benefits?
Yes, children can qualify for Social Security disability benefits due to severe asthma. SSI disability benefits are available to disabled children under 18 with limited incomes and resources.
To qualify, a child’s asthma must cause “marked and severe functional limitations” that are expected to persist for at least 12 months or result in death. This means it must severely restrict age-appropriate play, school, and daily activities.
The disability determination process for children involves specialized pediatric assessments. Parents must provide school records, hospitalizations, medical testing, and detailed examples of how asthma limits their child’s functioning.
How to Apply for Disability Benefits for Asthma
If you believe your asthma may qualify for disability benefits, follow these steps:
Review Program Criteria
Confirm you meet the non-medical criteria for SSDI and/or SSI, such as work history rules for SSDI or income limits for SSI.
Gather Medical Records
Collect detailed medical records from all your asthma treatment providers documenting your condition.
Complete Application
Apply by phone, in person, or online. Schedule any required interviews or medical exams.
Submit Supporting Evidence
Mail, upload, or fax all your asthma medical documentation, school/work records, and caregiver questionnaires.
Appeal if Denied
If denied, appeal and submit additional evidence. About 2/3 of denials are overturned upon appeal when new data is provided.
Navigating the disability application process takes diligence and patience. Consider seeking assistance from a disability lawyer or advocate.
Getting Approved for Asthma Disability
Getting approved for disability due to asthma can be challenging but possible in severe cases. Here are some tips that boost your odds of qualifying:
Document Frequent Exacerbations
Keep a detailed log of all your asthma flares, attacks, emergency care, hospital stays. This shows your impairment.
Follow Treatment Plans Closely
Adhere fully to your treatment regimen. Lack of compliance hurts your claim. Tell your doctor about any difficulties managing your asthma.
Track Work/School Absences
Record whenever asthma causes you to miss work or school. This helps substantiate disability.
Note Limitations
Describe how asthma restricts your capacity to work, exercise, care for yourself, attend school, etc.
Submit Objective Testing
Pulmonary function tests, chest x-rays, arterial blood gases provide measurable evidence that supports your claim.
In some cases, asthma dysfunctions severely enough despite optimal compliance and treatment to qualify for disability status. Thorough records and persistence are key to obtaining benefits.
If You're Denied
It’s very common to get denied initially when applying for asthma disability. Reasons may include:
- Perceived ability to work certain jobs
- Inadequate medical testing submitted
- Lack of objective airflow measurements
- Insufficient details on life limitations
- Concerns over compliance with medical advice
If you receive an SSA denial, don’t get discouraged. Around two-thirds of applicants get rejected the first time. You have the right to appeal, which often leads to approval once additional evidence is provided.
Working with a disability lawyer improves your odds, as they know how to build the strongest appeal case possible. Do not assume your asthma cannot qualify and give up without first appealing a denial.
The Bottom Line
Moderate, well-controlled asthma alone does not constitute a disability. But for those with severe, poorly controlled asthma causing substantial work impairment and restrictions in daily living, Social Security disability benefits and legal protections may be available.
Receiving disability status for asthma requires thorough medical documentation and records substantiating significant respiratory dysfunction. Even then, denials commonly happen initially. Persevering through the appeals process is often worth it in the end.
While not an easy process, those struggling daily with unrelenting asthma symptoms may find the disability route improves quality of life when all other options have been exhausted.
Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.
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