Is asthma a disability for Social Security?

Quick answer: It can be. SSA evaluates asthma under its respiratory listings, mainly Listing 3.03, and a diagnosis by itself does not meet it. The listing asks for a lung test result at or below a set value and three hospitalizations of at least 48 hours each within 12 months. If your asthma does not meet the listing, SSA can still look at what you can do at work.

By Crystal G. Rouse, Partner & Attorney, Hall & Rouse, P.C.

Is asthma a disability? For Social Security, it can be, and SSA has a listing written for it. The listing asks for two specific things, so it helps to know what they are and how SSA measures them.

In North Carolina, as in every state, a state agency called Disability Determination Services (DDS) makes the first decision on a claim for SSA, and it uses the same SSA listings described here.

Does SSA treat asthma as a disability?

SSA doesn’t treat a diagnosis alone as disabling. It looks at test results, hospital records and what the medical evidence shows about your condition. A listing is a description of an impairment that SSA treats as disabling when its criteria and the duration requirement are met.

Does asthma have to last a certain length of time?

Yes. SSA’s regulation says the impairment must have lasted, or be expected to last, for a continuous period of at least 12 months. SSA calls this the duration requirement. The one exception in the regulation is an impairment expected to result in death.

That is why Listing 3.03 looks at evidence over time: hospitalizations within a 12-month period and a lung test measured in that same period.

How does SSA evaluate asthma?

Under its respiratory disorders listings, SSA says asthma is evaluated under Listing 3.02 or Listing 3.03. It describes asthma as a chronic inflammatory disorder of the lung airways, and it says it needs evidence that you have listing-level airflow obstruction at baseline while you are medically stable.

What does Listing 3.03 require?

Listing 3.03 requires both of these:

A. A lung test result at or below SSA’s cutoff. The pulmonary function test (or spirometry) measures the FEV1, and the cutoff in SSA’s tables depends on your age, sex and height without shoes.
B. Three hospitalizations within a 12-month period. They must be for exacerbations or complications, and at least 30 days apart.

The FEV1 result has to be measured within the same 12-month period as the hospitalizations.

What is FEV1, and how does SSA measure it?

FEV1 is the amount of air you can force out of your lungs in one second. It is measured with a breathing test called spirometry.

SSA’s rules on spirometry say the test involves at least three forced breathing maneuvers during the same session, and that SSA uses your highest FEV1 value. If your FEV1 is less than 70 percent of your predicted normal value, SSA requires repeat spirometry after a bronchodilator, unless that is medically contraindicated.

What does “medically stable” mean for the test?

SSA says you must be medically stable at the time of the test. Its examples of not being medically stable include:

Being within 2 weeks of a change in your prescribed respiratory medication.
Experiencing, or being within 30 days of completing treatment for, a lower respiratory tract infection.
Experiencing, or being within 30 days of completing treatment for, an acute exacerbation, which is a temporary worsening of a chronic respiratory disorder.

SSA also says wheezing by itself does not mean you are not medically stable.

Which hospital stays count?

Under paragraph B, each hospitalization must last at least 48 hours, including hours in a hospital emergency department immediately before the hospitalization. The three hospitalizations must fall within a 12-month period and be at least 30 days apart. That 12-month period must fall within the period SSA is considering for your application or review.

If the hospitalization route is met, the listing says SSA considers you disabled for 1 year from the discharge date of the last hospitalization. After that, SSA evaluates the residual impairment under Listing 3.03 or another appropriate listing.

What is Listing 3.02, and does it apply to asthma?

Listing 3.02 covers chronic respiratory disorders from any cause except cystic fibrosis. Because SSA says asthma is evaluated under 3.02 or 3.03, either listing may apply to a file. Listing 3.02 can be met in one of four ways:

A. An FEV1 at or below the value in SSA’s table for your age, sex and height.
B. An FVC, the total amount of air you can force out, at or below the value in SSA’s table.
C. A chronic impairment of gas exchange, shown by a diffusing capacity test, a blood gas test or a pulse oximetry reading.
D. Three hospitalizations within a 12-month period and at least 30 days apart, for exacerbations or complications.

What other evidence does SSA look at?

SSA says medical evidence of a respiratory disorder should include your medical history, physical examination findings, imaging results, pulmonary function tests, other relevant laboratory tests, and descriptions of any prescribed treatment and your response to it. SSA also says it may not need all of this, depending on your particular disorder and its effects on you.

The symptoms and signs SSA lists for respiratory disorders include shortness of breath, chest pain, coughing, wheezing and sputum production.

What if my asthma does not meet the listing?

Meeting a listing is one route to a finding of disabled. If your condition does not meet or equal a listing, SSA goes on to assess your residual functional capacity (RFC, the most you can still do despite your limitations). It then asks whether you can still do your past work and, if not, whether you can adjust to other work given your RFC, age, education and work experience.

SSA’s regulation on RFC says impairments that impose environmental restrictions can limit other work-related abilities, and that SSA considers any resulting limits when it assesses what you can still do.

If you would like a real look at where your own records stand against these criteria, we’re here. This is general information about Social Security Disability law in North Carolina. It is not legal advice for any specific case. If you are dealing with a particular claim, contact Hall & Rouse, P.C. for a free consultation.

Learn more about SSDI eligibility requirements and how disability claims work on hall-rouse.com.

About the author

Crystal G. Rouse, Partner & Attorney at Hall & Rouse, P.C. Board Certified Social Security Disability Law Specialist (NC State Bar Board of Legal Specialization). Ms. Rouse has more than 16 years of private practice experience handling disability claims before the Social Security Administration. In 2019, she became a partner at Charles T. Hall Law Firm and continues to practice here as Hall & Rouse. Prior to private practice, for eight years she worked at the Social Security Administration’s Disability Determination Services. Ms. Rouse updates the law book, Social Security Disability Practice, published by Thomson Reuters. Past results do not guarantee future outcomes. No law firm can guarantee the outcome of a Social Security disability case.