Long-Term Disability For Asthma

Asthma, a chronic respiratory condition characterized by inflammation and narrowing of the airways, can vary widely in severity and impact from person to person. According to the Asthma and Allergy Foundation of America, the United States has more than 25 million Americans with asthma. While some individuals effectively manage their symptoms with medications and lifestyle adjustments, others may experience more frequent and severe asthma attacks that interfere with their ability to work or engage in daily activities. In cases where the frequency and duration of symptoms significantly limit a person’s ability to work, exploring long-term disability for asthma is crucial.

Understanding Asthma

Asthma is a chronic respiratory condition that affects the airways, causing inflammation and narrowing, leading to breathing difficulties. It can manifest with various symptoms triggered by factors like allergens, exercise, or stress, and it impacts daily life significantly.

If your work environment triggers your asthma, you may be considered for disability benefits for asthma. Be sure to include information about workplace triggers in your application for benefits and include evidence if possible.

Symptoms of Asthma

When a healthy person takes deep breaths, the airways typically relax. However, asthmatic patients may go into a spasm or find their airways constricted when they take a deep breath. Symptoms can vary in severity from person to person and may worsen during asthma attacks. Common asthma symptoms include the following:

• Wheezing
• Shortness of breath
• Chest tightness or pain
• Coughing, especially at night or early morning.

When trying to prove disability, it is not enough to identify your asthma symptoms. You must also explain why your condition prevents you from performing your job duties. If you can connect your symptoms to a specific limitation, you will improve your chances of being approved for disability benefits.

This could include regularly taking sick days due to poorly controlled chronic asthma or asthma attacks, leading to ineffectiveness in your work. You may also be fatigued due to wheezing and coughing at night. As such, you have distracted days where you cannot concentrate. Shortness of breath may prevent you from performing strenuous tasks, thus forcing you to seek help from a coworker.

Make sure your symptoms and resulting limitations are documented in your medical records. An attorney can also help you document your symptoms and limitations in a sworn statement. At Ortiz Law Firm, we do so in the form of a notarized affidavit that our office will prepare for you.

Diagnosing Asthma

Diagnosing asthma usually involves a physical exam, a medical history review, lung function tests like spirometry, and sometimes allergy or blood tests. Doctors may also consider the frequency and severity of symptoms before confirming an asthma diagnosis. Ensure you include any diagnostic testing results to support your claim.

Complications Associated with Asthma

Patients with asthma often have other serious medical problems as well, such as:

• Many cases of chronic asthma are usually connected to conditions like COPD, emphysema, chronic asthmatic bronchitis, or allergies.
• Some people with asthma experience the most symptoms at night, which can lead to a chronic lack of sleep. Long-term sleep deprivation can affect your cognitive ability and may make it difficult for you to function at work.
• Asthma may also keep some people from participating in exercise or sports, which increases the risk of diabetes, high blood pressure, weight gain, and depression.

When multiple medical conditions affect your ability to work, your claim for disability insurance benefits is more likely to be approved. Inform your disability insurance company about any associated complications you may experience.

Can I Get Long-Term Disability for Asthma?

Yes, you can qualify for long-term disability benefits because of asthma. You may qualify for long-term disability benefits if you can show that your asthma has affected your lung function to such an extent that you cannot hold down a job.

An example of a severe asthma condition that may qualify for disability benefits is when the patient has persistent asthma attacks, defined as symptomatic episodes lasting at least one day and requiring intensive treatment, or when the patient has asthma attacks that necessitate a doctor’s treatment or hospitalization at least once every two months.

However, claimants may struggle to obtain disability insurance benefits for asthma. Many cases are denied due to a policy exclusion or because the claimant does not provide sufficient evidence to support their claim. If your medical evidence does not support your claim, the insurance company may refer it for an independent medical examination (IME), but the results of these exams often support a claim denial.

Pre-Existing Condition Exclusions

You or your attorney must carefully review any exclusions in your disability insurance policy. In our experience, most disability insurance policies will not pay benefits for a claim for a pre-existing condition. Since asthma is a chronic condition, you have likely been receiving treatment for your condition before the date you filed your claim. Be sure to check your policy for information about what is considered a pre-existing condition, as this information varies between insurance policies.

Medical Evidence to Support an Asthma Disability Claim

Medical evidence, such as lung function test results, can help support your claim. To ensure you qualify for long-term disability benefits, you should produce evidence such as a lung function test performed by a consulting doctor to show minimal airflow. For example, a spirometry test documenting your FEV1 value (your forced expiratory volume in one second, meaning the amount of air you can exhale in one second) should show significant limitations.

You should also ask your doctor for an opinion on what activities you can and cannot do (such as lifting more than 10 pounds, walking no more than a half-hour at a time, and not being exposed to dust or fumes). The long-term disability insurance company may give you an attending physician statement (APS) for your doctor to complete, asking about your restrictions, limitations, and the type of work you can do.

However, the forms provided by the disability insurance company are designed to apply to claimants with any medical condition, whether a musculoskeletal condition or a heart problem. As such, the forms may not address asthma’s specific symptoms and limitations. If you work with an experienced disability lawyer, you may be able to obtain a custom residual functional capacity (RFC) form that is specific to asthma. The Ortiz Law Firm has prepared hundreds of custom RFC forms for past disability insurance claims.

Should I File For Social Security Disability Benefits Too?

If your long-term disability claim is approved, many insurance policies require you to file a disability claim with the Social Security Administration (SSA). This is because most policies allow the insurer to reduce your monthly benefit by the amount you receive from the SSA. We help with Social Security Disability claims, too, so you only need one attorney to handle both claims.

Contact Ortiz Law Firm to Get Help with Your Disability Claim for Asthma

If you have asthma that significantly affects your ability to work and have been unable to qualify for long-term disability benefits on your own, you should consult a long-term disability attorney. An experienced disability attorney understands the tricks and tactics the insurance company uses to deny disability claims and can help you fight against a wrongful denial. Hiring a lawyer is the difference between being approved or denied for benefits for many claimants.

At Ortiz Law Firm, our skilled legal team specializes in long-term disability appeals and lawsuits. Nick Ortiz is a highly skilled long-term disability attorney dedicated to helping his clients get the benefits they deserve. We will guide you through the disability appeal process and fight to recover the benefits you deserve so that you can focus on your health. If your insurance company has wrongfully denied your long-term disability claim, call us at (888) 321-8131 to schedule a free disability case evaluation.