Understanding Pulmonary Fibrosis and Qualifying for SSDI Benefits

At the Law Offices of Christopher Le, we specialize in helping individuals navigate the complexities of Social Security Disability Insurance (SSDI) claims. If you or a loved one has been diagnosed with pulmonary fibrosis, you may be eligible for benefits that can provide crucial financial support. In this blog post, we'll explore what pulmonary fibrosis is, how it impacts daily life, and the pathways to securing SSDI approval.

What Is Pulmonary Fibrosis?

Pulmonary fibrosis is a progressive lung disease characterized by the thickening and scarring of lung tissue, which makes it increasingly difficult for oxygen to pass into the bloodstream. Over time, this scarring—known as fibrosis—stiffens the lungs, leading to reduced lung function. The most common form is idiopathic pulmonary fibrosis (IPF), where the cause is unknown, but it can also result from exposure to environmental toxins, certain medications, autoimmune diseases, or radiation therapy.

Symptoms often include persistent dry cough, shortness of breath (especially during physical activity), fatigue, unexplained weight loss, and aching muscles or joints. Diagnosis typically involves imaging tests like high-resolution CT scans, pulmonary function tests, and sometimes lung biopsies. While there is no cure, treatments such as antifibrotic medications (e.g., pirfenidone or nintedanib), oxygen therapy, pulmonary rehabilitation, and in severe cases, lung transplantation, can help manage symptoms and slow progression.

This condition can severely limit a person's ability to work, perform daily tasks, or even engage in basic activities, which is why many turn to SSDI for assistance.

An Overview of SSDI

Social Security Disability Insurance (SSDI) is a federal program administered by the Social Security Administration (SSA) that provides monthly benefits to individuals who are unable to work due to a severe medical condition expected to last at least 12 months or result in death. To qualify, you must have paid into the Social Security system through payroll taxes and accumulated enough work credits—typically 40 credits, with 20 earned in the last 10 years.

The SSA evaluates claims through a five-step sequential process:

1. Are you working? If you're earning above the substantial gainful activity threshold (about $1,620 per month in 2025 for non-blind individuals), you generally won't qualify.

2. Is your condition severe? It must significantly limit your ability to perform basic work activities for at least 12 months.

3. Does your condition meet or equal a listed impairment? The SSA maintains a "Blue Book" of qualifying conditions. If your impairment matches one, you're approved.

4. Can you perform past work? The SSA assesses your residual functional capacity (RFC)—what you can still do despite limitations—and compares it to your previous jobs.

5. Can you do any other work? Considering your age, education, skills, and RFC, the SSA determines if you can adjust to other jobs in the national economy.

   
   

If approved, benefits can include monthly payments, Medicare coverage after a waiting period, and potential back pay.

How Pulmonary Fibrosis Qualifies for SSDI

Pulmonary fibrosis often qualifies under SSA Listing 3.02 for Chronic Respiratory Disorders in the Blue Book's respiratory section. This listing covers conditions like pulmonary fibrosis that cause obstruction, restriction, or impaired gas exchange in the lungs. To meet the listing, your condition must satisfy one of the following criteria, supported by medical evidence such as pulmonary function tests:

• FEV1 (Forced Expiratory Volume in one second): Less than or equal to specific values based on your age, gender, and height (e.g., for a male over 20 years old and 170-174 cm tall, ≤1.60 L).

• FVC (Forced Vital Capacity): Similarly, less than or equal to height- and gender-based thresholds (e.g., for the same individual, ≤2.00 L).

• Chronic Impairment of Gas Exchange: This can be shown through:

  • DLCO (Diffusing Capacity of the Lungs for Carbon Monoxide) average ≤ specific values (e.g., ≤11.0 mL/min/mmHg for the example above).

  • Arterial Blood Gas (ABG) test showing low PaO2 levels relative to PaCO2 at various altitudes.

  • Pulse oximetry (SpO2) ≤87% at sites below 3,000 feet above sea level, or adjusted for higher altitudes.

Idiopathic pulmonary fibrosis is also part of the SSA's Compassionate Allowances program, which fast-tracks claims for expedited decisions—often within weeks instead of months—due to the condition's severity and poor prognosis.

Even if you don't meet the listing exactly, you may still qualify at steps 4 or 5 if your RFC shows you can't sustain gainful employment. For instance, if symptoms like severe shortness of breath or oxygen dependency prevent you from standing, walking, or concentrating for extended periods, the SSA may find you disabled.

The Application Process and Common Challenges

Applying for SSDI involves submitting detailed medical records, work history, and personal information online, by phone, or at a local SSA office. However, initial approvals are low—around 30%—often due to insufficient evidence or technical errors. Appeals can take over a year, making strong documentation crucial from the start.

Common hurdles for pulmonary fibrosis claims include proving the condition's severity through consistent test results and showing how it impacts work capacity. The SSA requires objective medical evidence, like recent spirometry or DLCO tests performed under stable conditions.

Why Partner with the Law Offices of Christopher Le?

Navigating SSDI claims can be overwhelming, especially when dealing with a debilitating condition like pulmonary fibrosis. Our firm has extensive experience in disability law, helping clients gather compelling evidence, prepare for hearings, and appeal denials. We understand the nuances of respiratory listings and can advocate for expedited processing under Compassionate Allowances.

If pulmonary fibrosis is affecting your life and ability to work, don't face the process alone. Contact the Law Offices of Christopher Le today for a free consultation. We're here to fight for the benefits you deserve.