Social Security Disability Benefits for Emphysema

Emphysema is a chronic lung disease caused by long-term exposure to smoke or air pollution. The lungs of an emphysema sufferer can't hold their physical shape or function properly because the supporting tissue has been destroyed. Symptoms of emphysema include the following:

• shortness of breath with even mild activity
• coughing
• wheezing
• fatigue, and
• frequent respiratory infections.

Emphysema is a form of chronic obstructive pulmonary disease (COPD) that the Social Security Administration (SSA) considers a disability if it's severe enough.

When Does Emphysema Qualify for Disability?

If you suffer from severe emphysema, you'll qualify for disability benefits if either:

• you meet Social Security's listing requirements for chronic respiratory disorders, or
• your doctor's restrictions limit what you can do so much that there aren't any jobs you can still do.

Meeting a Listing: When Social Security Says Emphysema Is a Disability

To determine whether you meet the listing for chronic respiratory disorders, Social Security will give you a spirometry test to evaluate your lung function. Even if your doctor has given you this test before, the SSA requires that you undergo a new exam administered by a Social Security doctor at a consultative exam (CE). (Social Security will pay for the test.)

The spirometry test monitors the amount of air exchanged when you breathe and the rate at which you breathe. The test required for emphysema sufferers specifically measures the amount of air you can force out of your lungs in the first second of an exhalation (called FEV₁).

Social Security will compare your results to the charts included in the listing to determine whether you meet the listing's requirements. The chart results are based on your height, age, and gender. For instance, a 5-foot-2-inch woman over age 20 would need an FEV₁ of 1.15 (liters, BTPS) or less.

If your spirometry test results don't meet the listing's requirements, you can still qualify for disability with a DLCO test that shows enough gas exchange impairment (based on height and gender). DLCO (diffusing capacity of the lungs for carbon monoxide) tests measure how well your lungs transfer gas from the air you inhale into your bloodstream.

To receive automatic disability approval, you'll also have to provide Social Security with a chest X-ray or other diagnostic imaging test (like a CT scan) showing the extent of your emphysema. For more information on the specific listing requirements, see our article on chronic pulmonary insufficiency.

Qualify for Disability Because Emphysema Keeps You From Working

Mild or moderate emphysema isn't likely to meet the requirements of the respiratory disorders listing. But your limitations could still be severe enough to prevent you from working. If you can't work full-time because of your medical condition, Social Security will consider you disabled.

To qualify for disability benefits this way, you'll first need to show that your emphysema prevents you from doing any of your past work. Then, you'll have to prove that your condition is so limiting that you can't be expected to do any other type of work, even less demanding work. Proving you can't work is generally easier for older workers because of special Social Security rules called the grid rules.

Learn more about qualifying for disability because you can't work, including Social Security's special rules for older workers.

What Are the General Requirements for Social Security Disability?

Even if your emphysema qualifies as a disability under Social Security rules, you must still meet the basic eligibility requirements for disability benefits:

• you can't earn more than $1,550 a month from working (in 2024), and
• your emphysema must prevent you from working (or be expected to) for at least 12 months.

Social Security administers two types of disability benefits: Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI). Each program has specific legal and financial requirements you must meet for eligibility.

SSI is intended for people with little work history and limited financial resources. For more information on the financial requirements of SSI, see our article on SSI income and resource limits.

SSDI is available to people with a qualifying work history—where you and your employer paid Social Security taxes for a long enough time. For more information, see our section on SSDI eligibility.

Veterans Benefits Based on the Emphysema VA Rating

Unlike with Social Security, you don't have to be totally disabled to qualify for benefits from the Department of Veterans Affairs (VA). Instead, your eligibility for disability compensation is based on the VA disability rating you receive for your emphysema. But to qualify for VA disability compensation, you'll also need to prove your emphysema was caused by or made worse by your military service. (Learn more about establishing a VA service connection.)

The VA rating for emphysema is found in the Schedule of Ratings—respiratory system, in the section on Diseases of the Trachea and Bronchi under diagnostic code 6603. (38 C.F.R. § 4.97.) Like the Social Security listing, the VA rating for emphysema is based on spirometry or DLCO test results.

The VA rates emphysema from 10% to 100% disabling. The specific rating is based on the percent of the predicted FEV₁ or DLCO score you have or the ratio of FEV₁ to FVC (forced vital capacity, which is the most air you can exhale after taking a deep breath). The smaller the percentage of predicted value or FEV₁/FVC ratio, the higher your VA rating for emphysema will be.

Learn more about how your VA disability rating affects your benefits.

_{Updated April 5, 2024}