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Lung Transplant and SSA Disability Benefits

SSDI or SSI applicants who have had a lung transplant have had a diseased or nonfunctioning lung replaced with healthy lungs generally from a deceased donor. Recipients receive either a single or double lung transplant when they have damaged lungs which are unable to generate sufficient oxygen to survive. There are a variety of common lung conditions and diseases which may make a lung transplant necessary including:

  1. Sarcoidosis

  2. Pulmonary hypertension

  3. Pulmonary fibrosis

  4. Chronic obstructive pulmonary disease (COPD), including emphysema

  5. Cystic fibrosis

  6. Bronchiectasis

Risks of a lung transplant

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Although advancement of medical procedures has made a lung transplant safer and more routine, there are still risks. The most common risk is a rejection of the new lung by the recipient’s immune system. Anti-reaction drugs are powerful and although they are needed, they may also cause other side-effects such as kidney damage, diabetes and osteoporosis.

Winning Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) for a lung transplant

The Social Security Administration has several ways to determine if a SSDI or SSI applicant qualifies for Social Security disability benefits. First, the SSA will determine if their condition is listed in the SSA Listing of Impairments. This list, also known as the Blue Book, outlines the conditions and symptoms the SSA considers automatically disabling.

If the SSDI or SSI applicant’s condition is not in the SSA Blue Book the SSA will determine if it is severe enough that it leaves the applicant with no residual capacity to work. This process is called a medical vocational allowance. Older applicants will have a better chance of proving they do not have the residual ability to work.

Lung Transplant and Meeting a Listing in the SSA Listing of Impairments

There is a listing for lung transplant under 3.00 Respiratory System, Section 3.11 Lung transplant. The good news for transplant recipients is they are almost guaranteed to win SSDI or SSI for at least 12 months following the date of their surgery (assuming they meet the nonmedical requirements of either the SSI or SSDI program).

The SSA does not list any other symptoms they must have because the SSA assumes that if they have had a lung transplant than their health has already deteriorated to such a level that they are unable to perform substantial gainful activity.

The listing specific states that SSDI and SSI benefits are awarded for 12 months following surgery at which time the SSA will evaluate the claimant’s residual impairment. This means that a lung transplant patient will have an evaluation after 12 months, and the SSA will determine if they have the residual capacity to work.

If the SSA determines you can work after the review but you feel that your condition is too debilitating to work, you may have to fight to retain your SSDI or SSI benefits. At this point it may make sense to discuss your case with a disability lawyer if necessary.
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