Respiratory System

• Author: David A. Morton III
• Pages: 287-398

Chapter 3

Respiratory System

Contents

Part I – Adults

§3.00 Respiratory System

§3.01 Category of Impairments, Respiratory System

§3.02 Chronic Pulmonary Insufficiency

§3.03 Asthma

§3.04 Cystic Fibrosis

§3.05 (Reserved)

§3.06 Pneumoconiosis

§3.07 Bronchiectasis

§3.08 Mycobacterial, Mycotic, and Other Chronic Persistent Infections of the Lung

§3.09 Cor Pulmonale

§3.10 Sleep-Related Breathing Disorders

§3.11 Lung Transplant

Part II – Children

§103.00 Respiratory System

§103.01 Category of Impairments, Respiratory System

§103.02 Chronic Pulmonary Insufficiency

§103.03 Asthma

§103.04 Cystic Fibrosis

§103.05 Lung Transplant

§103.06 Growth Failure Due to Any Chronic Respiratory Disorder

MEDICAL ISSUES IN SOCIAL SECURITY DISABILITY 3-2

Part III – Forms

§3.02F Chronic Pulmonary Insufficiency

§3.03F Asthma

§3.04F Cystic Fibrosis

§3.07F Bronchiectasis

§3.08F Chronic Persistent Lung Infection

§3.09F Cor Pulmonale Secondary to Chronic Pulmonary Vascular Hypertension

§3.10F Sleep-Related Breathing Disorders

§3.11F Lung Transplant

Long Forms on Digital Access Only

§3.02F(L) Chronic Pulmonary Insufficiency

§3.03F(L) Asthma

§3.04F(L) Cystic Fibrosis

§3.07F(L) Bronchiectasis

§3.08F(L) Chronic Persistent Lung Infection

§3.09F(L) Cor Pulmonale Secondary to Chronic Pulmonary Vascular Hypertension

§3.10F(L) Sleep-Related Breathing Disorders

§3.11F(L) Lung Transplant

3-3 RESPIRATORY SYSTEM §3.00

1 Dyspnea on exertion means shortness of breath on exertion. The abbreviation DOE is commonly seen on medical records.

2 Hemoptysis means coughing up blood.

3 Other appropriate techniques might be computerized tomographic (CT) scans, magnetic resonance imaging (MRI) scans,

radionuclide scans, or ultrasonic scans.

Form Reference:

See Forms 3.02, 3.03, 3.04, 3.07, 3.08, 3.09, 3.10,

3.11 to solicit treating source medical information

relevant to the above adult and corresponding child

listings.

General Legal Text Cross-References:

Also see Bohr’s Social Security Issues Annotated

(James Publishing), §318, regarding specific court

cases involving respiratory impairments.

Part I – Adults

§3.00 Respiratory System

[The applicable Listing of Impairments introduces

each chapter and is typeset in Helvetica. Author

comments follow each Listing subsection and are type-

set in Times.]

SSA Listing of Impairments

A. Introduction. The listings in this section

describe impairments resulting from respiratory

disorders based on symptoms, physical signs, labo-

ratory test abnormalities, and response to a regi-

men of treatment prescribed by a treating source.

Respiratory disorders along with any associated

impairment(s) must be established by medical

evidence. Evidence must be provided in sufficient

detail to permit an independent reviewer to evaluate

the severity of the impairment.

Many individuals, especially those who have listing-

level impairments, will have received the benefit of

medically prescribed treatment. Whenever there is

evidence of such treatment, the longitudinal clinical

record must include a description of the treatment

prescribed by the treating source and response in

addition to information about the nature and severity

of the impairment. It is important to document any

prescribed treatment and response, because this medi-

cal management may have improved the individual’s

functional status. The longitudinal record should pro-

vide information regarding functional recovery, if any.

Some individuals will not have received ongoing

treatment or have an ongoing relationship with the

medical community, despite the existence of a severe

impairment(s). An individual who does not receive

treatment may or may not be able to show the exis-

tence of an impairment that meets the criteria of these

listings. Even if an individual does not show that his

or her impairment meets the criteria of these listings,

the individual may have an impairment(s) equivalent

in severity to one of the listed impairments or be dis-

abled because of a limited residual functional capac-

ity. Unless the claim can be decided favorably on the

basis of the current evidence, a longitudinal record

is still important because it will provide information

about such things as the ongoing medical sever-

ity of the impairment, the level of the individual’s

functioning, and the frequency, severity, and dura-

tion of symptoms. Also, the asthma listing specifi-

cally includes a requirement for continuing signs and

symptoms despite a regimen of prescribed treatment.

Impairments caused by chronic disorders of the respi-

ratory system generally produce irreversible loss

of pulmonary function due to ventilatory impair-

ments, gas exchange abnormalities, or a combina-

tion of both. The most common symptoms attribut-

able to these disorders are dyspnea on exertion1,

cough, wheezing, sputum production, hemoptysis2,

and chest pain. Because these symptoms are common

to many other diseases, a thorough medical history,

physical examination, and chest x-ray or other appro-

priate imaging technique are required to establish

chronic pulmonary disease.3 Pulmonary function

testing is required to assess the severity of the respi-

ratory impairment once a disease process is estab-

lished by appropriate clinical and laboratory findings.

Alterations of pulmonary function can be due to

obstructive airway disease (e.g., emphysema, chronic

bronchitis, asthma), restrictive pulmonary disorders

with primary loss of lung volume (e.g., pulmonary