Sleep Disorders and Social Security Disability Insurance
Here is an explanation of Social Security's five-step process to determine if a patient with a sleep-related breathing disorder qualifies for SSDI:
- Determine if an individual is "working (engaging in substantial gainful activity)" according to the SSA definition. Earning more than $1,040 a month as an employee is enough to be disqualified from receiving Social Security disability benefits.
- Conclude the sleep-related breathing disorder disability must be severe enough to significantly limit one's ability to perform basic work activities needed to do most jobs. For example:
- Walking, standing, sitting, lifting, pushing, pulling, reaching, carrying or handling
- Seeing, hearing and speaking
- Understanding/carrying out and remembering simple instructions
- Responding appropriately to supervision, co-workers and usual work situations
- Dealing with changes in a routine work setting
- Sleep-related breathing disorders are evaluated under the category of impairments known as the Respiratory System - Medical Listing 3.10. Sleep-related breathing disorders (sleep apneas) are caused by periodic cessation of respiration associated with hypoxemia and frequent arousals from sleep. Depending on severity, the disturbed sleep pattern and associated chronic nocturnal hypoxemia causes daytime sleepiness with chronic pulmonary hypertension and/or disturbances in cognitive function. Because daytime sleepiness can affect memory, orientation and personality, a longitudinal treatment record may be needed to evaluate mental functioning. Daytime somnolence may be associated with a disturbance in cognitive function, and is then evaluated under the criteria established for organic mental disorders. There also may be a physiologic basis for the sleep-related breathing impairment attributable to chronic cor pulmonale secondary to chronic pulmonary hypertension, which requires documentation by signs and laboratory findings of right ventricular overload or failure. The medical evidence of record should establish that cor pulmonale is chronic and irreversible.
- Explore the ability of an individual to perform work they have done in the past despite their sleep-related breathing disorder. If the SSA finds that a person can do his or her past work, benefits are denied. If the person cannot, then the process proceeds to the fifth and final step.
- Review age, education, work experience and physical/mental condition to determine what other work, if any, the person can perform. To determine sleep-related breathing disorder disability, the SSA enlists medical-vocational rules, which vary according to age.
For example, if a person is:
Under age 50 and, as a result of the symptoms of sleep-related breathing disorders, unable to perform what the SSA calls sedentary work, then the SSA will reach a determination of disabled. Sedentary work requires the ability to lift a maximum of 10 pounds at a time, sit six hours and occasionally walk and stand two hours per eight-hour day.
Age 50 or older and, due to sleep-related breathing disorders, limited to performing sedentary work, but has no work-related skills that allow the person to do so, the SSA will reach a determination of disabled.
Age 55 or older and, due to the disability, limited to performing light work, but has no work-related skills that allow the person to do so, the SSA will reach a determination of disabled.
Over age 60 and, due to sleep-related breathing disorders, unable to perform any of the jobs he or she performed in the last 15 years, the SSA likely will reach a determination of disabled.
Any age and, because of sleep-related breathing disorders, has a psychological impairment that prevents even simple, unskilled work, the SSA will reach a determination of disabled.
Check out information regarding the prescription drugs used to treat sleep disorders.
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