Sleep Apnea Disability

A common question apnea sufferers have relates to sleep apnea and disability.

Is sleep apnea considered a disability?

Read on to learn more.

A person who suffers daytime fatigue and lack of energy might consider himself disabled. Certainly, it is difficult to function, think and carry out tasks associated with a job.

Difficult” and “disabled” are not quite the same in the eyes of the Social Security Administration (SSA). Since a disability designation results in life time monthly benefits (i.e. cash), it is not something taken lightly. According to the SSA, qualifying for disability is based on an inability to work as you did previously, and that you cannot adjust to do any other kind of work.

To be considered a disability, the SSA also assumes that your medical condition is expected to last 12 months, or result in death. Since an SSA decision is not made quickly, they also assume you have financial support, such as worker’s compensation, insurance, and other resources, including family, to tide you over for a short time.

In other words, just being tired as a result of sleep apnea generally won’t be sufficient for a disability designation from SSA. Since “permanent” and “death” are part of their definition, your condition must be severe. With sleep apnea, it is likely the serious side effects of apnea, along with fatigue, etc., may lead to disability.

Serious side effects of sleep apnea range from hypertension, fibromyalgia, diabetes, mental conditions, and chronic heart failure. If these or other conditions exist and are serious enough to prevent work, it is likely that you will receive a disability designation.

Even with serious conditions, you must be able to demonstrate to the SSA that the conditions cannot be cured or controlled. This means that you have tried various treatments to control sleep apnea, and these treatments have failed in a medically supervised arena.
Even if a CPAP has failed to control apnea, it must be shown that other variations including BIPAP, APAP, and VPAP have also failed. Surgery may also be considered, if applicable.

If the cause of sleep apnea and conditions are directly related to obesity, the SSA may want evidence that medically supervised weight loss has failed. An SSA disability award for obesity alone is possible, but only in extreme cases where nothing else works.

Steps to Determine Sleep Apnea and Disability

To make a determination for disability, the SSA uses five sequential steps as follows:

  1. You must have stopped working or are working at substantially lower gainful capacity (income).
  2. Your condition must be severe. It has prevented you from working for the past 12 months or you are not expected to work for the next 12 months due to the medical condition(s). Or, you are expected to die.
  3. Your condition must be “in the book”. The SSA maintains a listing of adult medical conditions and assessment levels considered to meet qualifications. These levels of severity defined by the SSA must be met.
  4. SSA will evaluate your ability to perform functions of your past, primary work. They will also evaluate your ability to make adjustments and perform other work functions. If they find that mental or physical conditions do not prohibit you from performing those functions, you will not qualify as disabled.
  5. If you are not able to perform regular work or adjust to another capacity, SSA will determine what level of disability you will receive.This is based on age, education, work history and “residual ability”. In simple terms, residual ability means that you might not be able to carry a 50 pound sack of potatoes as you did formerly. However, can you carry a 10 pound sack? It is this residual capacity that will determine your award. No two cases are the same.

If you’re past 65, you cannot apply for disability. However, if disabled previously, at age 65, benefits will change to retirement, but the amount will stay the same.

Finally, your age and work history, including credits paid into Social Security factor in. You must have worked long enough and recently enough to qualify. The following chart shows the minimums.

Born After 1929

Become
Disabled At Age

Credits You Need

31 through 42

20

44

22

46

24

48

26

50

28

52

30

54

32

56

34

58

36

60

38

62 or older

40

Apnea and Disability: A Complex Question

Meeting the SSA requirements for disability is complicated and varies case by case. Although there is a handbook and consistent rules for all SSA employees, they might be interpreted differently, depending on location.

Applying for disability involves filling out forms, interviews and providing a great deal of documentation from medical sources. It will also include additional medical review deemed necessary by the SSA.

The level of complexity and degree of difficulty is underscored by the number of attorneys representing people who have been denied disability. Unfortunately, even success in obtaining a disability through a legal challenge might be offset by the percentage of attorney fees required to gain the ruling.

There is a great deal of information and forums regarding disability. Some is written from personal experience. Others are from a legal viewpoint. Obviously, the SSA has a great deal of information available.

If you are considering filing for disability, you would do well to conduct as much research as possible. It may be of benefit to employ a third party, perhaps a lawyer, to help with the process. Utilizing services for the application process would be much less expensive than trying to reverse a ruling, once declined.

Below are some of the many sources for information and services.

Information to Win a Social Security Disability (SSI, SSDI) or SSI Claim

Talk About Sleep – Disability & Medicare

Disability Blogger – Sleep Apnea and Disability

Applying for Social Security Disability

To receive a FREE e-course on 7 proven sleep apnea treatments (that don’t use CPAP), please click here.

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