Chronic respiratory disorders due to any cause except CF (for CF, see 3.04) SSDI Claims in Indiana

Medical criteria

SSA Blue Book listing

3.02 Chronic respiratory disorders due to any cause except CF (for CF, see 3.04)

Listing criteria (20 CFR Appendix 1, Part A)

with A, B, C, or D: A. FEV 1 (see 3.00E) less than or equal to the value in Table I-A or I-B for your age, gender, and height without shoes (see 3.00E3a). | Table I—FEV 1 Criteria for 3.02A | Height without shoes (centimeters) < means less than | Height without shoes (inches) < means less than | Table I-A | Table I-B | | --- | --- | --- | --- | --- | | Age 18 to attainment of age 20 | Age 20 or older | | Females FEV 1 less than or equal to (L, BTPS) | Males FEV 1 less than or equal to (L, BTPS) | Females FEV 1 less than or equal to (L, BTPS) | Males FEV 1 less than or equal to (L, BTPS) | | <153.0 | <60.25 | 1.20 | 1.45 | 1.05 | 1.20 | | 153.0 to <159.0 | 60.25 to <62.50 | 1.30 | 1.55 | 1.15 | 1.35 | | 159.0 to <164.0 | 62.50 to <64.50 | 1.40 | 1.65 | 1.25 | 1.40 | | 164.0 to <169.0 | 64.50 to <66.50 | 1.45 | 1.75 | 1.35 | 1.50 | | 169.0 to <174.0 | 66.50 to <68.50 | 1.55 | 1.85 | 1.45 | 1.60 | | 174.0 to <180.0 | 68.50 to <70.75 | 1.65 | 2.00 | 1.55 | 1.75 | | 180.0 to <185.0 | 70.75 to <72.75 | 1.75 | 2.10 | 1.65 | 1.85 | | 185.0 or more | 72.75 or more | 1.80 | 2.15 | 1.70 | 1.90 | OR B. FVC (see 3.00E) less than or equal to the value in Table II-A or II-B for your age, gender, and height without shoes (see 3.00E3a). | Height without shoes (centimeters) < means less than | Height without shoes (inches) < means less than | Table II-A | Table II-B | | --- | --- | --- | --- | | Age 18 to attainment of age 20 | Age 20 or older | | Females FVC less than or equal to (L, BTPS) | Males FVC less than or equal to (L, BTPS) | Females FVC less than or equal to (L, BTPS) | Males FVC less than or equal to (L, BTPS) | | <153.0 | <60.25 | 1.35 | 1.65 | 1.30 | 1.50 | | 153.0 to <159.0 | 60.25 to <62.50 | 1.50 | 1.80 | 1.40 | 1.65 | | 159.0 to <164.0 | 62.50 to <64.50 | 1.60 | 1.90 | 1.50 | 1.75 | | 164.0 to <169.0 | 64.50 to <66.50 | 1.70 | 2.05 | 1.60 | 1.90 | | 169.0 to <174.0 | 66.50 to <68.50 | 1.80 | 2.20 | 1.70 | 2.00 | | 174.0 to <180.0 | 68.50 to <70.75 | 1.90 | 2.35 | 1.85 | 2.20 | | 180.0 to <185.0 | 70.75 to <72.75 | 2.05 | 2.50 | 1.95 | 2.30 | | 185.0 or more | 72.75 or more | 2.10 | 2.60 | 2.00 | 2.40 | OR C. Chronic impairment of gas exchange demonstrated by 1, 2, or 3: 1. Average of two unadjusted, single-breath DLCO measurements (see 3.00F) less than or equal to the value in Table III for your gender and height without shoes (see 3.00F3a); or | Table III—DLCO Criteria for 3.02C1 | Height without shoes (centimeters) < means less than | Height without shoes (inches) < means less than | Females DLCO less than or equal to (mL CO (STPD)/min/mmHg) | Males DLCO less than or equal to (mL CO (STPD)/min/mmHg) | | --- | --- | --- | --- | --- | | <153.0 | < 60.25 | 8.0 | 9.0 | | 153.0 to <159.0 | 60.25 to <62.50 | 8.5 | 9.5 | | 159.0 to <164.0 | 62.50 to <64.50 | 9.0 | 10.0 | | 164.0 to <169.0 | 64.50 to <66.50 | 9.5 | 10.5 | | 169.0 to <174.0 | 66.50 to <68.50 | 10.0 | 11.0 | | 174.0 to <180.0 | 68.50 to <70.75 | 10.5 | 11.5 | | 180.0 to <185.0 | 70.75 to <72.75 | 11.0 | 12.0 | | 185.0 or more | 72.75 or more | 11.5 | 12.5 | 2. Arterial P a O 2 and P a CO 2 measured concurrently by an ABG test, while at rest or during steady state exercise, breathing room air (see 3.00G3b), less than or equal to the applicable values in Table IV-A, IV-B, or IV-C; or Tables IV-A, IV-B, and IV-C—ABG Criteria for 3.02C2 | Table IV-A[Applicable at test sites less than 3,000 feet above sea level] | Arterial P a CO 2 (mm Hg) and | Arterial P a O 2 less than or equal to (mm Hg) | | --- | --- | --- | | 30 or below | 65 | | 31 | 64 | | 32 | 63 | | 33 | 62 | | 34 | 61 | | 35 | 60 | | 36 | 59 | | 37 | 58 | | 38 | 57 | | 39 | 56 | | 40 or above | 55 | | Table IV-B[Applicable at test sites from 3,000 through 6,000 feet above sea level] | Arterial P a CO 2 (mm Hg) and | Arterial P a O 2 less than or equal to (mm Hg) | | --- | --- | --- | | 30 or below | 60 | | 31 | 59 | | 32 | 58 | | 33 | 57 | | 34 | 56 | | 35 | 55 | | 36 | 54 | | 37 | 53 | | 38 | 52 | | 39 | 51 | | 40 or above | 50 | | Table IV-C[Applicable at test sites over 6,000 feet above sea level] | Arterial P a CO 2 (mm Hg) and | Arterial P a O 2 less than or equal to (mm Hg) | | --- | --- | --- | | 30 or below | 55 | | 31 | 54 | | 32 | 53 | | 33 | 52 | | 34 | 51 | | 35 | 50 | | 36 | 49 | | 37 | 48 | | 38 | 47 | | 39 | 46 | | 40 or above | 45 | 3. S p O 2 measured by pulse oximetry (see 3.00H2) either at rest, during a 6MWT, or after a 6MWT, less than or equal to the value in Table V. | Table V—S p O 2 Criteria for 3.02C3 | Test site altitude (feet above sea level) | S p O 2 less than or equal to | | --- | --- | --- | | Less than 3,000 | 87 percent. | | 3,000 through 6,000 | 85 percent. | | Over 6,000 | 83 percent. | OR D. Exacerbations or complications requiring three hospitalizations within a 12-month period and at least 30 days apart (the 12-month period must occur within the period we are considering in connection with your application or continuing disability review). Each hospitalization must last at least 48 hours, including hours in a hospital emergency department immediately before the hospitalization.

Body system category

3.00 Respiratory Disorders

Common denial reason

Chronic respiratory claims are frequently denied when spirometry (FEV1, FVC, or DLCO) does not meet listing values or when exacerbations are not documented at required frequency.