Chronic obstructive pulmonary disease (COPD) is a type of lung disease characterized by long-term poor airflow. COPD usually develops slowly and some people may not know that they are ill. Symptoms include coughing, fatigue, repeated respiratory infections, shortness of breath (dyspnea) during mild activity, difficulty catching your breath and wheezing. The Centers for Disease Control and Prevention shows that over 5 percent of Texans have been diagnosed with COPD.
In the United States and United Kingdom, of those with COPD, 80–95% are either current smokers or previously smoked.The unfortunate reality of COPD is that, for many who have the disease, symptoms don’t begin to appear until significant damage within the lungs has already occurred. Because of this—especially when the patient is unaware and continues to smoke—this can further the damage already inflicted. When breathing becomes difficult and even mild exercise causes shortness of breath and fatigue, it affects almost all our daily activities and the ability to work is severely impaired. COPD makes it difficult to breathe. There are two main forms of COPD:
•· Chronic bronchitis, which involves a long-term cough with mucus
•· Emphysema, which involves destruction of the lungs over time
Spirometry Testing: the Gold Standard for Diagnosis and Severity Assessment
Spirometry measures the amount of airflow obstruction present. Two main metrics are measured to make the diagnosis:
- the forced expiratory volume in one second (FEV1), which is the greatest volume of air that can be breathed out in the first second of a breath, and
- the forced air capacity (FVC), which is the greatest volume of air that can be breathed out in a single large breath.
Normally, 75–80% of the FVC comes out in the first second and a FEV1/FVC ratio of less than 70% in someone with symptoms of COPD defines a person as having the disease. Spirometry and the critical metrics of FEV1 and FVC are also useful in assessing the severity of COPD. The lower the FEV1/FVC ratio, the more severe the COPD. One scale used by pulmonologists to determine COPD severity is the “GOLD Criteria for COPD” which relies solely on FEV1
|Stage I||Mild COPD||FEV1/FVC<0.70||FEV1≥ 80% normal|
|Stage II||Moderate COPD||FEV1/FVC<0.70||FEV1 50-79% normal|
|Stage III||Severe COPD||FEV1/FVC<0.70||FEV1 30-49% normal|
|Stage IV||Very Severe COPD||FEV1/FVC<0.70||FEV1 <30% normal, or <50% normal with chronic respiratory failure present*|
More recently the GOLD Criteria has been modified to include symptoms in assessment of COPD severity, not just the FEV score. This new criteria includes assessment under
|Scale 1||Breathless only with strenuous exercise|
|Scale 2||Short of breath when hurrying on the level or up a slight hill.|
|Scale 3||Slower than most people of the same age on a level surface or Have to stop when walking at my own pace on the leve|
|Scale 4||Stop for breath walking 100 meters or After a walking few minutes at my own pace on the level|
|Scale 5||Too breathless to leave the house|
In determining whether an individual with COPD is disabled, the assessment of severity is imperative. Just how severe is the breathing problem? Moreover, age and the type of past work is particularly relevant in the COPD disability case. Its just common sense that a person with COPD would have much more difficulty doing a physicial and ‘stand-up’ job than sitting at a computer terminal entering data all day long. Age is also important, because over the age of 50 the emphasis is on ability to do prior work, and the governments options in claiming someone over 50 can do new work are more limited.
Current tobacco use is also a factor. Even though the COPD will not end or reverse itself folloing smoking cessation, an ALJ will have a harder time granting benefits to someone who is continuing to accelerate the disease severity by smoking.
At Denman Law Office we have successfully handled hundreds of disability claims in Dallas Fort Worth based upon COPD. Call us with any questions without charge at 214-219-7288.