Bronchiectasis Can Lead to Social Security Disability
The lungs are balloon-like sacs that expand and contract by the flexing of the diaphragm. The bronchial tubes are the airways that channel air into the lung sacks. If these tubes are damaged, an individual develops bronchiectasis. Bronchiectasis is when the airways are widened and inflamed and “can no longer effectively clear mucus and bacteria from the lung, so that exacerbations of the cough, sputum production, and shortness of breath can occur.”
Many times bronchiectasis starts out with a cough. “The cough may be productive of mucus. With infections the mucus may be discolored, foul-smelling and may contain blood.” Some individuals experience “shortness of breath, wheezing, weight loss, and fatigue.”
Some individuals are born with conditions that lead to bronchiectasis. Cystic fibrosis impairs the lungs to where mucus and bacteria are not effectively drained and leads to repeated lung infections causing bronchiectasis. Individuals with primary ciliary dyskinesia have dysfunctional lung cilia and are unable to clear mucus and bacteria from the lungs allowing for repeated lung infections. There is also Alpha-1 antitrypsin deficiency where an individual is deficient in a certain protein that moderates inflammation due to infection.
Any number of infections can damage airways leading to bronchiectasis. Viral infections such as measles and influenza and bacterial infections like staphylococcus aureus can damage airways. Also mycobacterial infections like tuberculosis and fungal infections can also damage airways.
If a person inhales food or drink from their mouth or stomach contents into their lungs, the foreign particles can cause inflammation leading to bronchiectasis. Inhaling materials once or twice is not indicative of major inflammation, but repeated inhalation due to something like gastroesophageal reflux disease (GERD) can cause bronchiectasis.
“Rheumatoid arthritis, lupus, Sjogren's syndrome and Wegener's granulomatosis are examples of rheumatologic, autoimmune or connective tissue disease that can cause bronchiectasis.
Diagnosis starts with a complete medical history and physical examination. A chest CT (computerized tomography) scan can show a detailed picture of the lungs to determine if there are areas of bronchiectasis. Pulmonary function tests that test an individual's breath capacity can indicate abnormal airflow out of the lungs. It can also show the level of severity. If there is an underlying cause for the bronchiectasis, a doctor may order screening tests for that underlying cause.
Treatments focus on clearing the lungs, strengthening the undamaged airways, and treating associated infections or conditions. Bronchodilator inhalers are used to relax the muscles in the airways to open them up. Inhaled steroids are used to reduce airway swelling to keep the passages open. Doctors also prescribe saline sprays to loosen mucus for easier expelling.
There are a few devices used to clear trapped mucus. There are oscillating positive expiratory pressure devices that an individual exhales into to remove mucus from the lungs. The high-frequency chest wall oscillation vest inflates around the chest to “shake the chest to help dislodge the mucus from the airway walls.”
Infections are treated with antibiotics and other treatments. If there is an underlying condition that is causing the bronchiectasis, then doctors will treat that underlying condition to reduce the bronchiectasis. Pulmonary rehabilitation is used to improve an individual's overall health to reduce the impacts of bronchiectasis. Surgery to redirect airflow around a damaged airway is a last resort and only if the affected area is highly localized and all other treatments are not effective.
Social Security Disability
The Social Security Administration (SSA) requires imaging of the lungs to show areas of widened and inflamed bronchial tubes. Along with these images, there must be documentation of “impairment of pulmonary function due to extensive disease.” The SSA Blue Book shows a table for Forced Expiratory Volume (FEV) test results in relation to height to assess chronic obstructive pulmonary insufficiency and a table for Forced Vital Capacity, also in relation to height, to assess chronic restrictive ventilatory disease. These tables are used to determine if an individual has a severe decrease in lung volume due to a number of lung conditions, including bronchiectasis.
SSD applications require extensive documentation on an applicant's medical condition. If you are considering applying for disability benefits, contact our experienced attorney to assist you.