Background of pulmonary disability
Pulmonary impairment arises from chronic respiratory issues or environmental origin. A leading cause of respiratory disability in the United States is tobacco use.
The resulting severe emphysema causes complete inability to proceed with their daily duties.
The most engaging part is the management of a patient with chronic lung disease. Since treatment is not enough, it is imperative that a patient manages the condition under medical guidance.
Additional assistance is essential at advanced stages of the disorder. Assistance includes workplaces modification procedures, rehabilitation, compensation, and attribution. Other issues related to the pulmonary disorders include apportionment, and eligibility for vocation and removal from work. However, these are some of the issues, which are mostly ignored by employers as well as the medical fraternity.
According to the WHO framework for measuring health and disability, environmental and genetic factors must be considered as part of contributors to pulmonary disorders.
While a patient with permanent impairment is not expected to recover, patients with temporal impairment can live through to survive by eventually recovering totally.
According the WHO definitions, total disability means that the patient is not able to perform any work they normally do with their skills.
Partial disability, on the other hand, implies that the person to proceed with some but not all the work in their career.
The WHO defines causation as exposure to a major contributing factor that resulted in the chronic lung problem. The definition requires 95% certainty in medical research to conclude the level of causation.
Apportionment is used to describe the relative contribution of a collection of issues that resulted in the condition. For example, tobacco use, and chronic inhalation asbestos exposure may be the biggest contributing factors.
Diagnosis of Pulmonary Impairment
The criteria of diagnosis involve an examination on patients’ history, physical examination, and pulmonary function tests. The history includes; occupational history, smoking evidence, environmental conditions, dyspnea, coughing, and chest-wheezing.
Physical examination involves observation of the breathing patterns, clubbing, cyanosis, adventitious lung sounds, and corpulmonale. Finally, pulmonary tests are the main pillars of rating impairment.
The most common symptom is numbness or weakness in either or both of your limbs. This is common especially on one side of the body at a time. Some people experience numbness of the legs and trunk.
Partial of complete loss of vision is also a major indicator that you are suffering from Pulmonary Disability. Visual disturbance typically occurs on each eye at a time and not simultaneously.
Eye movement is accompanied by pain. Some people also experience prolonged double vision. A tingling feeling (like pins and needles), muscle weakness, and pain in various parts of the body are also pointers to Pulmonary Disability.
Most people experience an electric-shock sensation when they move their necks in certain directions. For example, when bending the neck forward causes sharp feelings within the region.
Other symptoms of Pulmonary Disability include tremor, difficulty in balance and coordination, or an unsteady gait, fatigue, dizziness, memory problems, and slurred speech. A disruption in bowel and bladder function is also a quick indicator to Pulmonary Disability.
Pulmonary Disability Progressive Course
Initially, many patients experience relapsing-remitting with instances of adaptable inadequacies. Another stage of newer symptoms emerges, which develop rapidly with time. The time ranges from a few days to weeks as the mild signs turn to definite symptoms.
The relapses come before a passive moment of disease remission. This period can take as little as a few months or extend into years of inactivity.
The common catalysts of the symptoms are minor increases in body temperature. Although they are not part of the relapses, they worsen the signs and symptoms. Intensive symptoms lead to extra mobility issues and gait.
Approximately 70% exhibit a steady progression of the symptoms of Pulmonary Disability. They are also less likely to experience long periods of remissions, which are the secondary-progressive part of the disease.
Most people develop the typical progress of the disease as the nerves breakdown over time to cause fewer responses from the body.
Secondary-progressive Pulmonary Disability determines the progress of the disease in different patients. While some exhibit a gradual onset and steady progression without relapses, most patients experience the full progression of the disease.
Those without relapses undergo the progressive Pulmonary Disability process.
Social Security Impairment System
The social security impairment system (SSI) provides special features to distinguish it from other compensation programs. For example, it requires a tangible program to determine the volume vs time curve of a recent study of the heart.
This program does not focus on the degree of impairment such as the percentage of impairment. Instead, it is based on whether the patient is impaired or not. Impairment here means that that the patient is not able to conduct their normal duties for a period exceeding one year.
The program also assumes occupational causation except on the disease itself. Instead, it considers coexisting contributory factors to pulmonary conditions. this means it takes into account issues such as substance use.
Pulmonary Disability leads to the following problems;
Bladder and bowel issues: The patient will experience difficulty to empty their bladder completely. The result will be frequent passing out of urine and an increased urge to incontinence. Constipation, on the other hand, results in fecal impaction, which in turn leads to bowel incontinence.
Fatigue and Dizziness: Over 90% of patients are prone to fatigue. This condition limits their ability to conduct normal duties of their daily lives. Dizziness accompanied with vertigo cause imbalance and lack of focus or coordination.
Vision Challenges: Blurry and double vision are the most common effects of Pulmonary Disability in most people. Patients experience mild, partial, or total loss of vision. Others have regular red-green color distortion experiences on each eye at a time.
Eventually, inflammation of the optic nerve will be causing unbearable pain with the slightest eyeball motions.
Muscle Spasms and spasticity: Distorted nerve action in the spinal cord and brain are responsible for muscle spasms. The patient will experience resistance to movement in the muscles. this condition is called spasticity.
Gait and mobility changes: Excessive mobility issues causes people to change how they walk and move. Muscle problems change their regular mobility system affecting their balance and coordination.
Sexual dysfunction: Both male and female patients experience a loss of interest in sex due to poor nerve communication.
Emotional changes: Depression is a common effect of Pulmonary Disability. The intense emotional changes are triggered by the demyelination and destruction of nerve fibers in the brain.
After the diagnosis, people are shocked and disappointed at their condition. This state of mind causes depression in most people. Learning about of the presence of an unpredictable, disabling disorder is disheartening and rightfully causes serious emotional imbalances.
According to recent studies, half of patients diagnoses with the disease fall into depression.
Other effects are; frequent headaches, hearing loss, itching, seizures, respiratory or breathing problems, speech disorders, and swallowing problems. In advanced stages of Pulmonary Disability, patients exhibit impairment in perception and thinking with high heat sensitivity.
Limitations to Impairment Management
The attitude of reluctance displayed by physicians towards impairment is based on multiple, reasons. Mainly, this reluctance is based on the uncertainty of the legal system surrounding the disease.
For example, the compensation system is surrounded by a confusion of ideas. There is also a limitation in training in impairment evaluation coupled by a desire to avoid compensation.
The American Thoracic Society (ATS) is committed to creation of a consensus guidelines towards precision in rating of pulmonary impairment. However, these guidelines may not be recognized by some of the compensation programs available.
This leaves the social security impairment system as the most reliable of the compensation programs. It does not focus on the degree of impairment but based on definite difference between impairment and no-impairment.
It is important to first take caution and ensure you have the correct diagnosis before proceeding to claiming the compensation or proceed with treatment. Confirm that the patient is eligible for an impairment rating by conducting several tests. The initial and most critical test is the diagnosis of lung disease.
The nature of evaluation demands extra certainty from the physician conducting the test. Conclusively, object confirmation of the test is most important.