Social Security Disability – Diabetes

Diabetes And Social Security Disability Benefits

What Is Diabetes?
Can I Get Social Security Disability Benefits If I Suffer From Diabetes?
Is There A Specific Listing For Diabetes?
If I Do Not Meet The Listing, Is There Another Way To Get Social Security Disability Benefits?


What Is Diabetes?

Diabetes mellitus, also known as “diabetes,” is a hormonal disorder falling within the body’s endocrine system. A very small percentage of the population suffers from diabetes. Yet, diabetes happens to be one of the most popular conditions listed on applications for Social Security disability benefits (whether SSDI or SSI). There are two main types of diabetes, Type I and II.

Type I diabetes is the most severe form of diabetes and has often been labeled “insulin-dependent diabetes mellitus”, “juvenile diabetes” or “juvenile onset-diabetes.” Type I diabetes is usually diagnosed during childhood and sometimes during young adulthood. It is characterized by the loss of insulin-producing beta cells in the pancreas, resulting in insulin deficiency.

Type II diabetes is by far the most common form of diabetes. It is not considered an autoimmune disorder and can typically be improved by managing diet, exercise, and medications. In the early stages of type II diabetes, the predominant abnormality is reduced insulin sensitivity.

Diabetes can implicate other systems of the body. People suffering from severe diabetes often experience diabetic retinopathy or neuropathy. In fact, diabetes is one of the leading causes of blindness in the United States.


Can I Get Social Security Disability Benefits If I Suffer From Diabetes?

Diabetes is absolutely recognized by the Social Security Administration! If diabetes prevents you from earning more than $1000 a month in gross wages for at least 12 months, you may qualify for Social Security disability benefits (whether SSDI or SSI). When you apply for disability benefits with diabetes, the Social Security Administration will first determine whether your condition is severe enough to meet a listing for other body systems. If you meet a listing, fantastic, you will be found disabled! If you do not meet a listing, the Social Security Administration will then evaluate your residual functional capacity (the most work that you can do despite your medical condition(s)) and then determine whether you are entitled to Social Security disability benefits.


Is There A Specific Listing For Diabetes?

The short answer is no. The way that the Social Security Administration views diabetes has gone through numerous changes in recent years. Diabetes used to fall under Listing of Impairments 9.08: Diabetes mellitus. Below was the listing:

9.08 Diabetes mellitus:
A.Neuropathy demonstrated by significant and persistent disorganization of motor function in two extremities resulting in sustained disturbance of gross and dexterous movements, or gait and station (see 11.00C);
or
B. Acidosis occurring at least on the average of once every 2 months documented by appropriate blood chemical tests (pH or pC02 or bicarbonate levels);
or
C. Retinitis proliferans; evaluate the visual impairment under the criteria in 2.02, 2.03, or 2.04.

However, effective June 7th, 2011, the Social Security Administration restructured all of the listings that fall under the endocrine system. For diabetes, the Social Security Administration published the following comment on their website, “We evaluate impairments that result from endocrine disorders under the listings for other body systems.” In other words, because diabetes can affect other systems of the body, Social Security will evaluate the listings for those systems that are being damaged due to diabetes. The following is a sample of the systems affected by diabetes and regulated under different listings:

a. Hyperglycemia. Both types of DM cause hyperglycemia, which is an abnormally high level of blood glucose that may produce acute and long-term complications. Acute complications of hyperglycemia include diabetic ketoacidosis. Long-term complications of chronic hyperglycemia include many conditions affecting various body systems.

(i) Diabetic ketoacidosis (DKA). DKA is an acute, potentially life-threatening complication of DM in which the chemical balance of the body becomes dangerously hyperglycemic and acidic. It results from a severe insulin deficiency, which can occur due to missed or inadequate daily insulin therapy or in association with an acute illness. It usually requires hospital treatment to correct the acute complications of dehydration, electrolyte imbalance, and insulin deficiency. You may have serious complications resulting from your treatment, which we evaluate under the affected body system. For example, we evaluate cardiac arrhythmias under 4.00, intestinal necrosis under 5.00, and cerebral edema and seizures under 11.00. Recurrent episodes of DKA may result from mood or eating disorders, which we evaluate under 12.00.

(ii) Chronic hyperglycemia. Chronic hyperglycemia, which is longstanding abnormally high levels of blood glucose, leads to long-term diabetic complications by disrupting nerve and blood vessel functioning. This disruption can have many different effects in other body systems. For example, we evaluate diabetic peripheral neurovascular disease that leads to gangrene and subsequent amputation of an extremity under 1.00; diabetic retinopathy under 2.00; coronary artery disease and peripheral vascular disease under 4.00; diabetic gastroparesis that results in abnormal gastrointestinal motility under 5.00; diabetic nephropathy under 6.00; poorly healing bacterial and fungal skin infections under 8.00; diabetic peripheral and sensory neuropathies under 11.00; and cognitive impairments, depression, and anxiety under 12.00.

b. Hypoglycemia. Persons with DM may experience episodes of hypoglycemia, which is an abnormally low level of blood glucose. Most adults recognize the symptoms of hypoglycemia and reverse them by consuming substances containing glucose; however, some do not take this step because of hypoglycemia unawareness. Severe hypoglycemia can lead to complications, including seizures or loss of consciousness, which we evaluate under 11.00, or altered mental status and cognitive deficits, which we evaluate under 12.00.

The changes made to Listing 9.00 and the descriptions above can be found on theSocial Security Administration website. However, because most of the listing is completely restructured, it can be quite difficult to know which listing your diabetes falls under. If you or a family member suffers from severe diabetes and are unable to work and want to know more about whether you might qualify for Social Security disability benefits (either SSDI or SSI), contact Social Security Defenders or fill out our free online consultation form.


If I Do Not Meet The Listing, Is There Another Way To Get Social Security Disability Benefits?

Yes! If your diabetes does not meet a particular listing but is preventing you from working, you may still qualify for Social Security disability benefits.

The Social Security Administration will proceed with your case by evaluating your Residual Functional Capacity. To do this, the Administration will determine the most amount of work that you can do despite your limitations. They do this by dividing “work” into four different categories: heavy, medium, light, and sedentary. It is worth noting that there is sometimes a fifth category that is recognized for very heavy work; however, very heavy work is scarcely used. Whether a claimant wins his or her disability claim is greatly affected by which category he or she is ultimately put into. Being put into a lower category increases the likelihood that a claim is approved for Social Security disability benefits. For more information on residual functional capacity, feel free to visit an article we published on GoingLegal.

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