A Free Guide to Social Security Disability Insurance and Supplemental Security Income Disability Benefits
Diabetes Mellitus and Social Security Disability Benefits
By R. M. Bottger
Diabetes Mellitus that is well-controlled and has not caused any damage to any organs is not considered disabling by SSA. When evaluating Social Security and/or Supplemental Security Income disability claims for diabetes, SSA looks at what effects the diabetes has had on the personís health. Here is what SSA looks at when evaluating disability claims for diabetes.
In the young, diabetes usually can be controlled by treatment. Therefore, it is relatively rare for SSA to find young people disabled due to diabetes. If the diabetes is not controlled because the person is not following prescribed treatment, the person will not be considered disabled. If prescribed treatment is not being followed, the disability claim will be denied on the grounds that with prescribed treatment the personís condition will not be disabling for 12 months in a row. The longer a person has diabetes, the more likely he or she is to develop disabling complications such as neuropathy, retinopathy, renal disease, and amputations.
Diabetes requiring insulin is considered disabling in children under age 18 if the child has had recent, recurrent hospitalizations with acidosis or recent, recurrent episodes of hypoglycemia. The child must be following prescribed treatment for the diabetes in order to be found disabled.
Children with diabetes can also be found disabled if they have a severe growth impairment. If the childís height falls greater than 15 percentiles, and that drop is sustained, then the child is considered disabled. If the childís height stays below the 3rd percentile, the child is considered disabled.
Children and adults with diabetes can also be found disabled due to severe kidney disease due to diabetes. In both adults and children, chronic renal dialysis due to irreversible renal failure is considered disabling. In both adults and children, a person is considered disabled for 12 months after a kidney transplant; after 12 months, the case is reevaluated to determine what residual impairment the person has (if any). In children under the age of 18, persistent elevation of serum creatinine to 3 mg. per deciliter (100 ml.) or greater over at least 3 months is considered disabling. In children under the age of 18, reduction of creatinine clearance to 30 ml. per minute (43 liters/24 hours) per 1.73 m2 of body surface area at least 3 months is considered disabling. In people of any age, persistent elevation of serum creatinine to 4 mg. per deciliter (100 ml.) or greater or reduction of creatinine clearance to 20 ml. per minute (29 liters/24 hours) or less, over at least 3 months, is considered disabling if it is accompanied by at least one of the following:
∑ Renal osteodystrophy manifested by severe bone pain and appropriate radiographic abnormalities (e.g., osteitis fibrosa, marked osteoporosis, pathologic fractures)
∑ A clinical episode of pericarditis
∑ Persistent motor or sensory neuropathy
∑ Intractable pruritus
∑ Persistent fluid overload syndrome resulting in diastolic hypertension (110 mm. or above) or signs of vascular congestion
∑ Persistent hematocrits of 30 percent or less
In people of any age, persistent elevation of serum creatinine to 4 mg. per deciliter (100 ml.) or greater or reduction of creatinine clearance to 20 ml. per minute (29 liters/24 hours) or less, over at least 3 months, is considered disabling if it is accompanied by persistent anorexia with recent weight loss and current weight equal to or less than that listed in the chart at the bottom of this article.
Uncontrolled diabetes mellitus due to pancreatic dysfunction with repeated hyperglycemia, hypoglycemia, or ketosis and a weight equal to or less than that listed in the chart at the bottom of this article is considered disabling.
Adults and children of any age can be found disabled due to severe neuropathy. Neuropathy due to diabetes is considered disabling if it causes severe, sustained limitations in the use of the hands or in the ability to stand and walk. Although theoretically children can be allowed due to diabetic neuropathy, it generally only occurs in people who have had diabetes for a very long time; therefore, it is older people that are actually allowed due to diabetic neuropathy.
Acidosis occurring at least on the average of once every 2 months documented by appropriate blood chemical tests (pH or pCO2 or bicarbonate levels) is considered disabling for both adults and children. Again, the person must follow prescribed treatment for diabetes in order to be found disabled.
Retinopathy is evaluated like any other vision impairment. If the personís best eye has a best corrected visual acuity of 20/200 or worse, then he or she is considered disabled. Decreased peripheral vision is considered disabling if contraction of the visual field in the better eye is 10 degrees or less from the point of fixation or so the widest diameter subtends an angle no greater than 20 degrees. Lost of visual efficiency is considered disabling if it is 20 percent or less in the better eye after best correction. SSA believes that a person with retinopathy should not do medium or heavy work because the physical exertion can cause more bleeding into the retina. In people age 49 and younger, this is not enough for the person to be found disabled. However, as a person ages, it becomes easier to qualify for disability benefits, and retinopathy may be considered disabling. SSAís laws and regulations concerning vision loss are too extensive to be covered in this article and will have to be addressed in a separate article.
Amputation of both hands is considered disabling. Amputation of one or both lower extremities at or above the tarsal region is considered disabling if the person has stump complications resulting in medical inability to use a prosthetic device to ambulate effectively which has lasted or is expected to last at least 12 months in a row. If a person has one hand amputated and one lower extremity amputated at or above the tarsal region, the person will be considered disabled if her or she is unable to ambulate effectively. Hemipelvectomy or hip disarticulation is considered disabling.
Once a person reaches age 50, it becomes easier to qualify for Social Security and/or Supplemental Security Income disability benefits. This is because SSA thinks that as a person ages, he or she becomes less able to adapt to other types of work. Therefore, once a person reaches that age, he or she may qualify for disability benefits with a condition that is less severe than is described in this article. Even in those over the age of 50, however, SSA looks at what damage the diabetes has caused (such as kidney disease, neuropathy, and retinopathy). Insulin-dependent diabetes mellitus that has not caused other health problems is not considered disabling at any age. Once the person reaches age 50, SSA takes into consideration the personís age, education, and past relevant work when deciding whether or not the person is disabled. People who have done physically demanding work benefit the most from the change in rules that occurs as a person ages.
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Keywords: Diabetes, Diabetes Mellitus, diabetes in children, adult onset diabetes, insulin dependant diabetes, non-insulin dependant diabetes, Type I diabetes, Type II diabetes, diabetes and retinopathy, diabetes and neuropathy, diabetes and amputations, diabetes and kidney disease, diabetes and acidosis, diabetes and insulin