Qualifying for Disability Benefits with Diabetic Nephropathy
Diabetic nephropathy is a serious complication of type 1 diabetes and type 2 diabetes. It’s also called diabetic kidney disease. In the United States, about 1 in 3 people living with diabetes have diabetic nephropathy. Diabetic nephropathy affects the kidneys’ usual work of removing waste products and extra fluid from the body. The best way to prevent or delay diabetic nephropathy is by living a healthy lifestyle and keeping diabetes and high blood pressure managed. To learn more about how the Social Security Administration (SSA) defines this disability, visit Section 6.00 of the Blue Book.
Does Diabetic Nephropathy Qualify for Disability?
Yes, people with diabetic nephropathy do qualify, in fact kidney disease is noted to be one of the conditions the SSA has deemed so severe as to be automatically disabling. The Blue Book listings for kidney disease comprise of five different categories, each requiring a different type of medical evidence to be proven:
The final potential listing you may meet regarding your diabetic nephropathy would be under Section 6.09 for complications of chronic kidney disease. This listing requires proof of at least three hospitalizations within a year, each 30 days apart and lasting a minimum of 48 hours per visit. It goes without saying that the hospitalizations need to be related to your kidney disease.
The first listing which addresses diabetic nephropathy is Section 6.03 for chronic kidney disease. To be found disabled under this listing, you must show you are on hemodialysis or peritoneal dialysis.
The next listing is Section 6.04, again for chronic kidney disease. Instead of dialysis, this listing comes into play if you have undergone a kidney transplant. If you have had a kidney transplant you will be considered disabled for one year following the transplant, with a review of your condition being performed again at that point. So far, the first two listings are fairly easy to prove, requiring either proof of dialysis or a new kidney. The last three Listings are more extensive in terms of proof requirements.
Section 6.05 for chronic kidney disease looks at the different levels of your kidney function to determine the impairment. You must show both the A and B criteria to meet this listing. The A criteria require proof of your serum creatinine of 4 mg or greater on two occasions, 90 days apart, in a 12-month time frame; or your creatinine clearance level of 20 ml/min or less; or your eGFR of 20 ml/min or less. If you are able to prove the A criteria with one of these three requirements, then the B criteria will be evaluated. The B criteria requires proof showing renal osteodystrophy, peripheral neuropathy, fluid overload syndrome, or anorexia with a BMI of 18.0 or less.
If your numbers do not meet Section 6.05, then you may consider Section 6.06 for nephrotic syndrome. This listing requires proof of both the A and B criteria. The A criteria requires documented two occasions 90 days apart in a 12-month time frame of proteinuria of 10.0g or greater or serum albumin of 3.0 or less. The B criteria requires proof of anasarca persisting for a minimum of 90 days.
If your condition does not meet one of these listing situations, you may still qualify for the disability program. After determining your condition does not qualify you for disability under a listing, the social security administration will then evaluate how your condition impacts your functional ability. They will determine what is called your residual functional capacity. This is the most you can do in spite of your medical conditions. Once your residual functional capacity is determined, social security will then consider whether you are able to perform your past relevant work in spite of these limitations. And if not, whether you are able to perform any other work in the national economy.
How Do I Apply for Disability Benefits?
To apply for disability benefits, it’s important to understand the disability application process. If you’ve been diagnosed with diabetic nephropathy and believe you may qualify, contact us today for a free disability case evaluation.
