Is Diabetes a Disability?
Since the SSA does not have a specific listing for diabetes, we are often asked, “can you get disability for diabetes? People with diabetes of all types may qualify for Social Security Disability Insurance (SSDI). Having diabetes by itself usually will not qualify you for Social Security Disability, but most diabetic applicants suffer from related medical problems that limit their ability to work.
It is often these related medical problems and symptoms that make diabetes a disability. Having symptoms such as dizziness, vision problems, or numbness that impact your ability to perform your job will be considered when you apply for SSDI.
Illness such as diabetic vision loss, peripheral neuropathy, heart disease, and kidney failure can be associated with diabetes and can be disabling and leave you eligible for disability. For people who have experienced significant complications related to diabetes, qualifying for disability benefits from the Social Security Administration may be possible. Your treating physician should document your symptoms and limitations on a residual functional capacity form.
It’s Difficult to Get Disability Benefits For Diabetes, But Most Diabetic Social Security Disability Applicants Suffer From Related Medical Problems That Limit Their Ability to Work.
Diabetes is usually controlled with medication, such as insulin and a proper diet. A condition that is well-controlled with medication won’t form the basis of a successful claim on its own. However, as a person ages, sometimes it cannot be controlled. This is a problem, as uncontrolled diabetes can cause damage to internal organs and a host of other problems. If uncontrolled diabetes prevents you from working you may have a chance of qualifying for disability benefits from the Social Security Administration.
Most people with diabetes also suffer from other medical problems that limit their ability to work such as diabetic nephropathy. When filing for disability benefits for diabetes, it’s important to list all your symptoms and diagnoses, even those unrelated to your diabetes.
If you’re looking for information about how to get long-term disability benefits from your insurance company due to diabetes then click here to read our article about diabetes and long-term disability claims.
What is Diabetes?
Diabetes is a medical condition in which a person’s level of glucose, or blood sugar, is elevated. Diabetes mellitus is the medical name for diabetes type 1 and type 2. High levels of glucose in the blood are an indication that the body does not produce enough insulin to process blood glucose, or the insulin produced does not work as it should, to help the body absorb the excess glucose. This results in excessive amounts of glucose in the blood and urine, excessive thirst, and weight loss.
Type 1 diabetes is most often diagnosed at a young age, although it can develop at any age. Type 2 diabetes, sometimes referred to as adult-onset diabetes, is most common in people over the age of 40. In some cases, there is progressive destruction of small blood vessels which leads to complications such as diabetic neuropathy, infections, gangrene of the limbs, and blindness.
Pre-diabetes is a condition in. which indicates an individual has a high risk of developing full-fledged Diabetes. The condition is a very serious disease that can result in high blood pressure, damage to the eyes, nerve damage, kidney disease, heart problems, blindness, and stroke.
Qualifying for Social Security Disability Benefits with Diabetes
If you have diabetes that cannot be controlled with insulin and you have been unable to work for at least 12 months, or you expect that you will not be able to work for at least 12 months, then you may be eligible for Social Security disability benefits or SSDI (SSDI/SSD) or Supplemental Security Income (SSI) benefits. To qualify for disability benefits, you must be able to demonstrate that the damage caused by your diabetes severely limits what you can do and prevents you from performing even sedentary work. To qualify, the damage caused by your diabetes must severely limit what you can do, or you must have complications that fulfill the requirements of one of Social Security’s disability listings.
One of the biggest reasons disability claims are denied is because the patient is “non-compliant” with the doctor’s orders. If you don’t follow your doctor’s prescribed treatment, you won’t be eligible. If your blood sugar levels are uncontrolled because you failed to follow your doctor’s prescribed treatment, your claim for disability will likely be denied. For more information, see our article on failing to comply with treatment orders.
Meeting the Social Security Administration’s Disability Listing for Diabetic Complications
The Social Security Administration (SSA) has a Listing of Impairments (the “Blue Book”) that tells you how severe an illness must be to qualify for disability benefits. Diabetes (type 1 and 2) is no longer included as one of the SSA’s disability listings, so a diabetes diagnosis will not automatically qualify you for disability benefits. You may be eligible to “meet” other listings in the Blue Book depending on the severity of your symptoms. Diabetes-related complications include kidney failure, cardiovascular issues, amputation of a limb, and kidney failure. If your symptoms and other conditions meet the requirements of a Disability Listing of Impairments, you will be approved for disability benefits automatically, before the SSA goes any further in the five-step sequential evaluation process.
The following are some SSA listings that may apply to patients with complications from diabetes (both hyperglycemia and hypoglycemia):
- Diabetic retinopathy (Listing 2.00). If you have blurred vision, poor visual acuity (between 20/100 and 20/200 in your better eye), or poor peripheral vision from surgery to correct your central vision, you might qualify for disability benefits under this listing.
- Diabetic nephropathy (Listing 6.06). If your kidneys are no longer filtering properly and you require daily dialysis or there is evidence of too much protein or creatine in your plasma, you may qualify for SSD benefits.
- Diabetic peripheral neuropathies (Listing 11.14). Many patients with diabetes have some form of neuropathy or nerve damage in their hands, feet, arms, or legs. Social Security Disability diabetic neuropathy claims may qualify for benefits under this listing, but you must demonstrate that your neuropathy significantly affects two extremities and causes a significant impairment of your ability to walk, stand, or use your hands in a skilled way.
- Cardiovascular problems. Diabetes can lead to coronary artery disease (listing 4.04), chronic heart failure (listing 4.02), peripheral vascular disease (listing 4.12), and an irregular heartbeat (listing 4.05).
- Poorly healing skin and bacterial infections (Listing 8.04). If you have ulcerating skin lesions that last for three months or longer despite treatment and such lesions make it difficult for you to walk or use your hands, you could qualify for disability benefits under the listing for chronic skin infections.
- Amputation of an extremity (Listing 1.05). If you’ve had a foot amputated due to nerve damage and poor circulation caused by diabetes, you could qualify for benefits if you have other limitations as well. Click here for more information related to disability for amputation.
- Diabetic ketoacidosis (DKA), DKA is an acute, potentially life-threatening complication of diabetes mellitus (DM) and usually requires hospital treatment to correct the acute complications of dehydration, electrolyte imbalance, and insulin deficiency. Recurrent episodes of DKA may result from mood or eating disorders, which SSA evaluates under Mental Disorders (Listing 12.00).
- Intestinal necrosis is evaluated under the Digestive System (Listing 5.00)
- Cerebral edema and seizures are evaluated under Neurological (Listing 11.00).
The Social Security’s disability listings require that the above complications be severe to qualify for disability. Social Security finds that most people who apply for disability due to diabetes do not meet a listing. If so, the next step is to determine how limiting your diabetes is.
Can You Get Disability for Diabetes If You Don’t Meet a Listing?
Qualifying for disability benefits is possible even if you do not meet a listing. To determine whether your diabetes limits your daily functioning so much that you cannot sustain work activity, the SSA or state agencies (called Disability Determination Services or DDS) will assess your residual functional capacity (RFC). Most people who apply for disability based largely on diabetes are denied benefits the first time around and need to file an appeal to get a hearing in front of an administrative law judge.
Your RFC is a measurement of the level of activity that you can still perform despite your diabetes. For example, an RFC can conclude that you are capable of performing medium work, light work, or sedentary work. To determine your RFC, the SSA will review your medical history, your doctor’s opinion(s) (if they detail your functional limitations and are backed up by medical evidence), and statements from you, your family, and your friends.
The SSA is also interested in whether you can focus on tasks, get along with others, and go to work on a regular basis. For example, if you have poorly controlled glucose levels during the day, the insurance adjuster might find that you are unable to concentrate for long periods of time. If you suffer from depression or extreme fatigue, your RFC might state that you cannot perform work on a consistent and regular basis.
If you have neuropathy in your legs due to your diabetes, you may be unable to stand and walk for long periods of time. If you have blurred vision, your RFC may state that you cannot perform jobs where vision is important. For example, if your visual acuity is 20/80 or worse, your RFC might state that you cannot drive or work around hazardous machinery.
Symptoms of Diabetes
The presence of Diabetes is generally indicated by some combination of several symptoms. Diabetes symptoms vary depending on your blood glucose levels. Some people may not experience symptoms, while others, like type 1 diabetics, tend to experience more severe symptoms. A diabetic often experiences dry, itchy skin and trouble with genital itching and fungal infections. Many diabetics report tingling sensation or numbness in the hands and feet. Other symptoms of type 1 and type 2 diabetes include:
- Uncontrolled blood sugar levels
- Frequent urination
- Increased thirst and hunger
- Weight loss
- Blurred vision,
- Frequent infections
- Cuts that are slow to heal, and
- Extreme fatigue.
Severe diabetes symptoms may leave you unable to perform your job duties. You should seek out medical advice if you experience the symptoms described above.
Potential Complications of Diabetes
Uncontrolled blood glucose due to type 1 or type 2 diabetes can increase your risk of developing other medical problems. Other issues that can result from diabetes may include:
- Diabetic retinopathy (eye and vision problems)
- Nephropathy (kidney disease)
- Neuropathy (nerve damage) in feet or hands that disrupts your ability to stand, walk, or use your hands
- Hypertension (high blood pressure)
- Heart disease
- Gastroparesis (a type of nerve damage that interferes with digestion)
- Peripheral arterial disease (reduced blood flow to your limbs when blood vessels and blood flow in your legs become blocked)
- Cellulitis (skin infections), and
Multiple medical conditions can improve your chances of being approved for Social Security Disability Insurance (aka SSDI or SSD) benefits. Be sure to list any additional medical problems you have that may be considered related to diabetes, even high blood pressure or depression, when you file your application for SSD.
Get Help from a Board Certified Attorney
You should get legal advice from an attorney if your claim is denied. However, you should not settle for a general practice lawyer that only accepts a handful of SSDI claims a year. The board certification program for Social Security Disability Advocacy by the National Board of Trial Advocacy (NBTA) will help you find a lawyer that is experienced with SSDI law. The NBTA is not a referral service, but you can trust that an attorney who has completed the board certification process has the ability and experience to handle your claim with the SSA.
To earn certification as a board-certified lawyer in social security disability law by the NBTA, an attorney must provide substantial involvement in cases related to this specialty area of the law by spending at least 30 percent of his or her time in the specialty area during each of the last three years, being involved in at least 100 SSDI hearings, filing at least 20 appeals council briefs and 10 federal court briefs, and fulfilled certain educational and CLE requirements related to the SSA’s disability law.
Contact Ortiz Law Firm today to schedule your free consultation. During your consultation, we will get additional information about your diabetes and any related medical conditions, walk you through the SSDI and SSI benefits claim process, and discuss the many benefits of forming an attorney-client relationship with the firm. You can contact us using our website or call (888) 321-8131.
And while you wait, our website may be able to help you prepare for your fight against the SSA: visit the resources page of our website to view our eBooks, download a residual functional capacity form to document the work activities your body is unable to perform, and browse a variety of free treatment logs to keep a detailed record of your health care.