Qualifying For Social Security/disability With Diabetes
If you have diabetes that cant be managed through medication or lifestyle changes, you may be eligible for assistance. Type 1 diabetes doesnt always qualify for disability benefits, but some people are able to receive monthly disability benefits from the Social Security Administration . Your benefits can be used on hospital bills and medical treatments, rent, utility bills, food expenses, and any other daily living needs.
Medically Qualifying for Diabetes
Children under age 6 will automatically medically qualify with type 1 diabetes if they require insulin every day. If you or your child has type 1 diabetes but is over age 6, qualification will be a little more complex.
After age 6, the SSA needs more evidence that your diabetes prevents you from working and earning a gainful living. The best way to do this is by showing that your diabetes complications meet a listing in the Blue Book, which is the SSAs guideline of qualifying criteria for disabilities. For example, some disabilities that qualify for benefits include, but are not limited to:
The entire Blue Book can be found online, so you can review the various listings with your doctor to determine if youre eligible for benefits.
Following a Doctors Orders
Because many people are able to successfully manage their diabetes, itll be important to show that despite your best efforts your diabetes still keeps you from earning a gainful living.
Starting Your Application
How Type 2 Diabetes Qualifies For Disability Benefits
Social Security Disability Income is a federal disability insurance benefit for those who have worked and paid into Social Security.
Keep in mind that SSDI is different from Supplemental Security Income . That program is for people with low incomes who didnât pay enough into Social Security during their working years to qualify for SSDI.
If that describes you, consider looking into SSI as a starting point.
In either case, benefits are limited to those who are unable to âperform substantial gainful activity,â according to Liz Supinski, director of data science at the Society for Human Resource Management.
There are limits on how much a person can earn and still collect, she says, and itâs about $1,200 per month for most people, or around $2,000 per month for those who are also blind.
The SSA no longer includes type 2 diabetes as a separate disability listing, so simply having that diagnosis wonât qualify you for benefits.
However, if you have complications that meet the criteria under other disability listings, then you may be eligible.
The most common are:
If you have symptoms like these due to your diabetes, even though youâre following your doctorâs prescribed treatment, you could be eligible for disability benefits.
However, keep in mind that if your condition isnât well managed because youâre not following a doctorâs prescribed treatment, youâre likely to be turned down for disability assistance.
How Can I Get Social Security Disability For Diabetes
The Social Security Administration maintains a listing of impairments, which includes both medical and mental health conditions that are considered severe enough to prevent a person from working. Diabetes is included on this listing of impairments under endocrine disorders. While the SSA notes that both Type 1 and Type 2 diabetes are usually well controlled, there may be a number of reasons why a person cannot control fluctuating blood glucose levels.
Most people who qualify for SSDI and/or SSI for diabetes do so because they have been diagnosed with a disabling condition related to the disease. In other words, the SSA typically does not approve a person for disability simply for having diabetes mellitus. Instead, an applicant may qualify for SSDI and/or SSI because their diabetes caused another condition and that condition is disabling.
The key to being approved for SSDI and/or SSI for diabetes or a related condition is demonstrating how it affects your ability to work. For diabetes mellitus, this may include showing that you cannot work because of the related conditions associated with diabetes. For any of these conditions, you must meet the specific criteria set out in the listing of impairments, and provide evidence of your diagnosis, treatment history, and how your illness affects your ability to work.
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To What Types Of Benefits May People With Diabetes Be Entitled
The U.S. offers two different types of support for people living with conditions that result in disability: SSDI and SSI. A person will only qualify for one or both of these benefits if they are unable to work.
SSDI provides financial support for adults of any age who have worked for a qualifying period. The benefit begins after 6 full months of disability, and a person will qualify for Medicare after 24 months. This qualification will be immediate for people with amyotrophic lateral sclerosis .
SSI provides basic financial help to people of any age who have a disability and have a very limited income or resources. State programs may supplement SSI. The benefit begins 1 month after a person files the claim. In most states, a person will automatically qualify for Medicaid when they start receiving SSI.
A person may receive both benefits if they have a work history in addition to a limited income or resources.
A person may also have health insurance through their work. Some insurance policies will pay out for 12 years following disability. Longer-term health insurance policies may pay for a few years or up until the policy ends.
A person can apply for disability benefits via:
- the SSA website
- a prearranged appointment at a local Social Security office
A person should have some information ready when applying for disability benefits, including:
Travel To And From Work
You may need to travel for your job, but your medical supplies wonât stop you from meeting this need. You can take diabetes supplies through security. This includes:
- Insulin and products to dispense it, such as vials and pens
- Unused syringes when you have them along with injectable medication
- Lancets
- Used syringes when you carry them in a hard-surface container to store used syringes and test strips
- Liquids or gels
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Social Security Disability Insurance Benefits For Diabetes Mellitus
The Social Security Administration lists diabetes as an Endocrine Disorder in its medical Listing of Impairments.
However, SSA does not list diabetes individually as an impairment. SSA looks at how disorders resulting from diabetes affect different body systems. SSA also considers the combined effects of your impairments.
For example, hyperglycemia may damage your nerve and blood vessel function, which in turn can damage any number of body symptoms, such as your eyes, heart, kidneys, extremities, digestive system, or mental state. If your condition fulfill the medical requirements of one affected SSA Listings, you may qualify for Social Security disability benefits for diabetes mellitus.
If your condition does not fulfill SSA listing criteria, SSA then goes to the next step to evaluate your disability claim.
At this stage of review, disability is based on whether you have the residual functional capacity to work and earn a living, given the combined effect of all of your health problems. RFC is a measure of the maximum you can still do despite your impairments.
Filing Your 2nd Appeal
If your first appeal is rejected, you can appeal a second time . This time, your case will be reviewed by an administrative law judge in the Social Securitys Office of Disability Adjudication and Review, explains the ADA.
The length of this application and response can take up to an entire year. While the process does not require an attorney, youll likely appreciate the support of one for this final attempt at acquiring disability benefits.
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For Many People Diabetes Mellitus Is Hard To Control
Those who do not live with diabetes may not understand how it becomes so disabling. Serious diabetes complications can result over time, causing chronic, painful, and destructive injury to many body organs and organ systems, including the heart, blood vessels, eyes, kidneys, gastrointestinal tract, and nerves.
How Do I Apply
You can do it through the local Social Security Administration office or state agencies .
You can apply in person, over the phone, by mail, or online. DDS will get information from your doctors to decide if your diabetes qualifies as a disability.
If you donât qualify, your case is kept on file in case you decide to appeal.
The process isnât quick. It can take 3 to 5 months to get a decision, depending on how long it takes for DDS to get your medical records and other information they need.
Itâs not unusual to be turned down the first time you apply. Up to 80% of first-time applications are rejected. If you appeal, it can take another 3 to 5 months to get a decision. If that appeal gets denied, you can appeal once more before an administrative law judge. That process can take as long as 2 years.
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Filing An Appeal If You Are Denied
The process of filing your first appeal will likely take another 3 to 5 months. Also referred to as reconsideration, this requires simply submitting the paperwork again.
If you havent already done so for your first application, working with a Disability Support attorney can be very helpful. An attorney can help ensure that the documentation on your health is thoroughly and constructed properly to illustrate a clear need for financial assistance.
You can also visit these two sites to find legal support for your appeal process:
Is Type 1 Diabetes Classed As A Disability
There are two types of diabetes to consider. Type 1 diabetes is an autoimmune condition caused when the body attacks its own cells, making them unable to produce the hormone insulin.
The body needs insulin to move glucose, a type of sugar, from the blood into its cells for energy. Without insulin, the level of glucose in the blood gets too high.
Insulin injections help people with type 1 diabetes reduce the glucose level in their blood and manage their condition. Type 1 diabetes is officially classified as a disability.
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How Does A Person With Diabetes Qualify For Disability Benefits
Diabetes is listed in the Social Security Administrations impairment listing manual, or Blue Book, as a condition which can qualify a person for Social Security Disability benefits, explains Disability Benefits Help.
Its important to know that a diagnosis of type 1 or type 2 diabetes on its own will not qualify you for disability. Instead, there must be an additional diagnosis of a diabetes-related complication or condition often associated with diabetes.
Many of the complications that can result from years of living with diabetes like retinopathy, nephropathy, amputation can significantly impact your ability to function and work on a daily basis.
Applying For Ssdi For Your Diabetes
Applying for SSDI is a multistep process. First, the initial application must be completed, along with a detailed activities of daily living questionnaire. A doctor must verify the relevant medical information and confirm that the diabetes will last for at least a year. Only 35 percent of SSDI claims are approved at the initial application stage.
If you are denied SSDI benefits, the second step is to request a reconsideration within 60 days. Your medical and job information must be verified and updated, and a different person will consider your application. The process takes three to five months. Nearly 90 percent of first reconsiderations are denied.
If the SSA denies your first reconsideration, you may appeal that decision within 60 days to an Administrative Law Judge, who will hold a hearing and rule on the case. Almost two-thirds of administrative appeal decisions are in favor of the applicant.
If the decision is not in your favor, you can take the next step and ask for a review by the SSDI Appeals Council. If this is denied which happens in 98 percent of the cases the final step is to file suit in federal court.
For more information about Social Security disability and diabetes, please see the SSA Blue Book, Section 9.00.
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Make Sure You Take The Right Steps With Your Diabetes Disability Claim
Social Security, insurance companies, and the VA will all require your medical history and ongoing screening, along with medical records from your treating doctor, your endocrinologist, and any other specialists you see for diabetes complications .
Regular screening is important to detect diabetes-related health problems early and to track treatment regimens against signs of worsening conditions. We can help you in all of these vital areas and more, to fully develop your claim or to fight a claim denial on appeal.
Call on us 24/7 1 562-9830. We handle cases nationally.
More articles on getting disability benefits with diabetes.
How Is Eligibility Determined
A person will only be eligible for disability payments if they can demonstrate total or severe disability that prevents them from undertaking most work. Medical experts must expect the disability to last at least 1 year or end in death.
There is an earnings cap that changes annually. People cannot earn above this cap and continue receiving disability benefits.
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It’s Difficult To Get Disability For Controlled Diabetes But Most Diabetic Applicants Suffer From Related Medical Problems That Limit Their Ability To Work
By Aaron Hotfelder, J.D., University of Missouri School of Law
An individual may qualify for Social Security disability benefits based on uncontrolled diabetes or related symptoms like peripheral neuropathy or poor vision. While diabetes that is well-controlled with medication won’t form the basis of a successful claim on its own, most disability applicants with diabetes also suffer from other medical problems that limit their ability to work. When filing for disability benefits for diabetes, it’s important to list all your symptoms and diagnoses, even those unrelated to your diabetes.
Technical Eligibility For Benefits
Childrenunder age 18 are only eligible for Supplemental Security Income, or SSIbenefits. SSI is awarded to families with a dire financial need for help. Thismeans that if your familys monthly income is too high, you will not qualify.The larger your family, the higher your income limits.
For example, a single parent with one child couldnt earn much more than $38,000 per year while qualifying for SSI. A two-parent household with three children, on the other hand, could earn up to $55,000. The SSA has a chart online outlining exactly how much your family can earn per month while still qualifying for SSI.
Unfortunately, income limits are the top reason why children with type 1 diabetes are denied benefits. The good news is that once your child turns 18, your income no longer counts towards his or her income limit, even if your child still lives at home.
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Skin Infections That Are Slow To Heal
People suffering from diabetes often have trouble healing from infections, especially superficial skin wounds. As many as one in three diabetes patients will develop some type of skin issue. Patients with diabetes appear more susceptible to skin infections, including fungal and bacterial infections.
The list of skin issues that seem to prey on diabetes patients is long and varied, ranging from simple pruritus, or itching of the skin, to dangerous skin infections like those caused by Staphylococcus aureus. Many of the most common skin ailments are either caused or exacerbated by lack of appropriate blood flow, which is often seen in diabetes patients with poorly managed blood glucose. Patients with uncontrolled diabetes can develop styes, which are infections of the glands in the eyelids, and they also may more easily develop fungal infections in their fingernails and toenails.
In order to be eligible for SSDI benefits, you must have medical documentation of skin infections that fail to appropriately heal within three months, making walking or using your hands difficult or impossible.
It is important to note that meeting the listings is only one way to qualify for benefits based on diabetes/diabetes-related illnesses. If you have a severe condition but do not meet the listings, your work history, training, education, and age will be considered in determining whether you are able to work in any occupation that would be possible with your physical limitations.
Diabetes And Social Security Disability
If you are unable to work due to a disability, then you may qualify for federal disability benefits. Social Security Disability Insurance and Supplemental Security Income are two types of benefits designed to provide monthly income to individuals who are unable to work because of their disability. Depending on a number of factors, you may qualify for one or both of these programs.
People with diabetes may qualify for SSDI and/or SSI benefits. Typically, an applicant will not be approved for disability benefits for diabetes alone. However, if they have developed one or more medical conditions related to their diabetes, then they may qualify for Social Security benefits if their conditions are sufficiently severe.
Being approved for Social Security disability benefits can be challenging, whether you have diabetes or a related condition. A skilled New Jersey can work with you to help you get the benefits that you need.
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Limitations Based On Your Monthly Income
In order to receive SSI benefits, your monthly income must not exceed a certain amount, explains the ADA. The amount changes each year, and your earnings may offset your benefit amount.
Additionally, if you live with a spouse who is not eligible for SSI benefits, the SSA may include your spouses income when determining your SSI benefit.
For a child with a disability under age 18, the SSA may count some of the parents income in figuring the childs SSI benefit. Additionally, you cannot own property in excess of a specified amount at the beginning of each month. The limits are $2,000 for an individual and $3,000 for a couple. You do not have to count certain things towards this $2000 or $3000 limit, such as: your home, household goods and personal items, one vehicle, property of your personal business, certain amounts of life insurance, and certain amounts of housing assistance.