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Applying for Social Security Disability Benefits with Diabetes

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Applying for Social Security Disability Benefits with Diabetes

September 05, 2013

Written for Diabetes1 by Dan Henderson

While most diabetics are able to control their condition with diet and lifestyle changes and consistent use of prescribed medications, not all can. If you suffer from uncontrolled diabetes and diabetic complications that prevent you from maintaining gainful employment, despite following your doctor’s prescribed therapies, you may be able to qualify for disability benefits.

Disability Programs

The Social Security Administration (SSA) has two programs for which you may qualify:

 Meeting Medical Eligibility Requirements

You can potentially qualify for benefits by meeting the medical requirements in the diabetes listing in the SSA’s Blue Book (http://www.ssa.gov/disability/professionals/bluebook/), which appears in section 9.00.5. You can also qualify if you suffer from severe diabetic complications.

To meet the 9.00.5 listing, your medical records must show you have:

  • Uncontrolled high blood sugar, despite consistently following prescribed therapies

AND

  • Severe complications resulting from your diabetes.

Qualifying with Severe Diabetic Complications

Even if you cannot be found eligible for benefits under the listing for diabetes, you may be able to qualify, if you suffer from one of the following severe complications. Also keep in mind that the SSA will consider the combined effects of multiple complications and medical conditions. It is therefore crucial that your medical records contain thorough documentation of all the issues you suffer as a result of your diabetes as well as any other health conditions you have.

  • Gangrene and subsequent amputation of both hands, or one hand and one foot, or one or both feet, resulting in an inability to utilize a prosthetic device to get around effectively. If you require the more rare amputation of the hip joint, then you can also qualify under this listing.
  • Diabetic retinopathy resulting in vision loss and legal blindness with a visual acuity of 20/200 or lower.
  • Heart and circulatory complications, resulting in heart disease, artery disease, or arrhythmia and documented through electrocardiography, elevated or severely lowered resting blood pressure, venous insufficiency, and other medically acceptable diagnostic tests.
  • Serious digestive complications like intestinal necrosis or gastroparesis, documented through imaging studies and endoscopy, operations, and pathology reports.
  • Neuropathies and other central and peripheral nervous system complications, documented through appropriate diagnostic procedures for the area of the body affected. For example, if kidney function is impaired, then persistent elevation of serum creatinine must be shown in your medical records.
  • Cognitive impairment or mental or emotional disorders, like depression and anxiety, proven through IQ tests, psychological evaluations, and other clinical measures.

The Application Process and What to Expect

You can apply for benefits in person at the SSA’s local office or online (http://www.socialsecurity.gov/pgm/disability.htm), which is often the fastest way to file a claim. You should receive a decision on your claim within 3-6 months. Since diabetes is usually controllable, most applicants are initially denied for benefits. If you are denied, you will have to file an appeal within 60 days of receiving your notice of denial. You should consider hiring a disability attorney or advocate during the appeals process. 

For more information, visit Social Security Disability Help

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Photo: Alex G.

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