Disability Benefits for Uncontrolled Diabetes and Severe Diabetic Complications

Disability Benefits for Uncontrolled Diabetes and Severe Diabetic Complications

This is a guest post by Molly Clarke. Molly is the Social Media Coordinator for Social Security Disability Help. She contributes regularly to the Social Security Disability Help blog where she works to promote disability awareness and assist individuals throughout the disability application process.

Diabetes is a fairly common medical condition that can often be controlled with medication and lifestyle changes. Unfortunately, not every diabetic is able to manage their symptoms. When diabetes cannot be controlled, serious health complications can arise. These may include kidney disease, vision loss, neuropathy, or tissue necrosis. Serious side effects such as these can make it impossible to maintain employment and earn a living.

If—despite following medical instructions—serious complications keep you from working, you may be eligible for Social Security Disability benefits.  The following article will give you a general overview of Social Security Disability and will provide you with the information needed to begin the application process.

Overview and Basic Requirements

The Social Security Administration is responsible for two different types of benefits. These are:

  • Social Security Disability Insurance (SSDI) - this type of benefit is offered to disabled workers and their dependent family members.
  • Supplemental Security Income (SSI) - this type of benefit is offered to elderly, blind, or disabled individuals who earn very little income.

To qualify for benefits from either program, you must first meet the SSA’s definition of disability. This definition is comprised of the following:

  • You are considered to have a disability if you suffer from a medical condition(s) that prevents gainful employment (Gainful employment is considered to be $1,040 a month for a disabled individual and $1,740 a month for a blind individual.); and
  • You have a physical or mental condition that has lasted or is expected to last at least 12 months or otherwise result in death.

If you meet both of these criteria, the SSA will consider you to be disabled. However, if the SSA believes that you can be “retrained” to do a different type of work, you will not be considered disabled.

Technical Qualification

In addition to meeting the SSA’s definition of disability, you must also meet technical eligibility criteria.

SSDI technical eligibility requirements are based on an applicant’s work history and tax contributions.

SSI technical eligibility requirements are based on having very limited income and financial resources.

Medical Qualification

After meeting the SSA’s definition of disability and the technical eligibility requirements, the SSA will then asses your medical eligibility. To do so, they will consult their official guide of disabling conditions—often referred to as the blue book. The blue book is essentially a list of all potentially disabling conditions and symptoms that qualify an applicant for Social Security Disability benefits.

Diabetes appears under listing 9.00 (Endocrine Disorders) of the SSA’s blue book. Section five of this listing states that to qualify with diabetes, applicants must provide evidence of the following:

  • Uncontrolled hyperglycemia (high blood sugar), despite following prescribed treatments.
  • Experience acute and long term complications from the condition.

If you do not meet the criteria of above-mentioned listing, you will be evaluated based on your specific complications or impaired body system. These may include the following blue book listings:

  • Section 1.05 – Amputation  
  • Section 2.00 – Special Senses and Speech (diabetic retinopathy)
  • Section 4.00 – Cardiovascular System (heart disease)
  • Section 5.00 – Digestive System (digestive complications)
  • Section 6.02 – Impairment of Renal Function (diabetic nephropathy or kidney disease)
  • Section 8.00 – Skin Disorders
  • Section 11.00 –  Neurological Disorders (central and peripheral nervous system complications)
  • Section 12.00 – Mental Disorders (mental and emotional complications)

It is important to note that the SSA will consider the combined effects of your symptoms when evaluating your application. This means that if your symptoms and side effects don’t match one specific blue book listing, you can still qualify for disability benefits if the combined effects of your medical conditions prevent you from working. For this reason, it is important to include information on all of your medical conditions when filling out your application for disability benefits.

Preparing to Apply for Benefits

Prior to beginning the Social Security Disability application process, you should collect extensive medical documentation to support your claim. This may include records of your diagnosis, physical examinations, mental examinations, and treatments. You should also collect written statements from all treating physicians who can attest to your physical and mental abilities. Without significant medical proof, you will not be approved for Social Security Disability benefits.

Once you are ready to begin the application process, you can do so online or in person at your local Social Security field office. It is important that you complete all forms in as much detail as possible. This will give the SSA a thorough understanding of your condition and day-to-day limitations.

After submitting your application, it may be months before you receive a decision. It is very important that you prepare yourself to face the possibility of a denial. While waiting for a decision, you should continue to collect up to date medical records in case you have to appeal a denial. Although being denied is certainly disheartening, it is not the end of the application process. If you are, in fact, denied, you will have 60 days to appeal this decision

Although the SSD application and review processes are long and complicated, disability benefits are often a valuable resource for those with debilitating health conditions. The time and effort it takes to submit a complete application is often worth the hassle for those who are awarded benefits in the end.

For more information about Social Security Disability Benefits visit Social Security Disability Help.