If you suffer from cirrhosis and it has left you unable to work, you may be eligible to receive Social Security disability benefits. The Social Security Administration (SSA) has the Social Security Disability Insurance (SSDI) program for individuals who are no longer able to work because of medical conditions. If you have worked enough to earn sufficient credits and to have paid enough taxes in to the SSA, you may be eligible for monthly benefits if you are deemed fully and completely disabled.
If you are deemed eligible for benefits, you may have some dependents who are also eligible, particularly your minor children. There are different kinds of cirrhosis. One kind is alcoholic liver disease, and there is a non-alcoholic form of cirrhosis. The common causes of cirrhosis are alcoholism, fatty liver disease, hepatitis B, and hepatitis C. There are a variety of other causes as well.
A chronic disorder that is progressive, cirrhosis causes healthy liver tissue to be replaced by fibrous scar tissue. The scar tissue results in a progressive loss of liver function, which can eventually lead you to need you to require a liver transplant. Once liver damage has occurred, it is irreversible to an extent. The severity of the cirrhosis and the extent to which you are incapacitated from engaging in your past work or doing any other kind of work impacts whether or not you are approved for disability.
The liver is a large organ located in your upper abdominal region, just below your diaphragm. It is designed to carry out a number of functions, including purifying the blood, detoxifying the body, and secreting bile for the digestion of fats. Often when the liver is diseased it can regenerate itself, but that can cause scar tissue, nodules, and fibrous tissue, which is called cirrhosis.
The symptoms are often not significant until the liver has been damaged. Some of those symptoms may include:
- Loss of appetite
- Fluid build-up in the abdominal area
- Swelling of the legs
- Unintended weight loss
If you don’t have the proper treatment, cirrhosis can lead to malnutrition, confusion or coma resulting from the buildup of toxins in the blood, increased blood pressure in the vein that takes blood to the liver and blood vessels can become enlarged and burst. You may also suffer from diabetes, kidney failure or gallstones that are caused by the cirrhosis.
The Cost of Treating Cirrhosis
Because of its severity and chronic nature, treating cirrhosis is expensive. The American Association for the Study of Liver Diseases and Trust for America’s Health estimates that treating cirrhosis can be as high as $62,000 for the first year of treatment. The first year of treatment after a liver transplant can be $267,000.
Patients who have a chronic liver infection with cirrhosis can expect to pay out $24,176 per year. If the cirrhosis has advanced to end-stage liver disease, the cost can be as high as $59,995 per year. The co-pays for the medications and treatment therapies are expensive, so even patients with health insurance can expect to pay out several thousands of dollars per year for co-pays, coinsurance, and deductibles.
The SSA Evaluation and Medical Qualifications
If you have been left unable to work because of cirrhosis, the SSA will use their medical guide of impairment listings, which is called the Blue Book.
Cirrhosis would fall under the classification for chronic liver disease. In order to be declared disabled and eligible for SSDI using that classification, you must meet the following criteria:
Hemorrhaging from varices of the esophagus or stomach or from disease of the stomach from high blood pressure in the abdominal arteries resulting in blood pressure that is unstable and requiring hospitalization for getting a transfusion of at least two units of blood or one of the following:
- The accumulation of fluid in the peritoneal cavity, causing abdominal swelling that cannot be attributed to any other causes despite of having continuing treatment. This must be present at least twice, 60 days apart within a 6-month time period OR
- Spontaneous bacterial infection of the abdominal wall or a pre-determined severity OR
- Hepatic encephalopathy that is of a pre-determined severity OR
- Liver failure of a pre-determined severity.
Some of the complications caused by cirrhosis may be sufficient reason to be approved for disability on your own. If your cirrhosis has caused diabetes mellitus, you could pursue disability based on that particular diagnosis.
Meeting Disability Criteria with an RFC and a Medical-Vocational Allowance
If your symptoms or complications do not meet the requirements that are set forth in the Blue Book, you could still be eligible for SSDI using the medical-vocational allowance with a residual functioning capacity (RFC) that shows your limitations and how you are left unable to work.
Disability Determination Services will complete a RFC to determine how your conditions and symptoms impact your ability to work. Your physician can complete a form for you, using his detailed experience and familiarity with your case to show that you are indeed unable to work and the limitations that he has given you in regards to your condition.
As an example, if you suffer from fluid buildup and nausea, you may not be able to bend or lift regularly. Swelling of the legs can keep you from walking significant distances or standing from long periods. The loss of appetite and fatigue can impact your ability to work, so you cannot sit, stand, or walk for long periods.
Applying Specific Medical Tests to Your Case
If you have cirrhosis of the liver, you have undergone extensive testing, including MRI and CAT scans, lab work that includes blood tests and urine samples, and biopsies and tissue samples. The disability claim process is very detailed and intensive, so you should provide as many records and as much documentation as possible to expedite the process.
The SSA sometimes orders at their expense medical evaluations and mental evaluations with the physicians they choose at their expense. These evaluations are to confirm conditions and symptoms and are not intended for any kind of medical treatment. If you are scheduled for an evaluation, you should attend it as it is an important part of the disability determination process.
You may be denied disability benefits twice, and you can appeal those rulings. The final step is to request a hearing before an administrative law judge for a ruling on your disability case. Be prepared for a lengthy process when you apply for SSDI benefits.