Diabetes and Social Security Disability

Diabetes is a life-threatening condition that affects almost 30 million Americans, the American Diabetes Association (ADA) reported. The number of cases of diabetes has been rising steadily over the years, causing almost 70,000 deaths in 2010 and contributing to about 230,000 more.

If you or a loved one has been diagnosed with diabetes, there is help available. The Social Security Administration (SSA) offers financial benefits for those struggling to work due to a disabling disease.

The Financial Costs of Diabetes

Diabetes is an expensive condition, costing individuals more than twice as much in healthcare costs than their healthy counterparts. ADA reports that those suffering from the condition will pay an extra $7,900 each year in hospital care, prescriptions, supplies, doctor’s visits and other direct medical expenses.

In addition to direct medical costs, diabetes caused $69 billion dollars in indirect costs, which include missed workdays, decreased productivity at work, and the inability to work. This means, on average, those with diabetes are also losing almost $2,500 per year.

Diabetes Self-Management pointed out that many with diabetes have trouble affording the necessary prescriptions and supplies, even with the help of insurance. Though some pharmaceutical companies offer assistance for those who can’t afford to pay full prices, people with diabetes are two and a half more times likely to be unemployed or live in poverty.

There are three types of diabetes. Type 1 or juvenile, is often diagnosed in children or young adults, and happens when their bodies can’t make enough insulin. Type 2 or adult onset, is usually caused by unhealthy lifestyles, and happens when their bodies can’t use insulin correctly. The third, gestational diabetes, occurs during pregnancy and rarely qualifies for benefits. In the United States, Type 2 is much more prevalent than Type 1, affecting 95 percent of diabetes population.

There is no cure for diabetes, but it can be kept under control by treatment, exercise, and healthy eating. However, even when managed, diabetes can take a toll on your life and your finances while restricting the jobs you’re able to do. Some sufferers have a case of diabetes too severe to manage on their own, and Social Security Disability (SSD) benefits can help you.

Medically Qualifying for Benefits with the Blue Book

When evaluating SSD applications the SSA uses the Blue Book. The Blue Book is a master list of all the impairments the SSA deems eligible for disability benefits. If you are applying for SSD under a listing, you need to meet or equal the requirements.

Diabetes can be found in section 8.00—Endocrine Disorders

The SSA assesses endocrine disorders by the other body parts affected by the disorder. To be approved for SSD with a Blue Book listing of diabetes, you need to submit medical proof to the SSA that at least one of the following disrupts other body functions:

  • Chronic hyperglycemia, constant high glucose levels, causes long-term nerve and blood vessel complications, which can adversely affect your other body systems.
  • Diabetic ketoacidosis (DKA) occurs when a severe insulin deficiency causes your glucose and acid levels are too high for your body to function and usually requires hospitalization to reverse. This should happen at least once every two months.
  • Hypoglycemia, or episodes of abnormally low blood glucose, which can lead to seizures or loss of consciousness.
  • Neuropathy, or when your diabetes significantly affects two extremities and causes long-term disruption in movement, walking, or standing.
  • Diabetic Retinopathy occurs when there is severe peripheral vision loss from damage to blood vessels in your eyes.

If you feel your diabetes is so severe that you’re unable to work, talk to your doctor. He or she can help you determine if applying for SSD is right for you.

Qualifying Without Meeting a Medical Listing

It’s rare to be approved for SSD with diabetes without another condition caused by the diabetes, which makes it hard for some to meet the Blue Book requirements. If your diabetes is too hard to manage, despite treatment, there is another option for your application.

When making a decision on your disability claim, the SSA will also consider your Residual Functioning Capacity (RFC). These approvals are more common than Blue Book approvals, because they measure the limitations of your condition that would affect your ability to work and/or do daily tasks. Like all SSD applications, an RFC approval requires that your diabetes be expected to keep you out of work for at least 12 months.

The SSA will evaluate the severity of your diabetes, as well as what you’re doing to manage the disease, and decide what level of work you can do—sedentary, light, medium, heavy, and very heavy. Then, it will look at your work history, age, education level, and skills to gauge what jobs are available in your work level. Diabetes can cause a number of related conditions, so finding a job to accommodate those may be challenging, especially for an older adult.

Criteria for RFC decisions are usually only for applicants 45 years and older, but more commonly for those 49 or older. If you’re younger than 45, you can argue either that you have non-exertional limitations, such as bending or arguing you can’t even do sedentary work, for reasons like frequently hospitalization, the constant need to shift between sitting and standing, inability to walk at times, and contents seizing or fainting, which are all possible side effects of diabetes.

Individuals who don’t have a college education or have no or limited skills for indoor jobs will have a better chance of approval, because they might not have learned the necessary skills for other kinds of jobs. For example, those with experience only in jobs with a lot of movement, walking, and standing, like construction, manual labor, or a minimum wage employee will be approved over someone who has worked in an office for most of his or her life.

How to Apply for Social Security Disability Benefits

If your diabetes is severe enough that it interferes with you ability to perform daily living activities or work activities, talk to your doctor about your likelihood of qualifying for disability benefits through either the Blue Book or an RFC. The application can take up to two years, while costing money you may not have and causing you unnecessary stress, so if approval isn’t likely, the time and effort of the application may not be worth it.

You are responsible for including all the necessary documentation. In addition to every relevant piece of medical information, you’ll also need personal documents, such as a birth certificate and tax information. Sending incomplete forms or insufficient medical evidence could force the SSA to take the time to collect the information themselves or deny you benefits.

Necessary medical testing will include:

  • Results from a fasting plasma glucose test, which is administered after an 8-hour fast
  • Results from an oral glucose test, which is administered after an 8-hour fast and waiting an additional 2 hours after a drinking a beverage that contains glucose
  • Results from a random plasma glucose test, which is given at any time without fasting
  • Other blood tests, including those that document other conditions, such as Diabetic ketoacidosis
  • Records of all hospitalizations and/or surgeries due to your diabetes
  • History, length, and outcomes of all prescribed treatments
  • Reports from your doctor detailing the severity and physical limitations of the diabetes

You can apply for Social Security Disability Insurance in person at your local SSA office, over the phone, or on their convenient online application. You can only apply for Supplementary Security Insurance in person at an SSA office.

Whether you’re applying online or in person, make sure you application has no errors and no questions are left blank. The SSA deals with thousands of cases on a daily bases, and missing or wrong information can cause a denial of benefits, or at the very least a delay.

If there is any new medical evidence during the process of the application, such as hospitalizations, doctor’s visits, or medication alterations, you need to notify the SSA immediately, because it will only help your case. The more medical proof you have of the limitations of your diabetes, the higher your chance of approval will be.

If you’re approved for SSD, your spouse and children may be entitled to benefits as well. Visit our pages on Social Security Disability Insurance to learn more about the necessary forms and requirements for SSD applications.