For individuals living with chronic liver disease, continuing to work may become impossible. Thankfully, the Social Security Administration (SSA) has created two distinct disability programs to help those who are too sick to work due to a health-related condition.
Before receiving disability benefits, however, individuals need to meet specific criteria as outlined in the “Blue Book.” The Blue Book, another name for the SSA’s online publication Disability Evaluation under Social Security, contains all of the physical and mental impairments that could qualify an individual for disability benefits.
How the Blue Book Can Help You Medically Qualify for Disability with Liver Disease
If you have been diagnosed with chronic liver disease, section 5.05 of the Blue Book is where you will want to turn. This section of the Blue Book addresses digestive system disorders, and liver dysfunction is included in this category.
To meet the listing for liver disease, the condition must be chronic. Many acute liver problems are often reversible.
There are many conditions that it into the category of chronic liver disease including, but not limited to, hepatitis, alcoholic liver disease, non alcoholic steatohepatitis (NASH), primary biliary cirrhosis (PBC), primary sclerosing cholangitis (PSC), autoimmune hepatitis, hemochromatosis, drug induced liver disease, Wilson’s disease, and serum alpha 1 antitrypsin deficiency.
Several medical criteria need to be met to be granted disability benefits for chronic liver disease. According to the Blue Book, chronic liver disease is characterized by liver cell death, inflammation, or scarring (fibrosis or cirrhosis) that persists for more than six months.
As the liver works so closely with other organs, chronic liver disease may result in portal hypertension, slowing of bile flow, extrahepatic manifestations, or liver cancer. When the liver stops working effectively, it can cause bleeding from several areas, fluid accumulation in the abdominal and chest cavity, or swelling in the brain.
To be considered disabled, a person must be affected by one of the seven following criteria:
- Bleeding from esophageal, gastric, or ectopic varices or from portal hypertensive gastropathy resulting in pale skin, sweating profusely, rapid pulse, low blood pressure or fainting. This hemorrhaging must result in hospitalization for a blood transfusion of at least two units of blood. If this occurs, the individual will be considered disabled for one year following the last transfusion.
- Fluid in the abdomen or lungs not attributable to other causes, despite continuing treatment as prescribed, present on at least two evaluations at least 60 days apart within a consecutive 6-month period.
- An infection of the lining of the abdomen with peritoneal fluid containing an absolute neutrophil count of at least 250 cells/mm3.
- Kidney failure associated with chronic liver disease in the absence of underlying kidney pathology
- Hepatopulmonary syndrome
- Hepatic encephalopathy
- End-stage liver disease
What Evidence Do I Need to Win My Liver Disease Claim?
In addition to listing the various medical impairments that could qualify an individual for disability benefits, the Blue Book also includes the medical evidence needed to support a claim. The medical documentation required for chronic liver disease will depend largely on the specific condition and symptoms.
First and foremost, the SSA will want to be provided with extensive laboratory results, including liver enzymes, total bilirubin, ammonia levels, albumin, and blood coagulation studies such as INR or platelets.
Imaging studies such as CT scans, MRIs, or liver ultrasounds are important as they may display liver enlargement, scarring, or fatty liver. Further, ultrasounds of the abdomen may show fluid in the lining of the stomach or a chest x-ray could show fluid around the lungs.
In some chronic liver cases, a liver biopsy is performed to show the degree of liver cell death, inflammation, fibrosis, or cirrhosis. Liver biopsy results, as well as any other procedures such as paracentesis or thoracentesis, should always be included in the medical record.
If a person’s chronic liver disease affects other body systems, documentation surrounding those systems should be included. For example, if the liver disease has led to hepatic encephalopathy, documentation of altered mental state or altered levels of consciousness need to be added.
Finally, if the chronic liver disease has resulted in end-stage liver disease (ESLD), scores from the SSA Chronic Liver Disease (CLD) as described in the Blue Book should be included.
Can A Lawyer Help Me Win My Claim for Liver Disease?
The medical criteria and evidence required to win a chronic liver disease disability claim are complex. In fact, section 5.05 is one of the more complicated parts of the Blue Book. Therefore, securing the help of a qualified Social Security lawyer may prove to be particularly beneficial.
An experienced disability lawyer is skilled at understanding the medical jargon included in the Blue Book and can help you to determine whether or not you have a strong case to earn a disability award. If you do not win your claim for liver disease, your lawyer will not be paid. As such, you only gain from contacting a disability lawyer or advocate.