Compassionate Allowance - Hepatorenal Syndrome

Hepatorenal Syndrome (HRS) can qualify you for Social Security Disability (SSD) benefits regardless of the type from which you suffer, but types II and III also qualify under the Social Security Administration’s (SSA) Compassionate Allowances (CAL) program, which ensure your application will be reviewed as quickly as possible and virtually guarantees you will be approved for disability benefits.

CAL Designation

While HRS is automatically qualified medically for disability benefits, you must still complete the full application process, including providing the SSA with the medical evidence necessary to make an evaluation of your diagnosis and the severity level of your condition.

What the CAL program does is ensure your application will be reviewed more quickly. Rather than waiting the typical four months of more for an eligibility decision, you will likely have a determination in just a few weeks. That is, provided the SSA has the medical evidence they need to make a decision.

Medical Evidence Requirements

The SSA’s program requirements dictate that every SSD application meets certain standards, even those that fall within the CAL program. The minimum evidence that your application and medical records must contain includes:

  • A thorough clinical history that documents the diagnosis and the progression of your HRS
  • Physical examination reports that describe the features of your condition, including:
    • the symptoms,
    • severity level,
    • the impact of the condition on your abilities,
    • treatment you have undergone,
    • and the prognosis

The specific test results the SSA needs to see at minimum include:

  • Lab test results that show your serum creatinine levels are consistently elevated at 2mg/dL or greater
  • OR

  • Urine output of less than 500 mL in 24 hours
  • OR

  • Urine sodium results that show sodium levels of greater than 10 miliequivalents (mEq) per liter

To substantiate the severity level of your condition, the SSA may also evaluate your medical records under the Blue Book listing in Section 5.05D. Additional medical documentation can help prove your eligibility as well.

To fully document the diagnosis of HRS, your medical records must also include test results and other evaluations that rule out other causes of kidney failure. Additionally, clinical evaluations and lab tests that document liver compromise, kidney function, and the presence of other HRS signs and symptoms can only strengthen your claim for benefits. These additional medical records are helpful in your application for SSD:

  • BUN and serum creatinine measurements
  • Urine specific gravity urinalysis results
  • Ultrasounds of the abdomen
  • Liver test showing the signs of liver disease that precede HRS

SSD Benefit Programs

There are two SSD programs for which you may qualify:

  • Social Security Disability Insurance (SSDI)
  • Supplemental Security Income (SSI)

HRS types II and III both meet the medical criteria for SSD benefits under SSDI and SSI. However, both of these disability programs also have technical and financial eligibility rules.

  • For SSDI, you must be unable to earn a substantial living and must have the required work credits from your previous employment.
  • For SSI, you must have very limited income and other financial resources or assets, but there is no work credit or work history requirement.

Applying for Benefits

To apply for benefits with Hepatorenal Syndrome, you can visit the SSA’s website, or call the main helpline at 1-800-772-1213 to schedule an appointment to file your application in person at your local office. Online application however, is usually the fastest way to file a claim.