Kidney Transplant and Disability Benefits

Kidney Transplant and Disability Benefits: What You Need to Know

Kidney failure, which is also known as Stage Five Kidney Failure or renal disease, is a debilitating condition characterized by decreased urine output, fluid retention, fatigue and, in worst case scenarios, chest pain, seizures, and coma. One of the most effective treatments is a kidney transplant.

If you have reached the stage where a kidney transplant becomes necessary, chances are that you have been unable to work for a long time. This situation alone can have a serious impact on your well-being, as financial worries are a major stressor. Fortunately, having a kidney transplant makes you eligible for Social Security Administration (SSA) disability benefits, which will provide you with an income as you recover.

Kidney Transplants

Are Kidney Transplant Patients Considered Disabled?

A kidney transplant is a major surgical procedure that also has an expansive range of possible risks. Additionally, this procedure can be, and at times is, very painful for patients. Thus, people recovering from kidney transplant surgery are considered to have a physical impairment.

Most impairments stemming from physical incidents—such as surgeries, accidents, and/or injuries—can, or do, result in the individual with such an impairment being unable to perform physical tasks both in a working and personal environment. The Social Security Administration (SSA) decides if your kidney transplant qualifies you for disability benefits based on the following criteria:

  • you care unable to work and engage in substantial gainful activity (SGA) because of your medical condition caused by the kidney transplant;
  • you are unable to carry out the job you did previously or adjust to other work because of your kidney transplant;
  • your medical condition caused by the kidney transplant has lasted or is expected to last for at least the next 12 months or result in your death.
    It will help if you can find your kidney transplant in the SSA’s Blue Book as well as if you have the results of a Residual Functional Capacity (RFC) assessment which show what your physical and mental capabilities are as a result of your kidney transplant.

Do Kidney Transplants Qualify for Disability Benefits?

Yes, kidney transplant surgery qualifies for disability benefits from the Social Security Administration (SSA). Anyone who has received a kidney transplant will qualify for disability benefits for the 12 months that follow their transplant. After 12 months, the SSA will reassess the claim. If the kidney transplant recipient’s medical condition means they are still too sick to be able to work, the length of time for the disability benefits can be extended.

There are several symptoms of a kidney transplant that could prevent the recipient from working for 12 months which include:

  • the continual presence of urinary tract infections (UTIs);
  • persistent outbreaks of colds and flu;
  • an outbreak of pneumonia and cytomegalovirus (CMV), which both may need hospital treatment;
  • blood clots could develop in the arteries that have been connected to the donated kidney requiring urgent medical treatment;
  • narrowing of the artery which is connected to the donated kidney;
  • when the ureter becomes blocked, which is the tube that carries urine from the kidney to the bladder. It might be possible to drain the ureter with a catheter (a small tube) in order to unblock the ureter. However, surgery may be required to unblock the ureter.
  • acute rejection may take place. A rejection refers to when the immune system suddenly recognizes the donated kidney as foreign tissue and starts to attack it.

Typically, people who have had a kidney transplant(s) will qualify for disability benefits for 12 months following their surgery, starting on the day of their surgery. They just need to provide the evidence proving that they have been the recipient of a kidney transplant.

Further Reading: What Conditions Qualify For Disability?

Medically Qualifying with a Kidney Transplant

Kidney transplants are referenced in the Blue Book, a list of disabling conditions that the SSA uses to determine an applicant’s eligibility for benefits. Listing 6:05--Chronic Kidney Disease With Kidney Transplant states that the SSA will consider you disabled for 12 months from the date of your transplant. After that, it will reassess your condition by considering the following:

  • Your level of functionality after the transplant
  • Any kidney rejection episodes you may have experienced
  • Renal infection frequency
  • Complications in other areas of your body
  • Any negative effects caused by immunosuppressants and corticosteroid treatment

When you apply for disability benefits, your doctor must include the following information and documentation:

  • Tests and laboratory findings that confirm your diagnosis of kidney failure
  • All treatments you have received, as well as their results
  • Records of hospitalization due to kidney failure
  • Evidence of any post-transplant complications

Your doctor will also fill out a residual functional capacity (RFC) form, which allows the SSA to assess how much of an impact chronic kidney failure and your transplant have had on your ability to function.

Those with kidney failure requiring a transplant usually qualify for a compassionate allowance, which enables your disability claim to be approved in a matter of weeks instead of months. Additionally, you will be able to qualify for Medicare assistance as soon as your application is approved, instead of waiting for two years like many Social Security Disability beneficiaries do.

How Long Can You Be On Disability After a Kidney Transplant?

Kidney disease can lead to potential kidney failure and the subsequent necessity of having a kidney transplant. Kidney transplants are not guaranteed to succeed and, even at the best of times, can be painful with complications. Few people who have been suffering from kidney disease and who have had a kidney transplant would be expected to be able to return to gainful employment quickly. Fortunately, the Social Security Administration (SSA) recognizes the disabling condition resulting from a kidney transplant and may offer disability benefit payments for a period of 12 months following your transplant operation taking place.

This 12-month period is designed to allow the kidney transplant recipient to recover from the operation sufficiently without suffering severe financial hardship because of their inability to earn a living. At the end of the 12-month benefits eligibility period, the SSA will re-evaluate your condition and make a decision about whether you may be able to continue receiving disability benefits for a further period if you are still unable to return to work. Usually this is because of persistent medical conditions related to your original kidney disease or complications of transplant surgery. Examples of symptoms that may mean an extension of eligibility include:

  • a rejection of the donated kidney tissue;
  • continued presence of urinary tract infections, outbreaks of colds and flu or other infections related to suppressed immune responses;
  • blood clots or arterial narrowing related to the donated kidney.

Getting Help with Your Kidney Transplant Claim

Many people who apply for SSDI are denied at first, even if they have a Blue Book listed condition. Hiring a Social Security disability attorney will provide you with the professional insights and support that maximize your chance at approval. He or she can:

  • Ensure that your claim is properly filled out and includes the required supporting documentation
  • Submit the claim according to approved process
  • Represent you if an appeal becomes necessary

Working with a Social Security disability attorney increases the likelihood that you will receive the benefits you need when you need them. Once the SSA approves your claim, your attorney will ensure that the disability payments arrive on time and as scheduled, removing your financial worries so you can focus on your recovery.

Additional Resources