Although many individuals who have diabetes are able to control their condition with medical treatment or lifestyle changes, not all people are able to control their diabetes. As a result, they may suffer from severely debilitating side effects. These side effects can include vision loss, kidney disease, nerve damage, heart disease, and depression. Health complications and side effects such as these can make it impossible for a person to continue working. The resulting loss of income and lack of medical insurance can be financially devastating.
If you suffer from severe health complications as a result of uncontrolled diabetes, you may be eligible for Social Security Disability benefits. Disability benefits can be used to offset the cost of medical treatment and day-to-day expenses.
The following article will provide you with a general understanding of Social Security disability benefits and will prepare you to begin the application process.
The SSA’s Definition of a Disability
Although diabetes is a serious health condition, it is not typically thought of as a disability. To erase confusion surrounding the subject of disability, the Social Security Administration (SSA) has established an official definition of the term. According to the SSA’s definition of disability, an adult is considered to be disabled if he or she meets the following three criteria despite following medical advice:
• He or she has been diagnosed with a physical or mental health condition that prevents them from doing any type of work that they were once able to do; and
• He or she cannot adjust to other types work due to their health condition; and
• His or her health condition has lasted or is expected to last for at least twelve months or result in death.
Individuals who do not meet this definition will not qualify for any type of Social Security Disability benefits. Those who do meet this definition will be required to meet further technical and medical criteria.
Social Security Disability Technical Eligibility Criteria
The SSA offers disability benefits through two separate programs—Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). Each of these programs has separate technical eligibility requirements.
SSDI is an entitlement program offered to disabled workers and their eligible family members. To qualify for SSDI, applicants must have adequate work history and past Social Security tax contributions. Typically, applicants must have worked and paid taxes for five of the past ten years. However, this can change depending on the applicant’s age at the time he or she became disabled. More information about eligibility for SSDI available here.
SSI is a needs-based benefit program that offers financial assistance to elderly, blind, or disabled individuals who have very limited income and financial resources. Eligibility for SSI is based on strict financial limits set by the SSA. More information about eligibility for SSI available here.
It is important to note that applicants who qualify for SSDI but still fall within the financial limits for SSI may qualify for both types of benefits.
Social Security Disability Medical Requirements
When you apply for Social Security Disability benefits, the SSA will compare your condition to the conditions listed in a publication referred to as the blue book. The SSA’s blue book contains all information on all conditions that can potentially qualify an individual for Social Security Disability benefits. The blue book also contains specific medical criteria that must be met in order to be approved under each condition.
Diabetes is mentioned under blue book listing 9.00- Endocrine Disorders. To qualify under this listing you must be able to prove that you suffer from one of the following for an extended:
• Hyperglycemia- An abnormally high level of blood glucose; or
• Diabetic Ketoacidosis- An acute complication of hyperglycemia that causes the chemical balance of the body to became dangerously hyperglycemin and acidic; or
• Hypoglycemia- An abnormally low level of blood glucose.
View this complete listing here.
If you do not meet this blue book listing, you may be able to qualify under a listing related to your affected body system. Related listings include:
• Loss of visual acuity (Section 2.02)
• Impairment of renal function (Section 6.02)
• Peripheral neuropathies (Section 11.14)
• Cor pulmonale secondary to chronic pulmonary vascular hypertension (Section 3.09)
• Chronic heart failure (Section 4.02)
• Peripheral arterial disease (Section 4.12)
• Chronic infections of the skin or mucous membranes (Section 8.04)
• Depression (Section 12.04)
You can access all blue book listings here.
It is important to note that if you suffer from health complications as a result of failing to follow medical advice, you will not qualify for disability benefits—even if you meet a blue book listing.
Applying for Social Security Disability Benefits
Before applying for disability benefits, you will want to prepare yourself by collecting all the necessary records and documentation to support your claim. A list of required documents can be found on the SSA’s Adult Disability Checklist here.
Once you are ready to begin the application process, you can do so online or in person at your local Social Security office. If you apply in person, make sure to bring copies of all required medical and non-medical documentation with you. If you are applying online, you will be provided with a cover sheet that will allow you to fax the necessary paperwork to the SSA.
You will also be asked to fill out a number of forms including the Adult Disability Report and the actual disability application. It is important that you fill these out in their entirety. Any missing or incomplete information may result in the denial of your application.
When evaluating your disability claim, the SSA will consider the combined effects of all health complications that you suffer from. For this reason it is important to provide the SSA with information regarding any and all of your diagnosed conditions.
Receiving a Decision
After submitting your claim, you will not receive the SSA’s decision for approximately 3 to 6 months. If your claim is denied for any reason, you will have 60 days in which to appeal this decision. Although it can be very discouraging to have your initial claim denied, the appeals process is often a necessary step toward receiving disability benefits. In fact, many more applicants are approved during the appeals phase of the application process than during the initial application.
If you remain persistent in your efforts, you will be more likely to receive the financial assistance you need. For more information about disability benefits and diabetes, visit Social Security Disability Help or contact Molly Clarke at mac@ssd-help.org.