For people afflicted with genitourinary disorders resulting in chronic kidney disease (CKD), the costly, painful and incapacitating complications associated with their disorder often makes it impossible for them to perform their jobs and earn a living. If you find yourself unable to work due to CKD, you may be able to recover disability benefits from the Social Security Administration (SSA).
Collecting Social Security Disability Benefits for Kidney Disease
Depending on the situation, there are two types of benefits persons with genitourinary disorders can apply for: Social Security Disability Insurance (SSDI) benefits and Supplementary Security Income (SSI) benefits. While the requirements to receive benefits differ between the two, the medical criteria that must be met in order to be approved for benefits is the same for both. The SSA will determine the onset of your disability based on the facts in your case record.
In order to have your claim SSDI or SSI benefits approved, you must provide the necessary evidence to support your claim for disability benefits. If you file a claim to receive SSDI benefits for CKD, you will need to produce evidence that documents your condition and its severity. This evidence should include reports of clinical examinations, treatment records, laboratory findings (such as kidney or bone biopsies and your eGFR), and documentation of your response to treatment.
Factors in Determining a Benefits Claim for Kidney Disease
There are additional factors the SSA takes into account when making their decision on claims related to Social Security disability benefits for kidney disease. These factors are based on the specific type of kidney disease a person has:
Chronic kidney diseases requiring chronic hemodialysis or peritoneal dialysis
Ongoing dialysis must have lasted or be expected to last for a continuous period of at least 12 months. A report from an acceptable medical source must be submitted that describes your CKD and your current dialysis, and indicates that your dialysis will be ongoing.
The SSA will consider you to be disabled for one year from the date of transplant. After that, the SSA will evaluate your residual impairments by considering your post-transplant function, any rejection episodes you have had, complications in other body systems, and any adverse effects related to ongoing treatment.
Conditions resulting from impaired kidney function include:
- Renal osteodystrophy (bone degeneration) – Severe bone pain and imaging studies documenting bone abnormalities, such as osteitis fibrosa, osteomalacia, or pathologic fractures.
- Peripheral neuropathy – Must be a severe impediment which must also have lasted or be expected to last for a continuous period of at least 12 months.
- Fluid overload syndrome – A physical examination that documents signs and symptoms of vascular congestion, such as congestive heart failure, pleural effusion (excess fluid in the chest), ascites (excess fluid in the abdomen), hypertension, fatigue, shortness of breath or peripheral edema.
- Anasarca (generalized massive edema or swelling) – Persisting for at least 90 days despite prescribed treatment; the SSA requires a description of the extent of edema, including pretibial (in front of the tibia), periorbital (around the eyes), or presacral (in front of the sacrum) edema.
- Nephrotic syndrome – Laboratory findings must show Proteinuria of 10.0 g or greater per 24 hours; or Serum albumin of 3.0 g/dL or less, and Proteinuria of 3.5 g or greater per 24 hours; or urine total-protein-to-creatinine ratio of 3.5 and anasarca – on at least two occasions at least 90 days apart during a consecutive 12-month period.
- Anorexia (diminished appetite) with weight loss – Determined by body mass index of 18.0or less, calculated on at least two occasions at least 90 days apart during a consecutive 12-month period.
Complications Caused by Chronic Kidney Disease
Complications from chronic kidney disease can include strokes, congestive heart failure, hypertensive crisis, or acute kidney failure that require at least three hospitalizations within a consecutive 12-month period and occurring at least 30 days apart. Each hospitalization must last at least 48 hours, including hours in a hospital emergency department immediately before the hospitalization.
The SSA evaluates co-occurring conditions, including those that result in hospitalizations, under the listings for the affected body system or under the SSA rules for medical equivalence.
M. Stanley Whitehead – Board-Certified Social Security Disability Attorney
Applying for Social Security disability benefits for kidney disease can be a complicated procedure if you aren’t familiar with the process. It is not uncommon for an initial application for benefits to be denied. Many times, this denial of benefits has nothing to do with the legitimacy of a claim but rather that the applicant failed to provide the proper documentation and other supporting evidence required for the SSA to make their decision.
If your claim for disability benefits has been denied, the best thing to do is seek the services of an attorney with extensive experience handling Social Security disability cases. Your chances for success are greatly improved with experienced legal representation.
Don’t let a simple mistake prevent you from receiving the SSDI benefits you need. M. Stanley Whitehead is one of Houston’s leading SSDI attorneys and has helped hundreds of people in Houston, across Texas and throughout the entire United States to successfully obtain the disability benefits they deserve.
If chronic kidney disease has left you unable to work, contact the law offices of M. Stanley Whitehead to schedule a free consultation.