If diabetes is preventing you from doing day-to-day activities, you may be eligible for disability benefits. In the year 2021, nearly 2.1% of disabled workers got approved for the Social Security Disability Benefits for endocrine disorders including diabetes.
To help disabled workers get a better idea of whether they may qualify for the benefits, you need to know the eligibility criteria of the SSA for diabetes and how to proceed with the disability claim process.
Is Diabetes A Disability?
Yes, diabetes can be considered a disability under certain circumstances. Type 1 Diabetes qualifies for disability in the US. In Type 2 Diabetes, people must be given accommodations along with the right to let them live according to the Americans with Disabilities Act (ADA). The determination of whether diabetes qualifies as a disability depends on the extent to which it substantially limits a person’s major life activities, such as working, walking, or caring for oneself.
Individuals with diabetes may be eligible for SSDI and SSI benefits if they meet certain requirements. The claimants must meet the medical criteria set by the SSA. Diabetes is mentioned under listing 9.00 of the Blue Book under the category of endocrine disorders.
To determine eligibility, the SSA reviews medical evidence, including laboratory results, treatment records, and statements from healthcare providers. It is essential to provide detailed and up-to-date medical documentation to support your claim.
How Does The Social Security Administration (SSA) Define Diabetes?
As there are two types of diabetes namely Type 1 and Type 2 diabetes, the SSA will be considering whether you meet the eligibility requirements or not. The SSA will decide when your health condition is severe and has been lasting for 12 months or more.
Can You Get Disability Benefits For Diabetes?
Yes, it is possible to qualify for disability benefits for both Type 1 and Type 2 diabetes. However, eligibility for disability benefits depends on several factors, including the severity of the condition, its impact on your ability to work, and the specific criteria set by the disability programs for at least 12 months or more.
The Social Security Administration considers factors such as the frequency and severity of hyperglycemia episodes, complications related to diabetes, the effectiveness of treatment, and the functional limitations caused by the condition.
To be considered disabled due to diabetes generally requires demonstrating that the condition and its associated complications substantially limit your ability to perform essential job tasks or engage in substantial gainful activity.
What Is Diabetes?
Diabetes is a chronic health condition characterized by high levels of glucose (sugar) in the blood. It occurs when the body either doesn’t produce enough insulin or cannot use the insulin it produces effectively. Insulin is a hormone that regulates blood sugar and allows cells to use glucose for energy.
Common Types Of Diabetes
There are several types of diabetes, including:
- Type 1 diabetes (an autoimmune condition where the body doesn’t produce insulin)
- Type 2 diabetes (a condition where the body becomes resistant to insulin or doesn’t produce enough)
Diabetes can have significant health implications and requires ongoing management, including medication, dietary changes, regular exercise, and monitoring blood sugar levels. If uncontrolled, diabetes can lead to various complications, such as
- Heart disease
- Kidney damage
- Nerve damage
- Hearing impairment
- Alzheimer’s disease
- Vision problems
What Are The Symptoms Of Diabetes?
The symptoms of diabetes can vary depending on the type of diabetes and the individual. Some common symptoms associated with diabetes disability are as follows:
- Frequent urination: Increased urination, especially during the night.
- Excessive thirst: Feeling unusually thirsty and needing to drink more fluids.
- Unexplained weight loss: Losing weight without trying, despite increased appetite.
- Fatigue: Feeling tired and lacking energy, even with sufficient rest.
- Increased hunger: Experiencing intense hunger, particularly after eating.
- Blurred vision: Having blurred or impaired vision.
- Slow-healing wounds: Cuts and sores take longer to heal than usual.
- Tingling or numbness: Feeling tingling, numbness, or pain in the hands and feet.
- Recurrent infections: Increased susceptibility to infections, such as urinary tract infections or yeast infections.
- Dry skin and itching: Skin becomes dry and itchy due to high blood sugar levels.
How Will I Qualify For Diabetes?
Whenever you are applying for diabetes, you may be able to prove that you are on insulin and your A1C test results show that it is showing at least 10% or higher. Furthermore, if your symptoms show that your medical condition is not improving despite medical treatment. If you are experiencing any of the complications mentioned below, your chances of approval may increase:
- Diabetic ketoacidosis (DKA), if you are required to go to the hospital for treatment
- Peripheral neuropathy
- Cerebral edema and seizures
- Cardiac arrhythmias
- Intestinal necrosis
- Hyperglycemia resulting in long-term complications
- Chronic hyperglycemia
- Diabetic nephropathy
- Mental health conditions such as anxiety or depression that make it difficult to treat diabetes
You must also consult a healthcare provider who may help you document your medical condition and may help to prove your diabetes to the SSA. Moreover, you will also be required to submit detailed medical records, diagnosis of diabetes, and treatment records.
If Your Answer To The Following Questions Results In YES, You Can Qualify For The Benefits.
Some questions that may help you in your disability claim are as follows:
- Are you insulin-dependent? Without insulin, is your sugar uncontrollable?
- Are you experiencing neuropathy?
- Do you have A1C results that indicate 10% or higher?
- Are your open wounds untreatable?
- Do you have been hospitalized for ketoacidosis?
- Are you struggling with multiple disabling conditions along with diabetes?
My Diabetes Meets The Eligibility Criteria. Now What?
If your diabetes meets the eligibility criteria, the next step is to apply for diabetes disability benefits. Some of the general steps are:
- Gather necessary documentation: Collect all relevant medical records, including doctor’s notes, laboratory test results, treatment history, and any other supporting documents that demonstrate the severity and impact of your diabetes on your ability to work.
- Review eligibility criteria: Familiarize yourself with the specific eligibility criteria for disability benefits. You would need to meet the requirements set by the Social Security Administration for disability benefits.
- Complete the application: Fill out the disability benefits application form provided by the relevant government agency, such as the SSA.
- Submit the application: Submit your completed application and supporting documents to the SSA according to their guidelines. Be sure to keep copies of all documents for your records.
My Diabetes Does Not Meet The Eligibility Criteria Of The SSA. Now What?
Disabled applicants try to control their diabetes and try to work. However, qualifying for the benefits may be difficult. Approximately 20% of the applicants get approved at the initial phase of the disability claim.
You can apply for the benefits even if your initial application has been rejected. One of the options is to file an appeal by getting help from a disability lawyer. They are well-versed in the legal system and how to guide you in the best possible way.
How Much Is a Disability Check For Diabetes?
The average monthly disability check for diabetes and similar endocrine disorders is approximately $1,318.54. However, the amount will vary depending on your work history and income.
In 2023, for Social Security Disability Insurance (SSDI), the maximum amount of benefits is nearly $3,600 every month, and Supplemental Security Income (SSI) benefits per month will be $914.
Need Legal Help? Contact Experienced Lawyers
A Social Security disability lawyer can provide invaluable assistance in obtaining diabetes disability benefits. They possess knowledge of disability law, eligibility criteria, and the application process. They can evaluate your case, gather and organize the necessary medical evidence, and ensure all required documentation is prepared correctly and submitted if your initial application gets denied.