SSDI Benefits Could Help Those With Diabetes

Can You Get SSDI for Diabetes?

If you have diabetes, you may qualify for Social Security Disability Insurance (SSDI).

To find out if you qualify, review your condition under the Social Security Administration’s (SSA) five-step sequential evaluation process:

1. Are you working? The SSA defines work as the ability to engage in substantial gainful activity (SGA). If you are working and earning more than SGA, your benefits will be denied. To qualify, your condition must prevent you from working for at least 12 continuous months.

2. Your condition must be severe enough to limit significantly your ability to perform basic work activities like:

• Walking, standing, sitting, lifting, pushing, pulling, reaching, carrying or handling.
• Seeing, hearing and speaking.
• Understanding/carrying out and remembering simple instructions.
• Responding appropriately to supervision, co-workers and work situations.
• Dealing with changes in a routine work setting.

According to the American Diabetes Association, people with diagnosed diabetes incur average medical expenditures of $16,752 per year, of which about $9,601 is attributed to diabetes. On average, people with diagnosed diabetes have medical expenditures approximately 2.3 times higher than what expenditures would be in the absence of diabetes.*

*Sources: 1. https://diabetes.org/newsroom/press-releases/new-american-diabetes-association-report-finds-annual-costs-diabetes-be.

3. Diabetes mellitus (DM) and other pancreatic gland disorders disrupt the production of several hormones, including insulin, that regulate metabolism and digestion. Insulin is essential to the absorption of glucose from the bloodstream into body cells for conversion into cellular energy. The most common pancreatic gland disorder is DM.

There are two major types of DM: Diabetes type 1 and Diabetes type 2.

Both types are chronic disorders that can have serious disabling complications that meet the duration requirement. Type 1 DM – previously known as “juvenile diabetes” or “insulin-dependent diabetes mellitus” (IDDM) – is an absolute deficiency of insulin production that commonly begins in childhood and continues throughout adulthood. Treatment of type 1 DM always requires lifelong daily insulin.

With type 2 DM – previously known as “adult-onset diabetes mellitus” or “non-insulin-dependent diabetes mellitus” (NIDDM) – the body’s cells resist the effects of insulin, impairing glucose absorption and metabolism. Treatment of type 2 DM generally requires lifestyle changes, such as increased exercise and dietary modification, and sometimes insulin in addition to other medications. While both type 1 and type 2 DM are usually controlled, some individuals do not achieve good control for a variety of reasons, including, but not limited to, hypoglycemia unawareness, other existing disorders that can affect blood glucose levels, inability to manage DM due to a mental disorder, or inadequate treatment.

Diabetic ketoacidosis (DKA) is an acute, potentially life-threatening complication of DM in which the chemical balance of the body becomes dangerously hyperglycemic and acidic. It results from a severe insulin deficiency, which can occur due to missed or inadequate daily insulin therapy or in association with an acute illness. It usually requires hospital treatment to correct the acute complications of dehydration, electrolyte imbalance, and insulin deficiency. You may have serious complications resulting from your treatment, which Social Security evaluates under the affected body system. For example, SSA evaluates cardiac arrhythmias under 4.00, intestinal necrosis under 5.00, and cerebral edema and seizures under 11.00. Recurrent episodes of DKA may result from mood or eating disorders, which SSA evaluates under 12.00.

Social Security Ruling 14-2p provides further information on the evaluation of DM.

If your diabetes doesn’t satisfy a medical listing, the SSA continues to the next two steps to review how your limitations and symptoms affect your ability to work.

4. Can you perform work you’ve done in the past? If you can, benefits are denied. If you cannot, the process proceeds to the last step.

5. Are you capable of performing other work? SSA will review vocational factors (age, education, work experience), to determine what other work, if any, you can do. At this step, the SSA enlists medical-vocational rules. If SSA finds there is other work you can perform, benefits are denied. If SSA finds you do not have transferable skills to do any other work, benefits are awarded.