Kidney dialysis is required when your own kidneys fail to operate as they should, and as kidney disease progresses, dialysis may be required more frequently to rid the body of toxins. When kidney dialysis is required multiple times per week, qualification for Social Security Disability (SSD) benefits is essentially guaranteed, though you will still need to proceed through the application and review processes in order for the Social Security Administration (SSA) to find you eligible for benefits. Even when dialysis is required less frequently, but is still necessary on a long term basis, you can qualify for SSD benefits.
Applying for SSD with Kidney Dialysis
The SSA utilizes a manual of potentially disabling conditions in the evaluation of applications for SSD benefits. This manual is known as the “Blue Book”, and it contains not only a listing of medical conditions, but also details of the documentation the SSA requires for validating a claim for disability benefits with each diagnosis.
Kidney dialysis falls under Section 6.00, Genitourinary Impairments, in the Blue Book, as dialysis is only a treatment for a medical condition and not a disability in and of itself. That being said, kidney disease that requires dialysis, and the treatments you must undergo, certainly result in disability and can prevent you from holding a full time job in which you’re able to earn a gainful living.
The eligibility and required documentation criteria for Kidney failure – which is the actual diagnosis under which the SSA will evaluate your claim for disability benefits – can be found in subsections “6.02: Impairment of renal function” in the Blue Book. To qualify for SSD under this listing, your kidney disease must:
- Have lasted or be expected to last at least a year,
- Require ongoing dialysis to manage the disease,
- Require kidney transplantation surgery,
- Cause continuous issues with elevated serum creatinine in urinalysis results.
To sufficiently document your disability through medical records and other information in your SSD application, you must ensure your substantiating documentation shows your “impairment of renal function” results in at least one of the following:
- Abnormalities in the bones due to inadequate processing of toxins by the kidneys
- Neuropathy or sensory or motor impairment
- Fluid overload syndrome resulting in hypertension or vascular congestion
If your kidney disease does not meet the criteria listed in Section 6.01 of the Blue Book, you could still meet the requirements of Nephrotic Syndrome, which appears under listing 6.06. This section of the manual documents the eligibility requirements for a number of kidney diseases that also require dialysis for ongoing treatment and management. To meet this listing, your kidney disease must cause:
- Severe edema for at least three months
- Low serum albumin and high protein levels in urinalysis
- Very elevated protein levels in urinalysis
Notably, if your kidney disease does require you to have kidney transplantation surgery, then you will automatically qualify for SSD benefits for one year following your surgery. Additionally, you can re-qualify after reevaluation, if you experience significant impairment even following the transplant.
Medical Documentation to Prove Kidney Dialysis
Regardless of which listing under which you may qualify for SSD benefits, medical documentation is critical to a successful application. You must ensure your medical records include:
- Records of all your medical treatments, hospitalizations and doctor visit
- Notes from your doctor showing the progression of your kidney disease
- Lab results supporting the diagnosis and the ongoing nature of your medical condition
- Findings from lab work and evaluations even after undergoing dialysis
- Renal biopsy findings, imaging scans showing bone abnormalities, and/or other clinical findings associated with the systemic affects – or wider implications for overall health – of your kidney disease
Qualifying for SSD with Kidney Dialysis without meeting a Blue Book Condition
Some individuals with kidney disease can also qualify for SSD benefits even if they don’t meet the listing criteria for either of the main categories listed above. To do so, your application must show you suffer from significant disability despite following prescribed treatments, including continuous dialysis. Qualification for SSD benefits in this manner is achieved through an evaluation of “residual functional capacity”, which is essentially a determination on what you are and are not able to do on a daily basis, including your ability to hold a job and perform essential job duties.
If you cannot work due to the affects of your medical condition, you can potentially qualify for SSD benefits under a “medical vocational allowance”. This basically means that you are unable to maintain gainful employment even though you don’t meet the criteria of a listed medical condition in the SSA’s Blue Book. Whether qualifying under a listed condition or under a medical vocational allowance, the medical records and other supporting documentation in your claim for benefits is still crucial to success.
Getting Help with Your Kidney Dialysis SSD Application
When applying for disability benefits with kidney disease of any kind, you must work closely with your doctor to ensure your medical records support your claim and meet the requirements of the SSA. You will also want to consider seeking the assistance of a disability advocate or Social Security Disability attorney. He or she will be able to help you fill out all the necessary forms, collect the right documentation for supporting your claim, and can assist you in proceeding through reevaluation reviews and appeal hearings, if necessary.