Chronic kidney disease, renal failure, and kidney transplant surgery all qualify for disability benefits from the Social Security Administration (SSA). The SSA understands that kidney disease and similar conditions present challenges in terms of medical expenses, everyday functional limitations and maintaining employment. Because of this, the SSA has standard disability listings for each of these conditions that qualify for disability.
Is Kidney Disease a Disability?
Yes, kidney disease can qualify for Social Security disability benefits. The SSA considers kidney disease to be a disability if you cannot work for at least 12 months and meet a Blue Book listing.
When kidney disease is advanced it may be possible to apply for disability benefits from the Social Security Administration (SSA) as long as you are likely to be out of work for at least 12 months.
Medically Qualifying for Disability for Kidney Disease
Before an SSDI application is submitted it is necessary to meet the requirements found in the SSAs Blue Book listing. Doing so can be the one of the most important signs your disability claim will be approved for kidney disease.
These listings are used to review disability applications, applicant medical records, and other documentation to determine eligibility for Social Security Disability for kidney disease.
There are several listings for kidney disease which include:
Section 6.03 Chronic Kidney Disease, which requires:
- chronic hemodialysis or peritoneal dialysis
Section 6.04 Chronic Kidney Disease, kidney transplant which requires:
- you are considered to have a disability for 1 year after a kidney transplant.
Section 6.05 Chronic Kidney Disease, with impairment of kidney function with:
- reduced glomerular filtration at least 90 days apart during a 12-month period:
- Serum creatinine of 4 mg/dL or greater; or
- Creatinine clearance of 20 ml/min. or less; or
- Estimated glomerular filtration rate (eGFR) of 20 ml/min/1.73m2 or less. AND
- One of the following:
- Renal osteodystrophy; or
- Peripheral neuropathy; or
- Fluid overload syndrome documented by:
- Diastolic hypertension OR
- Sings of vascular congestion or anasarca; or
- Anorexia with weight loss with a BMI of 18.0 or less
6.06 Nephrotic Syndrome with:
- Laboratory findings within 90 days of a 12-month period:
- Proteinuria of 10.0 g or greater; or
- Serum albumin of 3.0g/ddL or less and
- Proteinuria of 3.5 g or less; or
- Urine total-protein-to-creatinine ratio of 3.5 or greater. AND
- Anasarca persisting for at least 90 days despite prescribed treatment.
6.09 Complications of Chronic Kidney Disease requiring:
- at least 3 hospitalizations within a 12-month period occurring 30 days apart. Each hospitalization must be at least 48 hours long (including hours in the emergency department).
Along with these listings, kidney disease can also qualify as a compassionate allowance. Compassionate Allowance (CAL) Listings are severely disabling or terminal illnesses that fall under special review and approval guidelines with the SSA. Applications filed on these conditions are expedited to get benefits started as quickly as possible. Two kidney diseases are among the CAL program listings:
- Heptorenal Syndrome
- Nephrogenic Systemic Fibrosis
No matter which listing you may qualify under, you must ensure your application and medical records are thorough and detailed. Specifically, the SSA may need to see any or all of the following medical documentation of your kidney disease:
- A formal diagnosis and physical exam notes
- Repeated and recent urinalysis results, documenting serum creatinine and albumen
- Imaging scans, if you have kidney or renal abnormalities
- Renal biopsy results and any surgical notes
- Neurological exam results, if you experience nephropathy
- Other diagnostic test results documenting any complications of your kidney disease
- A statement from your doctor, outlining the diagnosis, treatment, and prognosis
What If I Don't Meet the Medical Requirements for Disability for Kidney Disease?
In some cases, the SSA will rule that even though you have a condition like kidney disease, the disease will not prevent you from doing work and if you are capable of working then you are not qualified to receive disability benefits.
However, your condition could still prevent you from working and so the SSA will request that you will out a residual function capacity form (RFC). The RFC form helps to determine how much work you are capable of performing given your condition.
Your doctor will be the one to fill out and submit the RFC form, which allows the SSA to trust that the information provided is accurate.
Since your doctor is likely the one who diagnosed your condition and is responsible for your treatment, your doctor knows how much you are capable of doing and what you cannot do, in addition to how you are responding to treatment and any side effects you might be encountering.
The RFC form will allow you and your doctor to outline your treatment plan and how the treatment for your kidney disease might make it difficult for you to keep up with the demands of your job.
You should inform your doctor as soon as you are diagnosed with your plan to file for disability benefits so that he or she can help you obtain all of the information needed for both the application and the RFC form.
Use our Social Security Benefits Calculator calculator to see how much you could get with disability benefits for kidney disease and other kidney-related conditions.
Is Having One Kidney Considered a Disability?
If your kidney disease has caused you to now only have one kidney, you may be eligible for disability benefits. Having one kidney can be considered if you meet the Blue Book requirements outlined by the SSA for kidney disease. If you can no longer work full time because of your kidney disease or because you have one kidney, the SSA could consider you disabled and you will be able to receive Social Security disability benefits.
The Cost of Kidney Disease
The sad reality of being diagnosed with a chronic condition is that you not only have to worry about the diagnosis itself, but you have to worry about how you will pay your bills and pay for treatment.
If your condition has the potential to impact your ability to work, then your stress level will be even higher.
Kidney disease has many stages and levels of severity, and the CDC reports that chronic kidney disease can cost upwards of $23,000 per person per year.
Medication has been shown to slow the disease’s progression or to stop it entirely, but in some cases by the time it is diagnosed it has already reached kidney failure. No matter where you fall on the spectrum there will be costs associated with kidney disease and this is something that patients worry about as they cope with their condition.
In addition to frequent doctor visits, patients who must undergo dialysis will miss work frequently and this can use up all of your paid medical leave very quickly. Once your paid time off runs out, you will be losing money as you miss work for treatment, and not only could this place your job at risk but the additional stress from worrying about your bills can also negatively impact your treatment.
If you qualify for disability benefits for Kidney disease, you may be eligible to $3,627 a month to help pay for the costs for kidney disease. Take our free disability evaluation to see if you qualify for disability.
You Could Earn Up to $3,627 Per Month! Get a Free Case Evaluation
Get Help With Your Disability Claim For Kidney Disease
While qualifying for disability is often clear-cut with kidney disease, not all applicants experience a quick or smooth case review. Work closely with your doctor to document your illness and to ensure the SSA has the information and medical records they need to evaluate your claim. You may wish to seek help of a Social Security lawyer or disability advocate. as well, especially if your kidney disease prevents you from working but does not meet one of the Blue Book listings mentioned above.
Sources
- 6.00 Genitourinary Disorders - Adult
- 6.03 Chronic Kidney Disease
- 6.04 Chronic Kidney Disease
- 6.05 Chronic Kidney Disease
- 6.06 Nephrotic syndrome
- 6.09 Complications of chronic kidney disease
