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.
Medically Qualifying with Kidney Disease
The SSA maintains disability listings for recognized impairments in its Blue Book manual. These listings are used to review disability applications, applicant medical records, and other documentation to determine eligibility for Social Security Disability (SSD) benefits.
Any of the following listings may apply to your disability claim.
Chronic Kidney Disease, which appears in Section 6.02, requires:
- You must undergo dialysis or a kidney transplant
- Your serum creatinine levels from a three-month period are:
- Above 4 mg per deciliter
- At a clearance level of 20 ml or lower per minute
- You experience at least one of the following complications:
- Renal osteodystropy
- Motor or sensory nephropathy
- Chronic fluid overload syndrome, accompanied by diastolic hypertension, vascular congestion, or anorexia
- Above 4 mg per deciliter
Nephrotic Syndrome, which appears in Section 6.06 and requires:
- Consistently serum albumin of 3.0 per deciliter or lower AND elevated proteinuria of 3.5 g or higher over a 24-hour period
- Proteinuria measurements over a 24-hour period of 10 g or higher AND a total-protein-to-creatinine ratio of 3.5 or higher
- Chronic Kidney Disease with Complications, which appears in Section 6.09 and requires:
- you have been hospitalized at least three times within 12 months, with no more than 30 days in between hospital admissions
- each hospital stay started in the ER and resulted in inpatient treatment of at least 48 hours.
Kidney Transplant, appears in Section 6.04 of the Blue Book. If you have chronic kidney disease and need a kidney transplant, you likely qualify for benefits under the Section 6.02 listing. However, if you have transplant surgery, you will qualify for benefits for a period of at least 12 months under this Section 6.04 listing instead.
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
Getting Help with Your Claim
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 an experienced Social Security advocate or attorney as well, especially if your kidney disease prevents you from working but does not meet one of the Blue Book listings mentioned above.