Kidney Failure and Social Security Disability

Kidney Failure

Kidney Failure is a complex disorder that affects every system in the body. It is also known as Renal Failure and is characterized by an inability of the kidneys to properly filter the blood, which leads to blood with increased levels of chemicals and toxins circulating through the body. Symptoms vary greatly from person to person. Some individuals may barely feel the effects of kidney failure while other are too fatigued and sick to leave their beds. In general, the most common symptoms include upset stomach, swelling in the feet and other extremities, fatigue, and muscle soreness or cramping. In some cases, abnormal heart rhythms and dozens of other symptoms may occur. Causes of this condition can also vary greatly based on the medical history of the individual, but in America the most common causes of kidney failure are hypertension, glomerulonephritis, and diabetes.

Diagnosis is based upon analysis of an individual's GFR, or glomerular filtration rate, which refers to the speed at which the kidneys clean the blood. A high GFR is good, but as kidney disease progresses an individual’s GFR will steadily decrease. GFR can easily be determined by a physician through simple blood test results compared against other information including age, sex, and body size.

Unfortunately, treatment options for kidney failure are somewhat limited. The preferred option is a kidney transplant. While a transplant offers the recipient a chance at a normal life, it also has the considerable life-time risk of rejection of the new kidney, which can potentially result in death.

The other option is dialysis. This is involves using a machine as an artificial kidney to filter the blood. When an individual is on dialysis they will be required to be hooked up to this machine for hours at a time as many as seven days per week. This will obviously greatly impact the ability of these people to maintain any sort of employment.

Filing for SSDI or SSI with Kidney Failure

If you have been diagnosed by a kidney specialist as having permanent kidney failure that requires a kidney transplant or dialysis, the Social Security Administration has a special listing that can make receiving disability benefits a relatively straightforward process. Section 6 of the disability impairment listing guide known as the “Blue Book” addresses all kidney function disorders and is used by state Disability Determination Services (DDS) to evaluate disability claims based on kidney failure. Many people that suffer from kidney failure will fit into several categories within this section. The keys to receiving Social Security Disability benefits for kidney failure are patience and complete medical records. The DDS will require a detailed history of your disorder including information on the treatment you are receiving and how your body is responding to those treatments. Additionally, the Social Security Administration gives greater weight to a diagnosis and treatment plan from a medical specialist rather than a primary care physician.

Your Kidney Failure Disability Case

When you have been diagnosed with kidney failure, all of your time and energy should be spent on treatments and trying to feel your best. For most people it will become impossible to work full-time while combating this debilitating disorder. Social Security Disability is designed to help these people financially survive during the course of their sickness and treatment. Unfortunately, applying for disability benefits may require substantially more time and energy than a person may have while undergoing daily treatments for kidney failure. In such cases, contacting a qualified disability lawyer or advocate may provide you with invaluable assistance with every step of the Social Security Disability application process.

Is Kidney Failure A Permanent Disability?

If you are unable to work because of kidney failure, you may qualify for Social Security Disability benefits. If you are going to be unable to work for at least a year, you can qualify for disability benefits. You may wonder if your disability will be permanent. Kidney failure can be a permanent disability depending on the severity of your kidney disease.

You will need to talk with your physician to determine if your disability will be permanent. Hard medical evidence that confirms your diagnosis and that details your symptoms, restrictions, treatment, side effects, and prognosis will be a necessity for a successful claim for disability benefits. You need to familiarize yourself with the stages of kidney failure and the treatment options.

The Stages Of Kidney Failure

There are five stages of kidney failure. According to Nephcure Kidney International, 1 in 10 people worldwide have some kind of kidney disease. A normal functioning kidney will filter anywhere from 120 to 150 quarts of blood to produce 1 to 2 quarts of urine made up of extra fluid and waste. Kidneys help with blood pressure regulation, waste and water removal, red blood cell production, and help regulate growth in children.

There are five stages of kidney disease or kidney failure. The accepted measure for kidney functioning is Glomerular Filtration Rate (GFR), and this determines how well your kidneys are cleaning your bloodstream. To estimate GFR, a blood test is done to determine creatinine in blood, which is called serum creatinine. The levels of creatinine increase as functioning of the kidneys decreases.

  • Stage 1 – Kidney functioning is at more than 90 percent, meaning that you have normal or high functioning kidneys.
  • Stage 2 – At this stage, kidney functioning is from 60 to 89 percent and there is mildly decreased functioning of the kidneys.
  • Stage 3 – At this point, kidney functioning ranges from 30 to 59 percent of its normal level and you experience mild to moderately decreased functioning of the kidneys.
  • Stage 4 – You have severely decreased functioning with your kidneys at 15 to 29 percent.
  • Stage 5 – Kidney failure is in full force with kidney functioning now at less than 15 percent its normal level.

If your kidney failure causes you to be out of work for at least 12 months, you may qualify for disability benefits You should maintain thorough documentation detailing the severity of your condition.

Medical Evidence To Support A Claim For Kidney Failure

To have a successful disability claim for kidney failure, you will need to provide supporting documentation. As with any disability claim, hard medical evidence is a necessity for a disability claim based on kidney failure. Your claim will be reviewed under the listing for genitourinary impairments. These listings indicate a disability claim will be approved if you can show that any of the following apply:

  • There is a need for regular kidney dialysis.
  • There has been a kidney transplant.
  • There is reduced glomerular filtration combined with symptoms of kidney damage.
  • You suffer from nephrotic syndrome, OR
  • There are serious complications of kidney disease.

Listings 6.03, 6.04, and 6.05 grant disability benefits automatically for poor kidney functioning caused by any chronic disease just so long as one of the following are present:

  • Kidney transplantation
  • Ongoing peritoneal dialysis – dialyzing solution being put into and removed from the peritoneal cavity intermittently or continuously
  • Ongoing hemodialysis – removes toxins from the blood via artificial kidney machine OR
  • Reduced glomerular filtration

You can prove reduced glomerular filtration by providing test results that reveal low creatinine clearance levels, persistently high levels of serum creatinine, or a low estimated glomerular filtration rate (eGFR).

In addition to showing that you have reduced glomerular filtration, you must show that you suffer from one of the following – bone pain and renal bone degradation, peripheral neuropathy, or fluid overload syndrome despite taking prescribed medications.

Listing 6.06 for nephrotic syndrome covers a group of kidney diseases that are apparent because of excess protein in the urine and edema of differing levels. Sometimes high cholesterol and low serum albumin are present in individuals with one of these conditions. To be automatically approved for disability benefits, you must have suffered extreme swelling for at least three months plus high levels of protein in the urine and low serum albumin levels with either a total protein to creatine ratio of 3.5 or higher or moderately high protein levels in the urine.

Qualifying With A Medical Vocational Allowance

If you are unable to work because of kidney disease and you are unable to meet the criteria of a listing, you may qualify using a medical-vocational allowance. This approach takes your medical conditions, symptoms and side effects, age, work history, transferrable skills, and educational background into consideration to determine what kind of work – if any – you can do.

A residual functional capacity (RFC) completed by your treating physician can be very helpful to your claim. It should be detailed, explaining your restrictions and limitations, such as how much you can lift, how often you must reposition, how much you carry, if you can bend, lift, and reach, and how long you can stand without having to sit or rest. A detailed RFC can paint a clear picture of your abilities, and it can also help you win your claim for disability benefits.

As an example, if your poor kidney functioning causes you to suffer from fatigue, and severe edema in your lower legs and feet keeps you from standing long periods or from walking considerable distances. Edema in your arms and hands may affect your ability to perform fine tasks, lift and carry items, or reach and grasp. A combination of these things along with your personal details, such as age, work history, and educational background, could help you win a disability claim based on a medical vocational allowance.

A disability attorney can help you get your supporting documentation and evidence together to support your disability claim. Remember, supporting documentation is a necessity for a disability claim approval for kidney failure.