Many people who have diabetes are able to manage their symptoms and lead relatively normal lives. Unfortunately, in cases where diabetes symptoms cannot be managed, serious health complications can arise. Uncontrolled diabetes can affect a person’s eyesight, hearing, skin, blood pressure, and their mental health. These side effects can be expensive to treat and can pose significant limitations throughout a person’s day to day life.
If you experience serious complications as a result of uncontrolled diabetes-despite following medical advice-you may qualify for Social Security Disability benefits. Disability benefits can be used to offset the cost of expensive medical treatment and can help support you if health complications prevent you from working.
Defining Disability
The first, most basic Social Security Disability requirement is to meet the SSA’s definition of disability. This definition is made up of the following three criteria:
- You are considered disabled if you have a physical and/or mental condition that prevents you from doing the work were once able to do;
- Your condition prevents you from learning to do a different type of work; and
- Your condition is has lasted or is expected to last at least one year.
Because diabetes affects people in a variety of ways, not everyone with diabetes will be considered to have a disability. Typically, only the most serious diabetic complications that occur despite medical treatment will qualify a person for disability benefits.
Technical Eligibility Requirements
If you meet the SSA’s definition of disability, you will then be required to meet the technical eligibility requirements of one-or both-of the Social Security Disability benefit programs. These programs are Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI).
SSDI is offered to disabled workers and their dependent family members. It is an insurance-type program that workers make tax contributions to throughout their careers. Therefore, eligibility for SSDI is based on an applicant’s work history and their past tax contributions. In most cases, an applicant will not qualify if they have not worked-and paid Social Security taxes-for five of the last ten years. To learn more about SSDI eligibility, click here:
Qualify for SSDI Benefits.
SSI, on the other hand, provides benefits to elderly, blind, or disabled individuals who earn very little income. Eligibility for SSI is based solely on the strict financial limitations set in place by the SSA. SSI has no tax or work history requirements and is open to individuals of all ages. For more information about qualifying for SSI, click here:
Qualify for SSI Benefits.
Medical Eligibility Requirements
When you apply for Social Security Disability benefits, the SSA will compare your condition to a manual of disabling conditions known as the blue book. The SSA’s blue book contains listings for many conditions that may qualify a person for disability benefits. Under each section of the blue book, the SSA lists specific medical criteria that applicants must meet.
Diabetes is covered in section 9.00 of the blue book under the heading Diabetes Mellitus. This listing states that for a person to qualify for disability benefits with diabetes, they must experience diabetic ketoacidosis (DKA), chronic hyperglycemia, or hypoglycemia. It is important to note that if you experience these symptoms as a result of not following doctor’s orders, you will not qualify for disability benefits.
To read blue book listing 9.00 in its entirety, click here:
Disability Evaluation Under Social Security
9.00 Endocrine Disorders - Adult.
Individuals who do not meet listing 9.00 but who experience serious health complications, may be able to qualify for disability benefits under the listing of their affected body system. This may include the following listings:
- Section 1.05 Amputation- This listing may apply to individuals who have undergone amputation as a result of diabetic complications
- Section 2.00 Special Senses and Speech- This listing may be useful for individuals who have experienced vision or hearing problems as a result of uncontrolled diabetes.
- Section 4.00 Cardiovascular System- Individuals who suffer serious cardiovascular related symptoms may qualify under this listing.
- Section 8.00 Skin- This listing may apply to those who suffer severe skin complications as a result of uncontrolled diabetes.
- Section 12.00 Mental Disorders- Applicants who suffer from severe mental disorders in addition to diabetes may be eligible for disability benefits under this listing.
To view all blue book listings visit the following web page:
Disability Evaluation Under Social Security
Listing Of Impairments - Adult Listings (Part A).
Preparing for Your Disability Application
If you meet the SSA’s definition of disability, the technical eligibility requirements, and the medical requirements, you are ready to begin the Social Security Disability application process. Before doing so however, it is in your best interest to collect medical and non-medical documentation to support your claim. Medical documentation serves as evidence of your symptoms and limitations. This should include:
- Record of diagnosis
- History of hospitalizations
- Lab results
- Medical imaging results
- Written statements from treating physicians
Non-medical documentation serves as proof of your technical eligibility and may include the following:
- Birth certificate
- Proof of U.S citizenship or lawful alien status
- W-2 forms or self-employment tax returns
- Military discharge papers if you had military service before 1968
- Proof of income
It is important to note that if you are unable to collect all of the previously mentioned documents, the SSA will help you do so. However, having the correct information available will prevent any delays in the processing of your claim.
Applying for Social Security Disability Benefits
Once you are ready to begin the application process, you can do so on the SSA’s website,
Disability Benefits
or by scheduling an appointment to apply in person at your local Social Security office. The actual application process is made up of several forms. It is important that you fill these out completely with as much detail as possible. Any incomplete, inaccurate, or missing information may result in the denial of your application for disability benefits.
After submitting your claim, you will not receive a decision for several months. While you are waiting you should continue any treatment prescribed by your doctor and you should continue to save copies of all medical records. This will help you during the appeals process, should your claim be denied.
If your claim is in fact denied, you will have 60 days to appeal this decision. It is important that you do not give up. If you remain persistent in your efforts, there is a better chance you will be awarded benefits. In fact, many more applicants are approved during appeal processes than during the initial application.
For more information about Social Security Disability benefits and diabetes visit Social Security Disability Help, at
Diabetes and Social Security Disability
or contact Molly Clarke at
mac@ssd-help.org.
Molly Clarke
Social Security Disability Help
