Can You Get Disability For Diabetes?

Since the Social Security Administration (SSA) does not have a specific listing for diabetes, we are often asked, “Can you get disability for diabetes?”

The answer is yes. The SSA considers diabetes a disability that may contribute to whether a claimant qualifies for Social Security Disability Insurance benefits. People with diabetes are also protected under the Americans with Disabilities Act (ADA). 

Is Diabetes a Disability?

Diabetes mellitus, commonly referred to as diabetes, is an endocrine disorder that affects a person’s glucose or blood sugar. High glucose levels in the blood indicate that the body does not produce enough insulin to process blood glucose or that the insulin does not work as it should to help the body absorb the excess glucose.

Types of Diabetes

• Pre-diabetes is a condition that indicates an individual has a high risk of developing full-fledged diabetes.
• Type 1 diabetes is most often diagnosed at a young age, although it can develop at any age.
• Type 2 diabetes, sometimes referred to as adult-onset diabetes, is most common in people over the age of 40.
• Gestational diabetes is when a woman develops diabetes during pregnancy. It often goes away after giving birth but raises the chance of developing type 2 diabetes later.

For people with diabetes, their body’s cells may become resistant to insulin, like in Type 2, prediabetes, and gestational diabetes. In Type 1 diabetes, the body attacks the insulin-producing cells in the pancreas, leaving little to no insulin. The result is too much sugar building up in the blood.

Symptoms of Diabetes

Diabetes symptoms vary depending on your blood glucose levels. Some people may not experience symptoms, while others, like type 1 diabetics, tend to experience more severe symptoms. Symptoms of type 1 and type 2 diabetes include:

• Frequent urination
• Increased thirst
• Excessive hunger
• Weight loss
• Irritability
• Blurred vision
• Frequent infections
• Cuts and sores that are slow to heal
• Extreme fatigue

Some symptoms are more serious than others and require immediate medical attention, such as:

• Hyperglycemia (high blood sugar)
• Diabetic ketoacidosis (high ketones in urine)
• Hyperglycemic hyperosmolar nonketotic syndrome (extremely high blood sugar)
• Hypoglycemia (low blood sugar)

If left untreated, these conditions could seriously harm your health. Over time, they may even lead to death in some cases.

Other complications associated with diabetes include high blood pressure, damage to the eyes, nerve damage, kidney disease, heart problems, blindness, and stroke. In some cases, there is progressive destruction of small blood vessels, which leads to complications such as diabetic neuropathy, infections, and gangrene of the limbs that disrupt your ability to stand, walk, or use your hands.

Understanding Disability Benefits for Diabetes: A Guide to Social Security Administration Criteria

Securing disability benefits specifically for diabetes can be challenging, as the Social Security Administration (SSA) often requires evidence of related complications that impair work ability. These complications, rather than diabetes itself, are pivotal in establishing eligibility for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI)

Diabetes may lead to conditions such as vision impairment, peripheral neuropathy, heart disease, and kidney failure, which significantly affect work capacity. Effective documentation of these conditions and their impact on your daily functioning is crucial for a successful SSDI claim. This includes comprehensive medical records from your healthcare provider detailing symptoms and limitations on a residual functional capacity form.

Claims based on well-controlled diabetes are less likely to succeed. Furthermore, if your blood sugar levels are uncontrolled because you failed to follow your doctor’s prescribed treatment, your disability claim will likely be denied. One of the biggest reasons disability claims are denied is because the patient is “non-compliant” with the doctor’s orders.

However, if diabetes progresses to a state where it’s unmanageable and significantly hampers your ability to work for at least 12 months despite adhering to your treatment plan, you might qualify for benefits. You must be able to demonstrate that the damage caused by your diabetes severely limits what you can do and prevents you from performing even sedentary work, or you satisfy the requirements of one of Social Security’s disability listings. You must also satisfy any non-medical requirements.

Meeting the SSA’s Disability Listing for Diabetic Complications

The SSA lists diabetes and other endocrine disorders under section 9.00 of its Blue Book, and many diabetes-related complications are also listed in the Blue Book. The following are some SSA listings that may apply to patients with complications from diabetes (both hyperglycemia and hypoglycemia):

• Diabetic Retinopathy: Suppose you have blurred vision, poor visual acuity (between 20/100 and 20/200 in your better eye), or poor peripheral vision from surgery to correct your central vision. In that case, you might qualify for disability benefits under listing 2.00.
• Diabetic Nephropathy: If your kidneys are no longer filtering properly and require daily dialysis, or there is evidence of too much protein or creatine in your plasma, you may qualify for SSDI benefits under section 6.06.
• Diabetic Peripheral Neuropathies: Many patients with diabetes have some form of neuropathy or nerve damage in their hands, feet, arms, or legs. Claims for diabetic neuropathy may qualify for benefits under listing 11.14. Still, you must demonstrate that your neuropathy significantly affects two extremities and significantly impairs your ability to walk, stand, or use your hands in a skilled way.
• Cardiovascular Problems: Diabetes can lead to coronary artery disease (listing 4.04), chronic heart failure (listing 4.02), peripheral vascular disease (listing 4.12), and an irregular heartbeat (listing 4.05).
• Poorly Healing Skin and Bacterial Infections: If you have ulcerating skin lesions that last for three months or longer despite treatment and such lesions make walking or using your hands difficult, you could qualify for disability benefits under section 8.04.
• Amputation of an Extremity: If you’ve had a foot amputated due to nerve damage and poor circulation caused by diabetes, you could qualify for benefits under listing 1.05.
• Diabetic Ketoacidosis (DKA): DKA is an acute, potentially life-threatening complication of diabetes mellitus (DM) and usually requires hospitalization. Your treatment may lead to serious complications, which we assess based on the affected body part. For instance, cardiac arrhythmias are evaluated under section 4.00, intestinal necrosis under section 5.00, and brain swelling and seizures under section 11.00. Recurring episodes of diabetic ketoacidosis might result from mood or eating disorders, which fall under listing 12.00.

When you apply for benefits, be sure to list any additional medical problems related to diabetes. If your complications align with these listings, you might be eligible for benefits, and the SSA will not have to go any further in the five-step sequential evaluation process to determine if you are disabled.

Winning Your Social Security Claim When You Do Not Meet a Listing

Social Security finds that most people who apply for disability due to diabetes do not meet a listing. If so, the next step is determining how limiting your diabetes is. The SSA will assess your residual functional capacity (RFC) to determine if your diabetes limits your daily activities to the point where you can’t work.

Your RFC measures what activities you can still perform despite your diabetes. For example, it could state that you can do medium, light, or sedentary work. To decide your RFC, the SSA reviews your medical records, your doctor’s opinion on your limitations (backed by evidence), and statements from you and your family.

The SSA also considers whether you can focus on tasks, get along with co-workers, and go to work regularly. If your glucose levels fluctuate during the day, you may have trouble concentrating. If you have depression or fatigue, your RFC might say you can’t work consistently.

Neuropathy in your legs from diabetes could prevent you from standing or walking for long periods. Blurred vision may mean you can’t do jobs requiring clear eyesight. If your visual acuity is 20/80 or worse, your RFC could restrict you from driving or operating hazardous machinery.

Many people get denied disability benefits for diabetes initially and have to appeal for a hearing with a judge. Describing your functional limitations clearly is crucial.

If you’re looking for information about how to get long-term disability benefits from your insurance company due to diabetes, then read our article about diabetes and long-term disability claims.

Get Help from a Social Security Disability Attorney

Considering the complexities of SSDI claims for diabetes, consulting with a specialized Social Security Disability attorney like Nick Ortiz can be beneficial. Legal expertise can guide you through the application process, improve your chances of approval, and handle appeals if necessary.

Contact Ortiz Law Firm today to schedule your free case review. During your case review, we will get additional information about your diabetes and any related medical conditions, walk you through the SSDI and SSI benefits claim process, and discuss the benefits of hiring an attorney to represent you. You can contact us online or call (888) 321-8131.

While you wait, our website may be able to help you prepare for your fight against the SSA. Visit our free resource page to view our eBooks, download a residual functional capacity form to document the work activities your body cannot perform, and browse a variety of free treatment logs to keep a detailed record of your health care.