Chronic kidney disease (CKD) is caused by a progressive deterioration of kidney function which, if left untreated, can lead to kidney failure. The two most common causes of CKD are diabetes and high blood pressure, although it can be the result of other medical conditions as well, including lupus, glomerulonephritis (a group of diseases that cause inflammation to the kidneys), and a host of other congenital issues. CKD can cause debilitating complications that can make it difficult to work, due either to the pain, frequent hospital and doctor’s visits, or both. Here’s what you need to know about applying for SSD benefits with chronic kidney disease.
Chronic kidney disease as a disabling condition
The Social Security Administration (SSA) disability blue book includes five categories of chronic kidney disease that it considers disabling. For the SSA to consider you disabled and eligible for SSD benefits, your CKD must be accompanied by any one of the following:
- The need for chronic hemodialysis or peritoneal dialysis;
- Kidney transplant within the previous 12 months;
- Impairment of kidney function with:
- Reduced glomerular filtration, and;
- Renal osteodystrophy, peripheral neuropathy or fluid overload syndrome;
- Nephrotic syndrome (loss of protein in the urine), or;
- Complications of CKD that required at least three, 48-hour hospitalizations within a consecutive 12-month period.
If your CKD does not fall within one of these categories, you may still qualify for SSD benefits. That is because an award of SSD benefits is not based solely on a finding of disability – your medical condition must also negatively impact your ability to engage in substantial gainful activity. If you can prove that your functional residual capacity, i.e., what tasks you can perform despite your condition, has deteriorated to the point that you are unable to work, your application may be approved.
Documenting chronic kidney disease
You must provide the SSA with specific information documenting your CKD diagnosis – a letter from your physician stating, “Patient A was diagnosed with chronic kidney disease and receives weekly dialysis” is insufficient to support a disability finding, and will likely result in your application being rejected.
To increase the chance that your application will be approved quickly, it is important that your medical record includes information that meets the SSA’s listing requirement for CKD. The record should document all signs, symptoms and laboratory findings that support your diagnosis, including, but not limited to:
- Reports of clinical examinations;
- Treatment records, including your response to each type of treatment, frequency, length and expected duration;
- Laboratory findings, such as creatinine or albumin levels;
- Estimated glomerular filtration rate (eGFR), if available (the eGFR estimates the kidneys’ filtering capacity);
- Surgical notes and/or pathology reports, if any, and;
- Records of hospitalizations, including reason for visit and length of stay.
The more detailed the information contained in the medical record, the better the chance that your application will be approved.
Chronic Kidney Disease and SSD Benefits Success Stories
Our office recently helped two clients who suffered from CKD receive SSD benefits. The first, who had worked assembling cell phones, had his application denied at both the initial and reconsideration levels before our office stepped in to represent him at the administrative law hearing. This client suffered from diabetic retinopathy; traction retinal detachment; uncontrolled insulin-dependent diabetes, along with complications of diabetes; had foot ulcers that made walking difficult, and; was on a variety of medication, among other conditions. We proved, through the medical record, that the combined effects of these conditions made our client completely disabled and unable to work in any capacity. The administrative law judge agreed and approved our client’s benefits application within 15 days of the hearing.
The second client, a salesman for an auto parts distributor, was diagnosed with cirrhosis of the liver, chronic kidney disease and severe lower extremity neuropathy, along with several other conditions that affected his balance and caused him to fall and fracture a shoulder. This client’s application was denied by both the disability examiner and during reconsideration. On an appeal to an administrative law judge, our office proved that the client’s physical and mental condition (he also suffered from depressive syndrome) made it impossible for him to work in any capacity and approved his benefits application.
Resources for those diagnosed with chronic kidney disease
If you have been diagnosed with chronic kidney disease, there are many resources that can provide you with information about the disease and connect you with others experiencing the same situation.
The National Kidney Foundation has information for patients and families not only on CKD, but financial resources (including insurance and employment), clinical trials and a searchable function to find local support groups.
The American Association of Kidney Patients offers information on the types of CKD, treatment options, transplant and advocacy opportunities.
If you or someone you know has Chronic Kidney Disease and is looking to apply for SSD benefits, consider the Law Office of Neil H. Good for your representation. Cll #(847) 577-4476 for a free case evaluation, or complete the online form here.