According to the CDC, an estimated 35.5 million people, or 14% of U.S. adults, have chronic kidney disease (CKD). If you’re suffering from CKD, you may experience symptoms that leave you unable to work. This can add to the already overwhelming circumstances that come with having a disability.
Many people struggle to take care of themselves, their families, and fail to receive proper medical care for their CKD. Once your finances begin to suffer, it can feel as if you have nowhere to turn.
Fortunately, for those with severe chronic kidney disease, Social Security Disability (SSD) benefits are available.
Disabled individuals can apply for either Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) if their CKD prevents them from working. To be approved for SSD, you must meet the Social Security Administration’s (SSA) definition of disabled. This involves meeting the following criteria:
- Your medical condition is expected to last for a consecutive 12-month period or longer, or result in death
- Your medical condition prevents you from performing Substantial Gainful Activity (SGA)
- Your medical condition is listed in the Blue Book, exceeds a listed impairment in severity, OR qualifies for a medical-vocational allowance
You must also meet the eligibility requirements for either SSI or SSDI, depending on which program you’re filing for.
- SSI: SSI is a needs-based program for disabled, blind, and aged individuals. To qualify for SSI with kidney disease, you must meet the criteria above and have limited income and resources. You must also be ineligible for SSDI due to a limited work history.
- SSDI: SSDI pays benefits to disabled workers who have paid into the Social Security System. You must have a sufficient number of work credits to qualify for SSDI with kidney disease.
If you have severe kidney disease and want to learn more about your eligibility for SSD, continue reading. We also invite you to contact Peña & Bromberg to schedule a free consultation with one of our knowledgeable attorneys.
What is Chronic Kidney Disease (CKD)?
CKD is a condition which affects the kidneys and ultimately leads to renal failure. The primary function of the kidneys is to filter waste and excess fluid from the bloodstream. When the kidneys malfunction, waste accumulates in the body, causing a variety of symptoms and other medical conditions.
Medications can help manage the symptoms of CKD. However, some patients don’t experience symptoms and only discover their kidney disease through laboratory testing.
When CKD is advanced, patients can require dialysis. This involves filtering blood through a machine. In severe cases of CKD, a kidney transplant may be necessary.
Symptoms of CKD
Symptoms of chronic kidney disease usually develop gradually as damage to the kidneys worsens over time. Many individuals are unaware of the damage until it reaches an advanced stage. As a matter of fact, as many as 9 in 10 adults are unaware they have CKD.
Some symptoms of CKD include:
- Nausea
- Vomiting
- Muscle cramps
- Loss of appetite
- Fatigue and weakness
- Brain fog
- Sleep issues
- Changes in urination
- Dry, itchy skin
- Swelling of the feet and ankles
- Uncontrolled high blood pressure
- Shortness of breath (can be due to fluid build-up in the lungs in severe cases)
- Chest pain or pressure
- Headaches
- Anemia
Symptoms of kidney disease frequently resemble those caused by other illnesses. Because the kidneys are able to make up for lost function, signs and symptoms of CKD may not show up until irreversible damage occurs. Consult with your doctor if you experience any of the symptoms mentioned above.
How Does the SSA Evaluate Disability Claims for Kidney Disease?
The SSA evaluates chronic kidney disease under Section 6.00, Genitourinary Disorders in the Blue Book. This section includes several examples of CKD resulting from genitourinary conditions. Some of these include:
- Chronic glomerulonephritis
- Nephrotic syndrome
- Hypertensive nephropathy
- Diabetic nephropathy
- Hereditary nephropathies
- Chronic obstructive uropathy
When reviewing a CKD disability claim, the SSA takes additional factors that may highlight the severity of the condition into account. These include a variety of complications that can result from severe CKD, such as:
- Need for ongoing dialysis treatment
- Kidney transplant
- Renal osteodystrophy
- Peripheral neuropathy
- Fluid overload syndrome
- Anasarca
- Anorexia
- Other complications of CKD resulting in hospitalization (such as stroke, congestive heart failure, and hypertensive crisis)
Medical Evidence
When filing a disability claim, you need to provide supportive medical and non-medical evidence to the SSA. This evidence will be evaluated to determine whether your disability is severe enough to qualify for benefits.
The SSA requests the following medical evidence for CKD disability claims:
- Medical records that document the signs, symptoms, and laboratory findings of your disease. This should include:
- Clinical examination reports
- Treatment records and documentation of response to treatment(s)
- Laboratory findings that document kidney function
- Estimated glomerular filtration rate (eGFR) findings (for evaluating CKD under listing 6.05)
- Kidney or bone biopsy pathology report (If a copy of the pathology report is unavailable, the SSA will accept a statement from a credible medical source confirming the completion of a biopsy and providing details about the findings.)
Typically, the SSA requires evidence that spans a minimum of 90 days to reach a determination.
Other combinations of laboratory test results, complications, imaging, and various medical criteria may be required to qualify under any one listing. When filing a claim, it’s important to provide accurate information related to the impairment listing under which you are applying. Working closely with a qualified Social Security Disability attorney can help ensure your claim includes the necessary medical evidence.
Seeking Social Security Disability After a Kidney Transplant
CKD with a kidney transplant is evaluated under listing 6.04 in the Blue Book. Patients are considered disabled for 1 year after receiving a kidney transplant. After this period, the SSA reevaluates the residual impairment.
Losing SSDI After a Kidney Transplant
When the SSA reevaluates a person’s eligibility for SSD following a kidney transplant, there is a risk of losing benefits. If the condition still leaves the claimant unable to perform SGA and restricts their daily activities, payments will continue. However, if the SSA determines the claimant is able to work, they will no longer qualify for benefits.
What if Your CKD Doesn’t Match a Blue Book Listing?
If your CKD doesn’t satisfy the medical criteria in the Blue Book, you may qualify for SSD under another body listing. However, if your condition doesn’t meet or equal any listing, you may still be eligible to receive benefits under a medical-vocational allowance.
A medical-vocational allowance represents an alternative pathway for applicants to qualify for disability benefits. The SSA considers a combination of factors beyond a claimant’s medical diagnosis to determine eligibility. This includes an applicant’s age, education, work experience, and transferable job skills.
Using a Residual Functional Capacity (RFC) assessment, the SSA evaluates what work-related tasks an individual is still capable of doing despite their disability. This assessment looks at both physical abilities (like lifting, standing, and walking) and mental abilities (like following instructions).
If the SSA determines that a claimant is unable to return to work or perform any new type of work, they will receive benefits.
Older applicants, those with less education, and those with job skills that don’t easily transfer to other employment may have an easier time qualifying under the Medical-Vocational Guidelines.
Contact Peña & Bromberg
If you’re struggling to apply for SSI or SSDI with chronic kidney disease, reach out to our law firm today. At Peña & Bromberg, we put our clients first. Our team will collaborate closely with you to review the details of your case. We will assist you in completing the necessary paperwork and collecting the required documentation and medical evidence to establish your eligibility.
Contact us to request a free consultation. We will stand by your side throughout the entire disability claims process. Our attorneys have the experience and knowledge necessary to help you get the benefits you need.
