Applying for disability with Cirrhosis

Basic requirements for disability claims

Social Security Disability programs require that you not be working or if you are working that your earnings not be over the SGA limit. Also, you must not have been able to perform SGA-level work activity for twelve months or Social Security must be able to project, after evaluating your medical records that you will be unable to work at the SGA level for twelve months.

This is true no matter what your disabling condition might be. If you are earning over the SGA limit, Social Security will technically deny your disability claim without sending it for a medical disability determination.

Filing for disability with Cirrhosis

If you meet the work requirements of the Social Security Disability program, you may be eligible for disability benefits if you have been diagnosed with alcoholic liver disease (cirrhosis) or non alcoholic cirrhosis.

Cirrhosis is most commonly caused by alcoholism, hepatitis B, hepatitis C, and fatty liver disease. For the purposes of a Social Security Disability, it does not matter what has caused the cirrhosis. Social Security Disability focuses on the functional limitations caused by your cirrhosis when they make their determination.

In order to evaluate the severity of an individual's cirrhosis, disability examiners use the criteria outlined in impairment listing: 5.05 - Chronic liver disease. The Social Security Disability handbook known as the blue book has impairment listings for all body systems. The listings provide the criteria needed to meet or equal the severity requirements of Social Security Disability and SSI.

The listing states that there must be a diagnosis of chronic liver disease along with other related conditions such as varices, ascites, spontaneous bacterial peritonitis, hepatorenal syndrome, hepatopulmonary syndrome, hepatic encephalopathy, or end stage liver disease. Listing 5.05 covers all of the above conditions providing the testing, symptoms, and signs needed to establish the severity of an individual's liver condition.

1. Symptoms may include, but are certainly not limited to, itching, fatigue, nausea, loss of appetite, or sleep disturbances. However, the symptoms of chronic liver disease may not have a strong correlation to the severity of the liver disease and functional ability.

2. Signs may include but are not limited to enlargement of the liver and spleen, jaundice, peripheral edema, and altered mental status.

3. Laboratory findings may include increased liver enzymes, increase in serum bilirubin, increased ammonia levels, decrease serum albumin, and abnormal coagulation studies. Social Security will accept liver biopsy results but they will never send a person for the biopsy because it is an invasive procedure. They will send a person to CT scans, MRI, or to an ultrasound to show the size and consistency (fatty liver, scarring) of the liver and to document ascites.

If cirrhosis or another related liver condition has prevented you from working, it is likely that you may have had multiple tests already. If you have not had recent testing, Social Security may send you for testing to help document your disability case. If they send you to testing they will pay for the testing.

Even if you do not meet or equal the criteria outlined in listing 5.05, you may still be able to be approved for disability benefits provided your cirrhosis causes you significant limitations. If you are unable to meet the demands of any of your past work and your residual functional capacity is so restrictive that when your age, education, and the transferability of your job skills are considered they preclude any other kind of work, you may be eligible for disability benefits.

More about the condition

Cirrhosis is a liver disease that is mostly commonly caused by hepatitis C or alcoholism, though it does have other causes, such as prolonged exposure to drugs and toxins. Cirrhosis happens when the tissues of the liver are replaced by scar tissue and nodules that are created when damaged tissue is regenerated. This causes fluid retention in the abdominal cavity, blockage of the flow of blood to the liver and ultimately, loss of liver function. Confusion and coma can result, as well as esophageal bleeding. Cirrhosis can be life threatening. In advanced stages, a liver transplant may be necessary. The liver is the largest organ in the body and is necessary for ongoing body function. You cannot live without a healthy, functioning liver. It is estimated that 27,000 people a year die from cirrhosis, making it the tenth leading cause of death. Cirrhosis has a ten-year mortality rate of around 50 percent.

There are several signs of the disease, though some people may not exhibit any signs or symptoms at all. Nausea, fatigue, weakness, loss of appetite and exhaustion may plague some sufferers. Others may experience abdominal pain, nail changes, jaundice, gallstones, a musty odor in their breath, weight loss or 'spider veins' appearing on the skin. As the disease progresses there may be more signs and complications, such as itching, trouble concentrating, sensitivity to medications, easy bruising and bleeding and liver tumors.

Clinical, laboratory and radiologic tests, as well as an ultrasound, can help determine cirrhosis of the liver, but if those data do not diagnosis, a liver biopsy may be needed. A liver biopsy consists of the doctor taking a liver sample with a needle and studying it under a microscope for a wide variety of signs of liver cirrhosis. The most common way to determine cirrhosis is by liver biopsy.

Cirrhosis of the liver cannot be reversed, though there are many treatments and lifestyle changes available to delay further complications. Antibiotics will be prescribed if there is infection. Laxatives may help constipation. Other medications may help itching and other symptoms of cirrhosis. Patients will be advised to eat a healthy diet, abstain from alcohol and acetaminophen and to restrict their salt intake.

When the liver becomes so damaged that it stops working properly, a liver transplant may be needed. A liver transplant is a when the patient gets their liver removed and replaced with a healthy, functioning liver. Liver transplants are improving with new medications, though survival rate is still only around eighty percent.

About the Author: Tim Moore is a former Social Security Disability Examiner in North Carolina, has been interviewed by the NY Times and the LA Times on the disability system, and is an Accredited Disability Representative (ADR) in North Carolina. For assistance on a disability application or Appeal in NC, click here.

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