Applying for disability with Diabetes

First, a bit about the condition

Diabetes, clinically named diabetes mellitus, is a disease that happens when the cells within the pancreas, known as the beta cells, aren't able to produce adequate insulin. This causes hyperglycemia, high levels of glucose in the blood. The most common symptoms are blurred vision, lethargy, extreme thirst, excessive urine production and in type 1, unexplained weight loss.

There are three different types of diabetes: type 1, type 2 and gestational diabetes. Type 1 and type 2 are chronic conditions.

Type 1 diabetes is an autoimmune disease that results in the permanent destruction of the pancreatic beta cells. This type of diabetes accounts for the majority of childhood cases and can be fatal if not treated with insulin injections or an insulin pump, along with close monitoring of blood glucose levels. Type 1 diabetes is thought to be genetic and usually triggered by an environmental factor, such as an infection. If type 1 diabetes is not treated and managed properly it can result in coma or death. Treatment for type 1 diabetes is a lifelong affair.

Type 2 diabetes is due to a loss of the ability to produce insulin, insulin resistance (which means that insulin is present, but the cells do not respond correctly to it), reduced insulin sensitivity or a combination of these factors. Most often regular exercise and a healthy diet can help to manage this type of diabetes, though additional medications including insulin or medications designed to stimulate insulin secretion can be a part of management, depending upon the body's needs. Type 2 diabetes must also be monitored and treated or many complications can ensue.

Gestational diabetes is very similar to type 2 diabetes, though it is only developed during pregnancy. Women with gestational diabetes did not have diabetes before becoming pregnant and this type of diabetes usually resolves after delivery. It occurs in about 5 percent or less of all pregnancies. It is treatable and must be watched carefully throughout pregnancy or damage can happen to mother and unborn child. Around 20 to 50 percent of all women who experience gestational diabetes during pregnancy develop type 2 diabetes eventually.

Both type 1 and 2 can be due to genetics, though it is most likely in type 2 diabetes. Type 2 is also linked to obesity, poor eating habits and lack of exercise, which is why it can usually be managed with weight loss, exercise and a healthy diet. There is no cure for type 1 diabetes, but type 2 has been cured by gastric bypass surgery for some patients. This cure is reserved for morbidly overweight patients and is due to the surgery processes and not simply the weight loss.

Filing for disability with Diabetes

If you have diabetes you may be eligible for disability benefits provided it has caused you to be out of work or to reduce your earnings to a level that is below the SGA monthly earnings limit. You must have been below the SGA limit for twelve months or expect to be below SGA for at least twelve months. For example, you could have a severe medical condition but you are working and earning over SGA. It does not matter that you have the severe medical condition if you are still earning over SGA, your disability claim would be denied for the performance of SGA without being sent for a medical determination. When it comes to a Social Security Disability determination, work activity is just as important your medical condition.

It's unlikely that you will be approved for disability benefits strictly on the basis of a diagnosis of diabetes. With diabetes, as with other impairments you have to have symptoms that cause significant limitations along with a medically determinable diagnosis.

When I was a disability examiner working on Social Security Disability and SSI claims, I would routinely see allegations on new claims involving A) amputations and B) neuropathy, all diabetes, mainly type II. Unfortunately, by the time an individual starts having symptomology to this level, the likelihood of beating back the the disease is probably fairly slim. I don't mean to issue that as a proclamation for everyone. It's just likely to be the case for most patients.

How cases are decided

Social Security Disability examiners review your medical records, evaluate questionnaires completed by you and the third party person you provided on your disability application, and in some cases they schedule a consultative examination to evaluate the severity of your diabetes.

Social Security uses a disability guidebook known as the blue book to make their disability decisions. The blue book contains impairment listings for all body systems, each impairment listing provides the necessary criteria needed to meet or equal the severity requirements of Social Security Disability.

Is there a listing for diabetes

In the past, there was a listing in the blue book for diabetes, but it has since been removed. SSA determined that individuals who have severe outcomes associated with diabetes, involving neuropathy that leads to problems with ambulation (walking) or diabetic retinopathy that leads to degraded vision, should be evaluated under the impairments relating to those specific body systems.

Here is what the old listing (listing 9.08) involved. The listing required you to have a diagnosis of diabetes mellitus with one or more of the following:

1. Neuropathy evidenced by persistent and significant disorganization of motor function abilities in two extremities. The disorganization must result in constant disturbance of both gross and dexterous movements as well as gait and station.

2. Acidosis that happens on average once every two months. This must be documented by the correct blood chemical testing.

3. Retinitis proliferans.

Dealing with diabetes

Dealing with diabetes doesn't have to be difficult. And here's a short list of things to keep in mind if you happen to get diagnosed with the condition.

1. Watch your diet. Type II diabetes is different from type I because there are multiple causes for the development of the condition and even in a single individual there may be multiple reasons for it. Your pancreas may not be producing enough insulin, your tissues may be resistant to insulin, your liver may be releasing too much glucose. However, a relative degree of physical inactivity and carrying too much weight typically corresponds to an initial diagnosis of diabetes. And in recent years, scientific health information seems to indicate that carrying too much mid-section and visceral fat can have a contributing effect. So, dropping weight drop and, at the very least, not gaining weight, should be a high priority for a type II patient. And such goals will, by necessity, usually require watching one's diet.

How do you do that? Making sure that the calories you consume are of higher quality is one way to start. So, reduce your consumption of empty calorie foods and aim for nutritious vegetables, lean meats, and better carbohydrate sources, meaning carbs that do not come from highly processed foods but are the types that are more slowly digested and less likely to contribute to sugar spikes that require your pancreas to work harder by releasing more insulin (which can be a double-edged sword if your own type II diabetes situation involves insulin resistance). You may also want to reduce the number of grams of carbohydrate you consume each day, or at least be more choosy about where you get your carbs from.

2. Increase your physical activity. Burning more calories than you take in is an approach devoid of gimmickry. And other than consuming fewer calories the only way to achieve this goal is to exercise. Engaging in exercise does not mean having to run marathons. It can be as simple as engaging in a thirty minute walk each day. If you read the health section of your local paper or online news source, no doubt you'll have seen articles that, increasingly, take the position that routine daily exercise can help to keep your weight down, improve your muscle tone, and contribute to healthier glucose levels.

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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