Facts about Nephrotic Syndrome and Filing for Disability
These selected pages answer some of the most basic, but also some of the most important, questions for individuals who are considering filing a claim for disability benefits.
Facts about the condition
1) Nephrotic syndrome is a condition that occurs in the kidneys, in which too much protein is transferred from the blood stream into urine.
2) The kidneys contain groups of small blood vessels that filter the blood to eliminate waste and excess water. They also keep protein in the blood. When damaged, these vessels allow blood protein to leave the body with urine.
3) Nephrotic syndrome leads to edema, widespread swelling all over the body, but most often in the legs and ankles and around the eyes. In addition to swelling, fluid retention also causes weight gain. Foam in toilet water after urination is another sign, and is caused by too much protein in urine.
4) There are many possible causes for nephrotic syndrome. Well-known conditions associated with nephrotic syndrome include hepatitis B, malaria, lupus, cancer, diabetes, blood clots (particularly in a kidney vein), and heart failure (particularly severe right heart failure).
5) Kidney conditions that lead to nephrotic syndrome include minimal change disease (the kidneys function abnormally but tissue appears normal), membranous nephropathy (membranes in the kidneys thicken for unknown reason), and focal segmental glomerulosclerosis (scarring of tissue in the kidneys either due to another condition or for no apparent reason).
6) Minimal change disease often occurs in children, and is the leading cause of nephrotic syndrome in children.
7) Nephrotic syndrome may lead to a variety of health problems. This includes blood clots, high cholesterol and blood pressure and poor nutrition. Individuals with the condition are also likely to have an increased risk of infection. Both chronic and acute kidney failure are dangerous complications of nephrotic syndrome.
8) Testing for nephrotic syndrome includes urine and blood tests to measure protein, as well as a biopsy and analysis of kidney tissue if initial tests show signs of the condition.
9) Treatment involves controlling the underlying condition and also targeting complications with medications like blood thinners, water pills and antibiotics.
10) Children with minimal change disease have the best prognosis of all patients.
Qualifying for disability benefits with this condition
Whether or not you qualify for disability and, as a result, are approved for disability benefits will depend entirely on the information obtained from your medical records.
This includes whatever statements and treatment notes that may have been obtained from your treating physician (a doctor who has a history of treating your condition and is, therefore, qualified to comment as to your condition and prognosis). It also includes discharge summaries from hospital stays, reports of imaging studies (such as xrays, MRIs, and CT scans) and lab panels (i.e. bloodwork) as well as reports from physical therapy.
In many disability claims, it may also include the results of a report issued by an independent physician who examines you at the request of the Social Security Administration.
Qualifying for SSD or SSI benefits will also depend on the information obtained from your vocational, or work, history if you are an adult, or academic records if you are a minor-age child. In the case of adults, your work history information will allow a disability examiner (examiners make decisions at the initial claim and reconsideration appeal levels, but not at the hearing level where a judges decides the outcome of the case) to A) classify your past work, B) determine the physical and mental demands of your past work, C) decide if you can go back to a past job, and D) whether or not you have the ability to switch to some type of other work.
The important thing to keep in mind is that the social security administration does not award benefits based on simply having a condition, but, instead, will base an approval or denial on the extent to which a condition causes functional limitations. Functional limitations can be great enough to make work activity not possible (or, for a child, make it impossible to engage in age-appropriate activities).
Why are so many disability cases lost at the disability application and reconsideration appeal levels?
There are several reasons but here are just two:
1) Social Security makes no attempt to obtain a statement from a claimant's treating physician. By contrast, at the hearing level, a claimant's disability attorney or disability representative will generally obtain and present this type of statement to a judge.
Note: it is not enough for a doctor to simply state that their patient is disabled. To satisy Social Security's requirements, the physician must list in what ways and to what extent the individual is functionally limited. For this reason, many representatives and attorneys request that the physician fill out and sign a specialized medical source statement that captures the correct information. Solid Supporting statements from physicians easily make the difference between winning or losing a disability case at the hearing level.
2) Prior to the hearing level, a claimant will not have the opportunity to explain how their condition limits them, nor will their attorney or representative have the opportunity to make a presentation based on the evidence of the case. This is because at the initial levels of the disability system, a disability examiner decides the case without meeting the claimant. The examiner may contact the claimant to gather information on activities of daily living and with regard to medical treatment or past jobs, but usually nothing more. At the hearing level, however, presenting an argument for approval based on medical evidence that has been obtained and submitted is exactly what happens.
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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