Facts about Renal Failure 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. Renal failure is also known as kidney failure, and can be chronic (long-term) or acute (sudden). Renal failure means the kidneys are not functioning as they should be.
2. Chronic kidney failure begins slowly with typically few signs or symptoms. Often those with renal failure do not realize there is a problem until the kidneys are functioning at only 25 percent or less of normal function.
3. Symptoms of chronic kidney disease include a variety of nonspecific problems, such as fatigue, weakness, headaches, sleep problems, and general malaise. Other symptoms include decreased urination, anemia, dark urine, swelling of the feet and ankles, yellow-brown skin and pain in the sides and mid to lower back.
4. The goal of treatment for chronic renal failure is to stop or slow the progression of the condition. Since chronic kidney failure is usually brought on due to another condition such as high blood pressure or diabetes, controlling this underlying cause is generally the focus of treatment.
5. The progression of chronic kidney failure leads to end-stage kidney disease, which requires dialysis (artificial filtering of waste from the kidneys) or a transplant.
6. Acute renal failure occurs suddenly, stopping the kidneys from filtering wastes and eliminating excess fluids from the blood stream. Acute kidney failure usually occurs in people who are already hospitalized for something else, and who are typically in intensive care.
7. Complicated surgical procedures, severe injuries or loss of large amounts of blood can all trigger renal failure, due to the disruption of blood flow to the kidneys.
8. Symptoms of acute renal failure include decreased urination, swelling in the legs, ankles and feet, drowsiness and fatigue, confusion, shortness of breath and chest pain, and sometimes seizures and coma.
9. Acute renal failure is often reversible, more so that chronic renal failure. Those in generally good health are more likely to return to normal kidney function.
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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