PANCREAS TRANSPLANT AND SSD BENEFITS

WINNING SSD BENEFITS AFTER ORGAN TRANSPLANT

When a person undergoes a pancreas transplant, it means their pancreas is no longer able to function properly. The pancreas plays a critical role in producing insulin and managing blood sugar levels. When it fails, life threatening complications occur.

A pancreas transplant is usually performed to treat severe cases of Type 1 Diabetes. Usually, this is because diabetes causes kidney damage or other serious issues. In some cases, patients have both a kidney and pancreas transplant because both organs are failing.

In the United States, pancreas transplants are rare compared to other types of organ transplants. According to the Organ Procurement and Transplantation Network (OPTN), only about 800 pancreas transplants are performed each year.

By comparison, there are more than 25,000 kidney transplants each year. While the number may seem small, a pancreas transplant is a major operation. It requires significant recovery time. Patients must take medications so they don’t reject the pancreas. They must also visit the doctor frequently and monitor their health to avoid illness.

A pancreas transplant usually prevents a person from working. The Social Security Administration (SSA) recognizes this by including pancreas transplant in its Blue Book or Listing of Impairments.

Specifically, Listing 5.12 covers pancreas transplants and provides a clear standard for SSD benefits. Understanding how to qualify for Social Security Disability benefits is important, because the process can be complex.

APPLYING FOR SSD BENEFITS AFTER PANCREAS TRANSPLANT

There are two main federal programs that provide benefits to people who cannot work because of a serious medical condition: Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). Both are run by the SSA. However, the requirements for each are different. You can file an application for both benefits on Social Security’s website.

SSDI is based on your work history and the payment of Social Security taxes. If you have worked and paid into the system over several years, you may qualify for SSDI. The amount of your monthly benefit will depend on your past earnings. SSDI also provides Medicare benefits. However, they don’t start until 29 months after your onset date of disability.

SSI, on the other hand, is a needs based benefit. It is for people who have little or no income and limited resources. You do not need a work history to qualify for SSI. Instead, you must meet the income and asset limits set by the SSA. If you qualify, then you will receive a monthly cash benefit. You should also receive Medicaid benefits, which helps pay for medical expenses.

After a pancreas transplant you may qualify for either SSI, SSDI, or both. It depends on your work history and financial situation. It is important to apply as soon as possible, because the SSA review process can take months. Even with a serious condition, the SSA still requires medical records, test results, and proof the surgery took place.

MEETING LISTING 5.12 FOR PANCREAS TRANSPLANT 

The SSA has a list of medical conditions that they considered so severe that they automatically qualify for SSD benefits if the criteria are met. A pancreas transplant falls under Listing 5.12.

Listing 5.12 is very clear. If you have a pancreas transplant, then the SSA will find you qualify for benefits for one year after the date of surgery. During this one year period, you do not need to prove that you cannot work. The assumes law that the surgery and the recovery period make you unable to work.

The one year period is designed to give your body time to recover and adjust to the new pancreas. It also accounts for frequent doctor visits during the first year after surgery. If you apply for benefits during this time and your records confirm that you had a pancreas transplant, then you should qualify for benefits under Listing 5.12.

However, after one year, the SSA will review your case to determine if you are still disabled. At that point, you will need to show either that you continue to meet a listing through severe symptoms or that your cannot work due to your residual functional capacity (RFC).

EQUALING THE LISTING FOR PANCREAS TRANSPLANT

Not every person fits neatly under Listing 5.12. For example, if you have not had a pancreas transplant but still have severe symptoms from diabetes or other pancreatic disorders, then you may be able to equal Listing 5.12.

Equaling a listing means that your medical issues are as serious as those in the listing, even if they are not identical. For instance, if you suffer from diabetes that causes frequent hospital visits, severe nerve damage, or kidney failure, then you may equal the listing. Similarly, if your body rejects the new pancreas or if you have medical issues after the first year, then you may equal the listing.

To prove that you equal the listing, your medical records must show your condition  impacts your ability to function. Hospital records, lab results, reports from your surgeon, and treatment notes from your doctor strengthen your case. The SSA considers the entire picture of your health. Therefore, make sure you submit all of your records.

RFC AND YOUR ABILITY TO WORK AFTER SURGERY

If you do not meet or equal Listing 5.12, then the SSA will move through the five step disability evaluation process. The fourth step in the process involves your RFC. RFC measures what you can still do despite your medical condition.

After a pancreas transplant, you will face problems that interfere with your ability to work. Anti-rejection medications can cause side effects like fatigue, nausea, and an increased risk of infection. Some people develop chronic kidney disease, heart problems, or nerve damage related to years of diabetes. These issues may not fit neatly into a listing, but they can make regular work impossible.

The SSA will look at whether you can perform seated, light, medium, or heavy work. After a pancreas transplant, your physical stamina will be limited. Repeated medical appointments and the need to avoid infections can also interfere with consistent attendance on a job. If the SSA finds you cannot perform your past work or adjust to new work, then you may still win benefits.

Age, education, and work history also play a role in RFC evaluations. For example, an older worker with limited education may qualify for benefits when their RFC limits them to seated work. The SSA uses the Medical-Vocational Guidelines to make this determination.

YOUR DOCTOR CAN HELP PROVE YOUR RFC

Once a year goes by, after your surgery, the SSA will review your medical records and define what they think you can physically do in an 8 hour day. They will also decide, based upon your statements and medical records, what type of work you can do.

In terms of mental limits, the SSA will determine if you have trouble with memory, focus, or learning new tasks. Additionally, your mental condition can impact your ability to use your skills, such as reading or doing math. Mental illness can also impair your ability to get along with other workers, your boss, or the general public.

It will help if your doctor submits an RFC form for you. An RFC form can be about your physical limits and also about mental limits. The main thing to keep in mind is that the medical evidence must support the opinion of your doctor. For example, progress notes from the doctor must show the same limits as those on your RFC form. If the RFC form is different from the progress notes, then the SSA will refuse to give weight to the opinion of your doctor.

THE IMPORTANCE OF MEDICAL EVIDENCE

One of the most important parts of a disability claim is medical evidence. The SSA requires detailed records to support your claim. This includes hospital records showing the date of your transplant. It also requires lab results and treatment notes from your doctors.

Because pancreas transplants are rare, the SSA may not be familiar with the condition. Providing complete medical records helps ensure that the SSA understands your case. When you file your application for benefits, explain your medical situation in detail. If possible, submit your records right away.

You may struggle to collect your medical records. Especially if you want a free copy of the medical records. Your doctor should be able to provide you a free copy of your medical records. Additionally, most doctors now have a portal where you can download a copy of your records. Hiring an SSD law firm is a good choice because they will obtain copies of your records for you.

WHY OUR SSD LAW FIRM CAN MAKE A DIFFERENCE 

Even though Listing 5.12 is clear, winning SSDI and SSI benefits after a pancreas transplant is not always simple. The SSA can deny claims if paperwork is not correct. They can also deny your case if you miss a deadline or if the medical evidence is not clear. Having an experienced disability attorney can help you avoid mistakes and present your case in the best way.

We understand how important it is to secure benefits after a serious medical event like a pancreas transplant. We can help you gather medical records, work with your doctors, and represent you in court before the SSA. Our goal is to ensure that you receive the benefits you need while you focus on your recovery.

We offer a free review of your case prior to becoming our client. Also, we do not charge any money upfront for you to hire us. Instead, we are only paid an attorney if we win your SSD benefits. Once we win the case, then we are paid out of your past due benefits. It is easy to hire us. Just contact us. Hiring the best SSD law firm will help reduce your stress.

GET TO KNOW OUR SSD LAW FIRM

Learn about our lawyers and staff on our About Us page. There you will find  information about each of us. For example, Andria Summers can help you with your Medicare advantage plan. Likewise, she has also won thousands of SSDI and SSI cases.

Dianna Cannon has many years of legal experience helping her clients win SSDI and SSI benefits. She has been an attorney for thirty years. Ms. Cannon also has an attorney license in a number of states. For example, she has a law license in California, Utah, Nevada, and Washington State. She also has experience taking cases to the Appeals Council and Federal Court.

Additionally, Brett Bunkall also has years of legal experience helping people obtain their SSI and SSD benefits. Mr. Bunkall has won thousands of Social Security hearings. He is an expert in SSD law. Similarly, all of our staff and lawyers are experts in Social Security law. You can trust us to help you win Social Security benefits for your pancreas disease. You can also learn about pancreatic cancer.

HIRE US FOR OUR TRACK RECORD

A pancreas transplant is a major medical procedure that affects every part of your life. The SSA recognizes this by including pancreas transplant in its Listing of Impairments under Listing 5.12. For the first year after surgery, you should qualify for benefits automatically. After that, you may still qualify by showing that you equal the listing. Or, you can always try to prove that your symptoms prevent you from working.

Our SSD law firm has won over 20,000 SSD claims for our clients. We have been in business for over 35 years. Consider the track record of the law firm you hire to help you win benefits. Do they have decades of experience fighting the SSA? How many cases have they won? Hire the SSD law firm with the most legal experience.

Filing an application for Social Security Disability benefits is complex, even with a serious condition. But with the right evidence and guidance, you can increase your chances of approval. If you or a loved one has had a pancreas transplant and cannot work, then contact us. We can help you understand your options and fight for the benefits you deserve.