DIABETES AND SSD BENEFITS
DIABETES AND WINNING SOCIAL SECURITY BENEFITS
Diabetes is a disease with severe symptoms that affects 34.2 million Americans. That is 10.5% of the U.S. population. The CDC reports in the 2020 National Diabetes Statistics Report that over 88 million U.S. citizens, approximately 1 in 3, have prediabetes. Additionally, 1.4 million adults 20 years or older reported having Type 1 Diabetes and using Insulin. The number of people with this medical condition has been rising over time.
The American Diabetes Association Report states that the costs of caring for the disease in the United States continues to increase. In 2007, the costs were $116 billion. The costs in 2012 to care for diabetes were $176 billion. In 2017, the costs were $237 billion. Sadly, the costs of caring for this disease continue to rise.
Currently, 1 in 4 dollars are spent on medical care for people with diabetes. If you have diabetes, then the average cost per year to care for your disease is almost $17,000 per year. In addition to direct personal medical costs, the disease also has other costs. These include missed days and low production at work. Finally, it includes the cost of being unable to work.
THE THREE TYPES OF DIABETES
TYPE 1 DIABETES
There are three different types of Diabetes. The first type of Diabetes is Type 1 Diabetes. This is also known as Juvenile Diabetes. It is usually found in children and young adults. Although, it is possible for an adult to have the diagnosis. Type 1 Diabetes is a chronic condition in which the pancreas produces little or no insulin. Signs of Type 1 Diabetes include thirst, increased need to urinate, and hunger. It can also include wetting the bed, weight loss, and blurred vision. Usually, you will also experience fatigue and depression. Type 1 Diabetes shortens life expectancy.
TYPE 2 DIABETES
The second type is Diabetes Mellitus Type 2 (DM). It is also known as adult onset diabetes. This condition is usually brought on by an unhealthy lifestyle. For example, if you are overweight, don’t exercise, and eat foods high in sugar, then your body will struggle with insulin resistance. Insulin is a hormone made by your pancreas. Insulin acts like a key to let blood sugar into the cells in your body for use as energy.
Your pancreas makes more insulin to try to get cells to respond. However, over time, your cells become insulin resistant. Eventually your pancreas can’t keep up. Then, your blood sugar rises and you get prediabetes. Prediabetes becomes Type 2 Diabetes when the cells don’t respond normally to insulin. High blood sugar, along with prediabetes and diabetes, damages your body. Therefore, DM can cause other health problems, such as heart disease, vision loss, peripheral neuropathy, and kidney disease. Read about reversing diabetes type 2.
GESTATIONAL DIABETES
The third type of Diabetes is Gestational diabetes. Gestational diabetes occurs during pregnancy and usually ends when pregnancy ends. Gestational diabetes occurs when your body can’t make enough insulin during your pregnancy.
When you are pregnant, your body makes more hormones and goes through changes, such as weight gain. These changes cause your cells to use insulin less effectively. Therefore, it is possible to become insulin resistant. Insulin resistance increases the need for insulin.
All pregnant women have some insulin resistance during the later part of pregnancy. However, some women have insulin resistance even before they get pregnant. Therefore, they start pregnancy with a greater need for insulin. These women are more likely to have gestational diabetes. Once the baby is born, the gestational diabetes usually goes away. However, approximately half of all women who have gestational diabetes during pregnancy develop Type 2 Diabetes at a later point in life.
TREATMENT FOR DIABETES
It is possible for Type 2 Diabetes to be managed through exercise and controlling your diet. You can start by working with a dietitian nutritionist who can make an eating plan that works for you. You need to eat foods that are not processed and do not contain sugar. For example, a high protein, low carbohydrate diet, is probably best if you are a diabetic or prediabetic. However, you should check with your doctor and nutritionist to find out what is best for you. Additionally, you will want to exercise regularly and maintain a healthy weight.
BMI CALCULATOR AND HEALTHY WEIGHT
Typically, a healthy weight can be found by learning you BMI. The BMI is your body mass index. You can find a BMI calculator in order to assess your weight. The BMI only considers your height and weight.
These are the medically accepted BMI classifications:
- Underweight: less than 18.5
- Normal weight: 18.5-25
- Overweight: 25-30
- Obese: BMI of 30 or greater
- Morbid obesity: BMI greater than 40
The BMI calculator is only one possible ways to assess your weight. The BMI calculator does not, for example, take into account your body muscle amount. If you are very muscular, like an athlete, then you may weigh more than the BMI amount. However, you might still be a healthy weight.
BMI FOR CHILDREN AND TEENAGERS
For children and teenagers, the BMI is looked at differently, even though it is calculated using the same formula as the adult BMI. Children and teen’s BMI needs to be age and sex-specific because the amount of body fat changes with age. Likewise, the amount of body fat differs between girls and boys.
The CDC BMI-for-age growth charts take into account these differences and visually show BMI as a percentile ranking. For more information about BMI in children and teens, access the CDC Growth Charts. Children and teenagers are usually found to have Diabetes Type I. Because they have no work history, they can only qualify for Supplemental Security Income benefits.
If you have concerns about your weight, please discuss them with your doctor. Remember, even if you are a healthy weight and eat properly, you may still have a genetic propensity for diabetes. Also, if you have Type 1 or Type 2 diabetes, you will need to manage your blood sugar. You can monitor your blood sugar using a number of tools. Check with your insurance to find out what kind of monitor your health insurance will cover.
BLOOD GLUCOSE METER
For most people, a blood glucose meter will be necessary to track your blood sugar levels. The two main types are standard blood glucose meters that use a drop of blood to check what your levels are at that moment. Another is the Continuous Glucose Monitors (CGM), that reports your blood glucose level every five minutes throughout the day. This kind of monitor alerts you when your glucose is too high or too low. Learn about continuous glucose monitoring and time in range. You need to choose the tool that is best for you. Make sure you pick one that you feel comfortable using.
SMART INSULIN PEN
Another choice to monitor your blood glucose level is a smart insulin pen. A smart insulin pen is a reusable injector pen with a smartphone app. It can help people with diabetes better manage insulin delivery. The smart pen tracks insulin doses and gives you helpful alerts and reports. They come in the form of an add-on to your current insulin pen. Or, they come in a reusable form which uses pre-filled cartridges instead of vials or disposable pens.
INSULIN PUMP
If your doctor determines that a pump is a good option for you, then check with your health insurance company before you buy anything. Most health insurance cover pumps, but sometimes they may not be covered and pumps can be expensive. In addition to cost, some things to think about when it comes to buying a pump are lifestyle, commitment, and safety. Learn about the pros and cons of insulin pumps, and if they may be a good fit for you.
THE COVID-19 PANDEMIC AND DIABETES
The National Geographic recently published an article about how Covid-19 may be damaging the pancreas and thereby, causing diabetes. Experts have known since the beginning of the pandemic that having diabetes is a risk factor for more severe COVID-19 infections. But they also suspect that the inverse might be true as well. In May, Peter Jackson, a microbiologist, published a study in the journal Cell Metabolism showing that SARS-CoV-2 infects cells in the pancreas that produce insulin and may even target and destroy them. This shows that the Covid-19 virus may also cause diabetes. (Why scientists began investigating the link between COVID-19 and diabetes.) Learn information about Covid-19 and benefits.
“This is a real thing,” Jackson says of the complaints from newly diabetic people that email him. Although some experts argue the condition is rare, Jackson says the data shows that in 2020, as many as 100,000 people were found to have an unexpected case of diabetes.
It hasn’t been long enough yet for scientists to fully understand the pancreas after patients recover from a COVID-19 infection. But in May 2021, one study showed that a third of the people who were newly hyperglycemic remained that way for at least six months after their recovery from the virus.
WIN SOCIAL SECURITY BENEFITS FOR DIABETES
In order to win benefits, your physical or mental condition should meet or equal an SSA listing. However, the SSA removed Obesity, along with Diabetes Mellitus from the adult listing. This means an adult cannot meet or equal the listing for diabetes, because there isn’t one.
Almost six years ago, the SSA removed the listing for Diabetes in adults from the Listing of Impairments. The only thing the SSA left intact is the childhood DM Type 1 listing. And, that listing only applies to children with DM Type 1 who require daily insulin and have not reached the age of 6. For older children, the SSA does a functional analysis to see if the child equals the criteria for SSI benefits.
The reason the SSA took away the adult diabetes listing is because the listing “no longer accurately identified people who are disabled.”
To put this in context, in order to win benefits under the old SSA listing, you needed to have more than just diabetes. Your diabetes had to be so severe that the doctor needed to remove a limb – like an amputation of the leg above the knee. While the old listing was hard to meet, not having a listing for DM Type 2 is simply ridiculous.
In reality, the SSA fears aging baby boomers will have the disease and that too many people will apply and win SSD benefits for diabetes. By eliminating DM Type 2 as an official listing, it became easier for the SSA to deny benefits to thousands of people.
SOCIAL SECURITY RULING 14-2P
To be fair, in 2014, the SSA published Social Security Ruling 14-2p. SSR 14-2p guides the SSA employees and judges on how to evaluate diabetes in children over the age of 6 and adults. The Ruling outlines the two types of diabetes: Type 1 (normally found in children) and Type 2 (adult onset – which is often coupled with obesity or caused by genetics).
In order to win benefits due to diabetes, the disease must be looked at under other body systems. For example, if a person has had an amputation due to diabetes, then the SSA will look to listing 1.00. Or, a person might have Addison’s disease along with diabetes. The SSR lists the following body systems that can be affected by DM and points the judge to the following list:
- Amputation under the musculoskeletal system (1.00).
- Diabetic retinopathy, under special senses and speech (2.00).
- Hypertension, cardiac arrhythmias, and heart failure, under the cardiovascular system (4.00).
- Gastroparesis and ischemic bowel disease under the digestive system (5.00).
- Diabetic nephropathy, under genitourinary conditions (6.00).
- Slow healing bacterial and fungal infections, under skin conditions (8.00).
- Diabetic neuropathy, under the neurological listing (11.00).
- Cognitive disorders, depression, anxiety and eating disorders, under mental conditions (12.00).
SSA’S DIABETES RULES CAN BE FOUND UNDER LISTING 9.00 FOR ENDOCRINE DISORDERS
The SSA will only assess diabetes under the other body parts affected by the condition. Therefore, in order to win SSD benefits your medical condition must equal the listing. You will need to submit medical proof that at least one of the following impacts other body functions:
HYPERGLYCEMIA
Both types of diabetes, Type 1 and Type 2, cause hyperglycemia, which is a very high level of blood glucose that may produce long term health issues. Acute problems with hyperglycemia include diabetic ketoacidosis. Long term issues with chronic hyperglycemia include many conditions that impact a number of body systems.
DIABETIC KETOACIDOSIS
Diabetic ketoacidosis (DKA) occurs when a severe insulin deficiency causes your glucose and acid levels to be too high for your body to function. DKA can threat your like due to health complications, because the chemical balance of your body becomes dangerously hyperglycemic and acidic. DKA results from a severe insulin deficiency. This can occur due to missing your daily insulin therapy. It can also occur in association with another severe illness.
It requires hospital treatment to correct DKA problems, such as dehydration, electrolyte imbalance, and insulin deficiency. Also, you can have major health problems from DKA treatment. The SSA looks at each of these conditions under the body system that has the problem.
For example, the SSA will look at cardiac arrhythmias under listing 4.00. Likewise, they look at intestinal necrosis under listing 5.00. Issues like cerebral edema and seizures are under listing 11.00. Recurrent episodes of DKA may occur from eating or mood conditions, which the SSA will look at under listing 12.00. Find out about SSD benefits for depression. Likewise, find out about winning benefits for eating disorders.
DIABETIC RETINOPATHY
Diabetic retinopathy occurs when there is severe vision loss from damage to blood vessels in your eyes.
HYPOGLYCEMIA
Persons with DM may experience episodes of hypoglycemia, which is a very low level of blood glucose. Most adults recognize the symptoms of hypoglycemia and reverse them by eating food that contains glucose. However, some do not take this step because of they are unaware of the symptoms. Severe hypoglycemia can lead to serious problems, including seizures, which the SSA looks at under listing 11.00. It can also result in altered mental status. The SSA looks at mental symptoms under listing 12.00.
CHRONIC HYPERGLYCEMIA
Chronic hyperglycemia, which is chronic high levels of blood glucose, leads to health problems by damaging the function of your nerves and blood vessels. This can have many different effects on other body systems. For example, the SSA will consider diabetic peripheral neurovascular disease that leads to gangrene and amputation under listing 1.00.
Other examples include diabetic retinopathy which is found under listing 2.00. Heart issues, including coronary artery disease and peripheral vascular disease, are under listing 4.00. Diabetic gastroparesis that results in slow motility is under listing 5.00. Or, diabetic nephropathy is under under listing 6.00. Poorly healing bacterial and fungal skin infections are under listing 8.00. Diabetic peripheral and sensory neuropathies are under listing 11.00. Mental issues like cognitive disorder, depression, and anxiety are all under listing 12.00.
As you can see, diabetes has severe effects on many organs in the body. There is no cure for DM Type 2, but you can keep it under control with treatment, a healthy diet, and exercise. However, even when managed, it can impact your ability to work.
HOW TO APPLY FOR SOCIAL SECURITY BENEFITS IF YOU HAVE DIABETES
If your diabetes is severe enough that it interferes with your ability to perform daily living activities and work, then talk to your doctor about writing down your RFC in your medical records. It can take up to two years to obtain benefits from the SSA. Make sure your doctor supports your SSD application.
You are responsible for getting your medical records in to the SSA. In addition to medical information, you’ll also need personal documents, such as a birth certificate and tax information. Sending forms that are halfway complete or sending only part of your medical evidence could force the SSA to deny you benefits.
NECESSARY MEDICAL TESTING
Necessary medical testing includes:
- A fasting plasma glucose test given to you after an 8-hour fast.
- An oral glucose test given after an 8-hour fast and then waiting 2 hours after a drinking a soda that has glucose in it.
- Results from a random plasma glucose test given without fasting.
- Other blood tests, such as those that document ketoacidosis.
- Medical records of all hospital stays and operations due to your medical condition.
- Reports from your doctor that discuss the severe physical limits caused by your condition.
You can apply for Social Security Disability Insurance in person at your local SSA office. Also, you can apply for benefits over the phone or online at the Social Security website. You can apply for Supplemental Security Income (SSI) benefits in the same way. Whether you apply online or in person make sure you complete your application. The SSA deals with thousands of cases on a daily basis. If there are errors in your application, then it will delay your case.
If you have any new visits to the hospital or progress notes from doctor visits, then you will also need to send those to the SSA. The more medical evidence you have showing your symptoms, the better your chance of winning benefits. If you do not have enough medical evidence, then request an exam from one of SSA’s doctors. The SSA provides these exams at no cost to you.
WIN BENEFITS FOR DIABETES USING YOUR RESIDUAL FUNCTIONAL CAPACITY
It’s rare to win SSD benefits unless you have another condition caused by your diabetes. However, if your DM Type 2 causes severe symptoms, despite treatment, then there is another option for winning benefits. You can use your residual functional capacity (RFC).
Your RFC is what you are physically capable of doing after considering all of your medical symptoms. Your doctor should write down your physical limits in your medical records. For example, if you cannot stand for more than 15 minutes, then your doctor needs to state that fact in your records. This is why winning your benefits depends upon the evidence in your medical records.
YOUR RFC SHOWS WHAT WORK YOU CAN DO
The SSA will look at the symptoms of your diabetes and determine your RFC. Then, they will decide what kind of work you can do. The types of work are: seated, light, medium, heavy, and very heavy work. The SSA will look at your work history, your age, and education level. Then, they will determine whether or not you have skills that you could use on the job.
If DM Type 2 limits your ability to use your hands due to nerve damage, then you might not be able to use your skills. For example, you might not be able to type 6 hours a day. Or, you might have anxiety and this could cause you to not be able to concentrate or finish work tasks. DM Type 2 can cause a number of work related problems.
The ALJ, at your hearing, may call a medical expert to testify about your health. The medical expert is at the hearing to testify about your medical records and your symptoms. If the judge calls a medical expert to the hearing, then you need an attorney to question them. Learn information about the role of the medical expert at your hearing.
Additionally, at your hearing, there will be a job expert who will testify about what jobs might be available to someone with your physical limits. The decision about your ability to work will depend largely upon your RFC limits.
THE MEDICAL EXPERT CAN TESTIFY ABOUT DIABETES
Medical Experts (ME) often testify at Social Security hearings. The ALJ calls them to review your medical records for diabetes. Also, they explain your other medical conditions to the judge. Your attorney can request that an ME testify in court. This is, however, mostly done in complex medical cases.
The medical expert who appears at the hearing is not your treating doctor. The doctor at the hearing must have never met you before. Because, the medical expert is there to give testimony about your medical records and should not be for either side of the case.
Usually, the medical expert comes to the hearing. However, they can also testify by video or by telephone. It is also possible for an ME to answer written questions after the hearing. The judge sends written questions to the expert. The ME’s answers require review and possibly filing objections. If you do not know how to do this, then hire an attorney. Do not make the mistake of failing to prepare for the medical expert.
THE VOCATIONAL EXPERT & YOUR SSD BENEFITS
The vocational expert (VE) is also an expert witness, just like the medical expert. Normally, the Social Security Judge calls a VE to testify at the hearing. The Judge will ask the VE about jobs that are available to you based upon your RFC. VEs have training in placing people in jobs. They also understand the numbers and types of jobs that exist in the nation. They are at the hearing in order to answer questions about jobs in the national economy.
Once the Judge asks you questions about your medical conditions, she will decide what you are capable of doing during an 8 hour work day. The SSA calls this your RFC. Therefore, your answers to the questions at the hearing are very important. They are just as the important as the medical records you submit.
The Judge listens to your hearing testimony and the takes the symptoms from your medical records to determine how your DM symptoms impact you on the job. At the end of your hearing, the Judge will ask the VE questions. Likewise, your attorney will also ask questions. If you do not know how to question the VE, then hire an attorney.
WHAT DOES IT COST TO HIRE OUR LAW FIRM?
Another important factor to consider is what it costs to hire an attorney to represent you. We don’t charge you an attorney fee until we win your case. Once you win, the attorney fee comes out of your back benefit. If we do not win your case, then there is no back benefit. Therefore, you will not owe an attorney fee.
How much is the attorney fee? It is 25% of your back benefit. But, the fee is currently capped at $7200. You do not pay more than the cap of $7200. If you win, then you will pay either 25% of the back benefit or the $7200 cap. You pay whatever is the lesser amount. For example, if your back benefit is $100,000, our attorney fee would be $7200, not $25,000. Or, if your benefit is $10,000, then you would pay 25% of the back benefit. That would be $2500.
If there are costs in your case, then you pay for those costs. However, the costs are minimal. For example, you must pay for a copy of your medical records. The medical records cost is whatever your doctor charges for them. You owe costs whether we win or lose your case. But, to hire most lawyers, you have to pay a fee upfront. That doesn’t happen when you hire our law firm to help you win SSD and SSI benefits for diabetes.
WHAT WILL IT COST IF YOU DON’T HIRE THE RIGHT LAWYER?
What will it cost you if you don’t hire a lawyer with the legal experience to win your benefits? For example, if you win benefits at 50 years old, then you will be paid for the next 17 years. You may also win two of years of past due benefits. On the line, if you are 50 years old, is 19 years of SSD payments.
Nineteen years is is 228 months. At $1200 a month (which is a lower than average monthly benefit amount), that is $273,600. Additionally, you will win a higher retirement benefit after the age of 67. Let’s say the average higher retirement benefit is $300 a month and you live to be 90 years old. That is another $82,800.
It costs 25% of your back benefit OR $7200 from your back benefit to pay your attorney. You pay us whatever is less and only if you win. If you win your case, then your attorney has just won you $356,400, plus early Medicare benefits. You attorney will be paid $7200 and you will be paid $349,200.
All attorneys charge the same fee. So, you can go it alone and not hire an attorney, but chances are you will lose $356,400. Or, you can hire an attorney with over 30 years of experience and pay $7200 and win $349,200. The choice is yours. But, we hope you can see that the cost of a lawyer with 30 years of experience is worth it.
WHAT WE DO TO HELP YOU WIN YOUR SSD BENEFITS
You do not need to obtain SSD benefits for diabetes on your own. Our law firm can help file your SSD application. Also, we can help you file an appeal after every SSA denial. That way, you can focus on your health and living your life. Our attorneys and staff can:
- Send you the paperwork you need to become our client
- Help you file your application for SSD and SSI benefits
- Request an appeal if you receive an initial denial from DDS
- Help you confirm your SSA doctor exam
- Request a Hearing with an Administrative Law Judge (ALJ)
- Prepare you to testify at your ALJ hearing
- Represent you at your hearing and question the expert witnesses
- Read about job expert testimony
- Learn about the medical expert
- Request review of an SSA decision with the Appeals Council
- Request review of an Appeals Council denial in Federal Court
If you file your application for SSD benefits online at Social Security’s website, then you have 6 months to complete the application. Once you submit your application online, the SSA sends you an application summary in the mail. You must sign the summary and mail it back quickly.
THE LAWYERS & STAFF AT OUR LAW FIRM
At Cannon Disability Law we can help you apply for benefits. Also, we can help you appeal an SSA denial. Likewise, we can represent you in court at your SSA hearing. We will help you be a witness in your case. If necessary, we can also appeal your case to the Appeals Council.
Additionally, we file appeals in Federal Court. Finally, we can represent you where you live. For example, we can represent you if need an attorney in Utah or Nevada. Additionally, we can help you if you live in Idaho, Colorado, or California.
Your ability to receive Medicaid and Medicare depends upon whether you win your benefits. In order to fight SSA’s denials, you need a lawyer. Hire us. Dianna Cannon has been helping clients win SSDI cases for over thirty years. Brett Bunkall and Andria Summers also have many years of legal experience. Together, we have won over 20,000 SSD and SSI hearings. You can trust us. We will do everything we can to win your SSD and SSI benefits.
WE HAVE THE EXPERIENCE YOU NEED TO WIN BENEFITS
Our law firm is one of the best SSD law firms in the country. We are listed as one of the best Social Security law firms in Las Vegas, Nevada. Our lawyers are also members of the National Organization of Social Security Claimant’s Representatives.
Learn about Utah SSD benefits. Nevada SSDI Information can also be found on this website. We also represent clients in Idaho. Learn about Idaho benefits. Find out about Colorado SSD benefits. Likewise, California SSDI and SSI information is also on our website.
Over the last 30 years, we have won thousands of SSDI and SSI cases. Additionally, we have won over $100 million in SSD benefits. for our clients. Over time, it has become more difficult to win Social Security cases. Also, the SSA medical rules are harder to meet. This applies to diabetes, as you can see by the SSA being willing to simply get rid of the listing. The baby boomer generation is aging and many of them have DM. The SSA found the growing cost of paying benefits to those with this illness to be too high.
That should tell you to hire an attorney. Do not go to your hearing without a lawyer who has the experience to win your case. Those who come to the hearing without counsel are usually not successful in winning benefits. You should hire an attorney with experience in dealing with the SSA. Contact our law firm. We can help. Call today.