DIABETES AND SSD BENEFITS
DIABETES AND WINNING SOCIAL SECURITY DISABILITY BENEFITS
Diabetes is a life-threatening disease with severe symptoms that affects approximately 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 cases of diabetes has been rising steadily over the years.
The American Diabetes Association Report states that the costs of caring for diabetes 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 diabetes continue to rise. Currently, 1 in 4 healthcare dollars are spent to care for people with diabetes. If you have diabetes, the average cost per year to care for your disease is approximately $16,752 per year. In addition to direct personal medical costs, diabetes also causes indirect costs. These include missed workdays and decreased productivity 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 of Diabetes is Type 2 Diabetes. 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, which you have with prediabetes and diabetes, is damaging to the body. Therefore, diabetes can cause other health problems, such as heart disease, vision loss, and kidney disease.
The third type of Diabetes is Gestational diabetes. Gestational diabetes occurs during pregnancy and typically ends when pregnancy ends. Gestational diabetes occurs when your body can’t make enough insulin during your pregnancy. During pregnancy, your body makes more hormones and goes through changes, such as weight gain. These changes cause your body’s cells to use insulin less effectively. Therefore, it is possible to become insulin resistant. Insulin resistance increases your body’s 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. They start pregnancy with an increased need for insulin. Therefore, they 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.
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 diabetic 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 more 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 calculates and tracks insulin doses and provides 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.
If your doctor determines that a pump is a good option for you, it’s important to check with your insurance provider before you buy anything. Most insurance providers cover pumps, but sometimes they may not be covered and pumps can be expensive. In addition to cost, some considerations to consider when it comes to getting a pump are lifestyle, commitment, and safety. Learn more 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.)
“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 diagnosed with an unexpected case of diabetes.
It hasn’t been long enough yet for scientists to fully understand the fate of the pancreas in the months 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.
QUALIFYING FOR SOCIAL SECURITY DISABILITY BENEFITS WITH DIABETES
In order to win disability benefits, your physical or mental impairment can meet or equal an SSA listing. The SSA has a list of impairments that they consider to be disabilities. However, the SSA removed Diabetes Mellitus from their list. This means you cannot meet or equal the listing for diabetes, because there isn’t one.
Almost six years ago, the SSA published final rules in the Federal Register removing the listing for Diabetes in adults and in children from the Listing of Impairments. The reason the SSA eliminated Diabetes as a listing level disability is because, in their words, the diabetes listing “no longer accurately identified people who are disabled.”
To put this in context, in order to be found disabled under the old SSA listing, an individual required more than just being diagnosed with diabetes. They also had to have severe enough diabetes that they needed an amputation – like an amputation of the leg below the knee. For the SSA to claim that diabetes this severe was not a disability is simply ridiculous. In reality, the SSA feared that aging baby boomers would have diabetes and that too many people would apply and win disability benefits. By eliminating diabetes as an official disability, it has been easier for the SSA to deny millions of disability claims over the last six years.
SOCIAL SECURITY RULING 14-2P
To be fair, in 2014, the SSA published Social Security Ruling 14-2p. SSR 14-2p gives guidance to SSA employees and judges on how to evaluate diabetes in children and adults. The Ruling discusses the two types of diabetes: Type 1 (typically found in children) and Type 2 (adult-onset – which is often coupled with obesity and/or brought on by genetics).
In order to be found disabled due to diabetes, the disease must be evaluated under other body systems that can be impaired by the disease. For example, if a person has undergone an amputation due to diabetes, the SSA will look to listing 1.00. The SSR lists the following body systems that can be affected by diabetes and points the adjudicator to other listings for an evaluation as follows:
- Amputation under the musculoskeletal system (1.00).
- Diabetic retinopathy, under the special senses and speech listings (2.00).
- Hypertension, cardiac arrhythmias, and heart failure, under the cardiovascular system listings (4.00).
- Gastroparesis and ischemic bowel disease (intestinal necrosis), under the digestive system listings (5.00).
- Diabetic nephropathy, under the genitourinary impairments listings (6.00).
- Slow-healing bacterial and fungal infections, under the skin disorders listings (8.00).
- Diabetic neuropathy, under the neurological listings (11.00).
- Cognitive impairments, depression, anxiety, and eating disorders, under the mental disorders listings (12.00).
SSA’S DIABETES RULES CAN BE FOUND UNDER LISTING 9.00 – ENDOCRINE DISORDERS
The SSA assesses diabetes by the other body parts affected by the disorder. To be approved for SSD benefits under an equalling of the listing for diabetes, you will need to submit medical proof that at least one of the following disrupts other body functions:
Both types of diabetes, Type 1 and Type 2, cause hyperglycemia, which is an abnormally high level of blood glucose that may produce acute and long-term complications. Acute complications of hyperglycemia include diabetic ketoacidosis. Long-term complications of chronic hyperglycemia include many conditions affecting various body systems.
Diabetic ketoacidosis (DKA) occurs when a severe insulin deficiency causes your glucose and acid levels are too high for your body to function. DKA is a potentially life-threatening diabetes complication in which the chemical balance of the body becomes dangerously hyperglycemic and acidic. It results from a severe insulin deficiency, which can occur due to missed or inadequate daily insulin therapy or in association with an acute illness.
It usually requires hospital treatment to correct the acute complications of dehydration, electrolyte imbalance, and insulin deficiency. You may have serious complications resulting from your treatment, which the SSA evaluates under the affected body system. For example, the SSA evaluates cardiac arrhythmias under listing 4.00. Likewise, they evaluate intestinal necrosis under listing 5.00. Issues like cerebral edema and seizures are under listing 11.00. Recurrent episodes of DKA may result from mood or eating disorders, which the SSA evaluates under listing 12.00 for mental disorders.
Diabetic retinopathy occurs when there is severe peripheral vision loss from damage to blood vessels in your eyes.
Persons with DM may experience episodes of hypoglycemia, which is an abnormally low level of blood glucose. Most adults recognize the symptoms of hypoglycemia and reverse them by consuming substances containing glucose; however, some do not take this step because of hypoglycemia unawareness. Severe hypoglycemia can lead to complications, including seizures or loss of consciousness, which the SSA evaluates under listing 11.00. It can also results in altered mental status and cognitive deficits. The SSA evaluates those symptoms under the mental listings, under 12.00.
Chronic hyperglycemia, which is longstanding abnormally high levels of blood glucose, leads to long-term diabetic complications by disrupting nerve and blood vessel functioning. This disruption can have many different effects in other body systems. For example, the SSA evaluates diabetic peripheral neurovascular disease that leads to gangrene and subsequent amputation of an extremity under listing 1.00.
Other examples include diabetic retinopathy which is under listing 2.00. Heart issues, including coronary artery disease and peripheral vascular disease are under listing 4.00. Diabetic gastroparesis that results in abnormal gastrointestinal motility is under listing 5.00. Or, diabetic nephropathy 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 impairments, 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 diabetes, but you can keep it under control with treatment, a healthy diet, and exercise. However, even when managed, diabetes can impact your ability to work.
HOW TO APPLY FOR SOCIAL SECURITY DISABILITY BENEFITS & SSI 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 documenting your RFC. The disability application can take up to two years to obtain benefits. Make sure your doctor supports your disability application.
You are responsible for obtaining your medical records. In addition to relevant medical information, you’ll also need personal documents, such as a birth certificate and tax information. Sending incomplete forms or insufficient medical evidence could force the SSA to take the time to collect the information themselves or deny you benefits.
NECESSARY MEDICAL TESTING
Necessary medical testing includes:
- A fasting plasma glucose test administered after an 8-hour fast.
- An oral glucose test administered after an 8-hour fast and waiting an additional 2 hours after a drinking a beverage that contains glucose.
- Results from a random plasma glucose test given without fasting.
- Other blood tests, such as those that document diabetic ketoacidosis.
- Medical records of all hospitalizations and surgeries due to your diabetes.
- Reports from your doctor detailing the severity and physical limitations of your diabetes.
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 your application contains errors, then it will delay your case.
If there are any new hospitalizations or progress notes from doctor’s visits, then you will also need to send those to the SSA. The more medical evidence you have showing your limitations, the better your chance of winning benefits. If you do not have sufficient medical evidence, then request a consultative examination. The SSA provides these kind of examinations at no cost to you.
WIN BENEFITS FOR DIABETES USING YOUR RESIDUAL FUNCTIONAL CAPACITY
It’s rare to win disability benefits unless you have another condition caused by diabetes. However, if your diabetes 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 your diabetes symptoms. Typically, your limitations need to be in your medical records. For example, if you cannot stand for more than 15 minutes due to neuropathy, your doctor needs to document that limitation.
The SSA will evaluate the severity of your diabetes and determine your RFC. Then, they will decide what category of work you can do. The categories of work are: sedentary, 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 you diabetes limits your ability to use your hands due to neuropathy, 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 depression from diabetes and this could cause you to not be able to concentrate or finish work tasks. Diabetes can cause a number of work related limitations. At your hearing, there will be a vocational expert who will determine if you can work. The determination of your ability to work will depend largely upon your RFC.
THE REPRESENTATIVES AT CANNON DISABILITY LAW
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 disability 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 a disability 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 or not you are successful with your disability claim. Even your future retirement is at risk if you do not win benefits. In order to fight the SSA’s denials, you need a lawyer. Hire us. Dianna Cannon has been representing people with disabilities for over thirty years. Brett Bunkall and Andria Summers also have many years of litigation experience. We have won over 20,000 disability hearings. You can trust us. We will do everything we can to win your SSD and SSI benefits.
CANNON DISABILITY LAW HAS THE EXPERIENCE YOU NEED TO WIN BENEFITS
Cannon Disability Law is one of the best disability firms. They are listed as one of the best Social Security Disability firms in Las Vegas, Nevada. The representatives at Cannon Disability Law are also members of the National Organization of Social Security Claimant’s Representatives. Learn more about Utah SSD benefits here. Nevada Disability Information can also be found on this website. We also represent claimant’s in Idaho. Find out more about Colorado disability benefits here. Likewise, if you are from California, California disability information can also be found on our website.
Over the last 30 years, Cannon Disability has won over 20,000 disability claims. Additionally, during that time we have won over $100 million in ongoing and past-due SSD disability benefits. It has become more difficult to win Social Security cases. Also, the listing requirements are harder to meet. This applies to diabetes, as you can see by the SSA’s willingness to simply eliminate the listing. The baby boomer generation is aging and many of them have or will have diabetes. The SSA found the growing cost of paying benefits to those with diabetes too high.
That should tell you to hire an attorney. More importantly, do not go to your hearing without a representative with the experience to win your case. Those who come to the hearing without counsel are typically not successful in winning benefits. You should hire an attorney with experience in disability law. Contact Cannon Disability Law today. We can help you with your disability case.