Chronic kidney disease can come as a shock. You may not know about your condition until you are already experiencing kidney failure or until you have routine bloodwork which indicates that your kidney function is impaired.
Currently, there is no cure for many types of chronic kidney disease. Medical treatment may slow down the progression of your condition, but it may still progress to end-stage renal disease (ESRD) and you may be eligible for Social Security disability benefits.
How the Social Security Administration Evaluates Chronic Kidney Disease
Chronic kidney disease is included in Section 6.00 of the Social Security Administration’s Blue Book Listing of Impairments. More specifically, Section 6.00 explains how a person with a genitourinary disorder that results in chronic kidney disease may be eligible for Social Security disability.
Section 6.00 of the Listing of Impairments
The specific kidney conditions in Section 6.00 of the Listing of Impairments include:
- Chronic kidney disease with chronic hemodialysis or peritoneal dialysis (Section 6.03). Dialysis must have lasted, or be expected to last for at least 12 months.
- Chronic kidney disease with kidney transplant (Section 6.04). This is considered a disability for one year after the date of transplant. After one year, your continued disability would be evaluated if you have a residual impairment.
- Chronic kidney disease with impairment of kidney function (Section 6.05). In order to qualify pursuant to this section you must have reduced glomerular filtration evidenced by specific lab results at least twice, 90 days apart, and within 12 months. Additionally, you must have renal osteodystrophy, peripheral neuropathy, fluid overload syndrome, or anorexia with weight loss.
- Nephrotic syndrome (Section 6.06). This condition causes you to excrete too much protein your urine. If your lab findings meet certain requirements over a specific amount of time then you may be eligible for disability benefits.
- Complications of chronic kidney disease. (Section 6.09). In some cases, it is not the diagnosis of the kidney disease, but instead it is the complications that you suffer from it that make you eligible for Social Security disability benefits.
Evidence Required If You Qualify Pursuant to Section 6.00
The Social Security Administration requires the following evidence to determine whether a person qualifies for disability benefits pursuant to Section 6.00:
- Reports from clinical examinations
- Treatment records, including information about your response to treatment
- Lab findings, such as serum creatinine or serum albumin levels
- Estimated glomerular filtration rate (eGFR). This is an estimate of your kidneys’ filtering capacity.
- Kidney or bone biopsy. If you have had a kidney or bone biopsy done, a copy of the pathology report or a statement from your doctor should be submitted with your disability application.
Generally, evidence is needed for a period that covers at least 90 days.
Other Ways to Qualify
The specific conditions listed in Section 6.00 are common genitourinary disorders that may be severe enough to prevent you from working, but they are not the only genitourinary disorders that may prevent you from working. If you have a different kidney disorder that does not meet the specific criteria of this section, you may still be eligible for benefits if:
- You are eligible pursuant to a different listing in the Listing of Impairments.
- Your condition is medically equivalent to another listing in the Listing of Impairments.
- You lack the residual functional capacity to engage in substantial gainful activity.
Only one of these three things must be true in order for you to be found eligible for Social Security disability benefits.
Talk to a Board-Certified Social Security Disability Lawyer Before You Apply for Benefits
Even if you meet the qualifications described above and you have the required evidence to support your claim, you may benefit from the experience and assistance of a Social Security disability lawyer. The majority of initial Social Security disability claims are denied. This results in a delay in benefits and unnecessary frustration. We can help you avoid this complication by submitting a complete and accurate application on your behalf. Please contact us today or download our FREE report, Social Security Disability: What You Need to Know, to learn more.
by Paul B. Burkhalter Managing Partner of Morgan & Weisbrod, Board Certified in Social Security Disability Law.