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Cirrhosis Social Security Disability

 I have been diagnosed with cirrhosis, can I get Social Security Disability benefits (SSD or SSDI), Disability Insurance Benefits (DIB), or Supplemental Security Income benefits (SSI)?

Receiving a diagnosis of cirrhosis is just the start.  The main focus in a Social Security disability claim is usually on the symptoms you experience from cirrhosis and how those symptoms affect your ability to engage in physical and mental work-related activities eight (8) hours per day, five (5) days per week.

Cirrhosis is the late-stage scarring of the liver due to health conditions like hepatitis and chronic alcoholism. Such conditions injure the liver, which then tries to repair itself, and in the process, develops scar tissues. The more scar tissues form, the more difficult it is for the liver to function normally. This is dangerous because one of the primary functions of the organ is to detoxify harmful substances from the blood.

Unfortunately, cirrhosis often shows no symptoms until the damage to the liver is extensive. When the signs do occur, they may include fatigue, itchy skin, bleeding or bruising easily, yellowish discoloration on the skin and eyes (jaundice), fluid accumulation in the abdomen, nausea, weight loss, and leg swelling. In men, there may be breast enlargement and testicular atrophy.

Can you get disability if you have cirrhosis of the liver?

The Social Security Administration (SSA) uses a 5-step process to decide if you are disabled.

Step 1.  Are you working?

At the first step, SSA considers your work activity.  If you are engaged in Substantial Gainful Activity (SGA) you will not be found disabled.  The amount you must earn to be working at SGA changes each year. For 2018 it is $1,180 per month if you are not blind and $1,970 per month if you are blind.  If you are working, and your earnings average more than the SGA limit, then you will not be found disabled.  If you are not working, or your earnings are less than SGA, the process proceeds to Step 2 where your cirrhosis and any other physical or mental conditions are considered.

Step 2.  Is your medical condition “severe”?

For SSA to determine that you are disabled, your medical condition must significantly limit your ability to do basic work activities—such as sitting; standing; walking; lifting; carrying; understanding, remembering, and carrying out simple instructions; making simple work-related decisions; responding appropriately to supervision, co-workers, and work stress; and dealing with changes in a routine work setting.

To be found disabled, you must have a medically determinable physical or mental impairment (or a combination of impairments) that is severe and has lasted or is expected last one (1) year or end in death. If your medical condition is not that severe, you will not be found to meet the requirements for Social Security disability benefits.  If your condition is that severe, SSA goes to Step 3.

Step 3.  Does your medical condition meet or equal the severity of a Listing?

The Social Security Administration maintains a listing of medical criteria that are considered to be so severe that you will be found disabled if your medically determinable physical or mental impairment(s) matches them.  The Adult Listing for cirrhosis can be found here.

If you do not have an impairment that meets or equals one of the listings or the duration requirement is not met, SSA determines what you’re capable of doing despite your impairments (your Residual Functional Capacity [RFC]) and will proceed to Step 4.

RFC is a function-by-function assessment of your maximum ability to do sustained work-related physical and mental activities on a regular and continuing basis (8 hours a day, for 5 days a week) despite the limitations and restrictions resulting from your medically determinable impairments.In short, it is an evaluation of your capacity for full-time work.

Step 4.  Can you do any of the jobs you have performed in the past fifteen (15) years?

At this step, SSA decides if your medical condition prevents you from being able to work full-time at jobs you have done in the past fifteen (15) years. If SSA decides you can perform any of your past relevant work (PRW), you will be found not disabled. To be PRW, the work must have been substantial gainful activity(SGA); performed in the fifteen (15) year relevant period; and performed long enough to learn the job.  If SSA decides you cannot perform your past relevant work, or you have not worked in the past fifteen (15) years, SSA goes on to Step 5.

You have the burden of proof at Step 4.  Two of the strongest types of evidence at this stage are medical records and the opinions of the doctors who are treating you for the conditions that are affecting your ability to work.  The strongest medical evidence is what is known as objective medical evidence, or evidence that does not rely upon what you tell your doctors.  The strongest opinions are opinions that are offered by doctors who specialize in the condition that is keeping you from working and which are supported by objective medical evidence.

Some types of objective medical evidence that can support a claim for disability based upon cirrhosis include:

  • Endoscopy
  • Operations
  • Pathology
  • Imaging such as, but not limited to, x-ray, sonography, CAT scan, magnetic resonance imaging (MRI), and radionuclide scans
  • Laboratory findings such as, but not limited to, increased liver enzymes, increased serum total bilirubin, increased ammonia levels, decreased serum albumin, and abnormal coagulation studies, such as increased International Normalized Ratio (INR) or decreased platelet counts.

Doctors who specialize in treating cirrhosis include:

  • Gastroenterologists – specialists on digestive organs and the liver
  • Hepatologists – specialists focused on the liver
  • Hematologists – specialists on the blood.

If you are only treating with your family doctor, or primary care doctor, for your cirrhosis, SSA may interpret this as meaning that your condition is not that serious (otherwise you would be treating with a specialist).  An experienced Social Security disability lawyer can help you locate sources of treatment (even if you don’t have health insurance).

Step 5.  Can you do any other type of work?

At Step 5 the “burden of proof” shifts to SSA.  If you cannot do your past relevant work, SSA looks to see if you would be able to do other work. It evaluates your medical condition, your age,education, past work experience, and any skills you may have that could be used to do other work. If you can do other work, SSA will determine you are not disabled. If you cannot do other work, SSA will find you disabled.  After age 50, there are special rules that may apply to your claim that can result in a finding of disability even if there is some other work you could perform on a full-time basis. An experienced Social Security disability lawyer will be familiar with these rules and can ensure that they are considered in the evaluation of your case.

With the liver being a vital part of your body, you may truly deserve assistance when cirrhosis affects you. But getting disability benefits can be highly challenging – so challenging that about two-thirds of all initial claims get rejected. It can be even more difficult to claim for a liver disease, especially for those who are found to still be consuming alcohol.

Contact Gillette Law Group

If you are faced with the tough climb of applying for Social Security Disability benefits, or if your previous claim was denied, we can help you succeed this time. We at Gillette Law Group are highly experienced in this process, and we commit this experience to real people like you.

You may have a tight deadline, so contact us right away at (855) 873-2604. Your consultation with us is free.

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