Social Security Disability for End Stage Renal Disease

July 12, 2022 in
social security disability claim approved

End stage renal disease, abbreviated as ESRD, is a condition where the person’s kidneys no longer function properly to meet the body’s needs. ESRD is a permanent condition, and a person at end stage renal disease will need a kidney transplant or long term dialysis in order to maintain life. ESRD is a fatal condition if not treated properly and promptly, and can severely impact a person’s ability to maintain normal work activity, especially if the person requires dialysis.

What are the stages of kidney disease?

Chronic kidney disease is divided into five stages. The stages of chronic kidney disease are determined by how well your kidneys are functioning. Your doctor will determine which stage of chronic kidney disease is occurring by ordering eGFR tests and urine tests. eGFR tests are blood tests which determine how well your kidneys are working. The stages of chronic kidney disease are as follows:

Stage 1: eGFR of 90 or higher

Stage 2: eGFR of 60-89

Stage 3a: eGFR of 45-49

Stage 3b: eGFR of 30-44

Stage 4: eGFR of 15-29

Stage 5: eGFR measuring less than 15

People in stages 1 and 2 of chronic kidney disease may not have any symptoms as the damage to the kidneys is mild. People in stages 3 and 4 may have symptoms such as swelling in the hands or feet, lower back pain, or feeling weak and tired. At stage 5, the kidneys have stopped working to filter out waste products in the blood, which causes the person to feel very sick. Symptoms of end stage renal disease include nausea, vomiting, loss of appetite, fatigue and weakness, changes in urinary frequency, chest pain, shortness of breath, headaches, difficulty sleeping, muscle cramps, and changes in mental sharpness.

What causes End Stage Renal Disease?

Kidney damage is often caused by type 1 or type 2 diabetes. Therefore, a person who is suffering from end stage renal disease may also be experiencing symptoms related to diabetes, such as peripheral neuropathy, dizziness due to difficulty controlling blood sugars, and changes in vision. Injectable insulin may be required to manage the diabetes. Kidney disease may also be caused by kidney infections, high blood pressure, prolonged obstruction of the urinary tract, glomerulonephritis, interstitial nephrosis, or vesicoureteral reflux.

Risk factors for end stage renal disease include a family history of kidney failure, poorly controlled diabetes, tobacco use, older age, or long term use of medications which may cause kidney damage.

What is dialysis?

Dialysis is a medical procedure which removes waste products and excess fluid from the blood when the kidneys no longer work properly. There are two types of dialysis. Hemodialysis occurs when the blood is put through a filter outside of the body, cleaned, and then returned to the body. Peritoneal dialysis occurs when the blood is cleaned inside of the body through a special fluid which absorbs waste from the blood. Hemodialysis may occur either at home or in a dialysis facility.

People who need hemodialysis will undergo minor surgery to create direct access to the bloodstream through a fistula, graft, or catheter. Hemodialysis sessions in a facility last from 3 to 5 hours, and typically are required three times a week.

Apply for Disability Benefits for ESRD with LaBovick Law Group

The Social Security Disability Attorneys have experience with End Stage Renal Disease claims and are ready to assist you with your case. Whether you need to complete an initial application or are scheduled for a hearing with an Administrative Law Judge, we have the necessary expertise to handle your case and are ready to fight to win. Give our office a call at (561) 625-8400 to speak with our team regarding your circumstances.  

Does End Stage Renal Disease Qualify me for Social Security Disability?

If End Stage Renal Disease is preventing you from performing normal work activity, you may be eligible for Social Security Disability Insurance benefits. SSDI is available for those who have a condition which lasts or is expected to last for at least one year or result in death. The person must not be engaging in “substantial gainful activity” in order to maintain eligibility for benefits. This means that if you are engaging in any work, you cannot earn more that $1350 per month gross (in 2022) from your work activity.

Social Security’s Bluebook contains a Listing of Impairments. These are conditions which medically qualify a person for benefits. Very few people meet the criteria for a listing. In most cases, Social Security is required to evaluate a person’s past work, whether they are able to continue to perform that past work, and whether there are other jobs that the person can perform with those limitations.

However, people with End Stage Renal Disease are more likely to meet the listing criteria. Those who have received a kidney transplant due to chronic kidney disease meet the criteria for listing 6.04 and are considered to be disabled for one year following the transplant. After the one year has passed, Social Security will reevaluate the individual and determine their current capacity for performing work activity.

People with ESRD who are receiving either chronic hemodialysis or peritoneal dialysis will meet criteria for listing 6.03. The dialysis must have lasted or be expected to last for a continuous period of at least 12 months. For approval based on this listing, the claimant must provide documentation from a medical source which describes your chronic kidney disease and dialysis regimen. An example of acceptable documentation includes an End Stage Renal Disease Medical Evidence Report Medicare Entitlement, which physicians complete to qualify dialysis patients for Medicare.

If you have received a kidney transplant, or are undergoing dialysis, Social Security may determine that you meet its definition of disability prior to your transplant or your dialysis start date. Hiring an experienced attorney is your best bet for ensuring your case is established prior to your dialysis start date or transplant date and will maximize your benefits.