Getting Disability Benefits for Diabetes
It's difficult to get disability for controlled diabetes, but most diabetic applicants suffer from related medical problems that limit their ability to work.
An individual may qualify for Social Security disability benefits based on uncontrolled diabetes or related symptoms like peripheral neuropathy or poor vision. While diabetes that is well-controlled with medication won't form the basis of a successful claim on its own, most disability applicants with diabetes also suffer from other medical problems that limit their ability to work. When filing for disability benefits for diabetes, it's important to list all your symptoms and diagnoses, even those unrelated to your diabetes.
Diabetes Mellitus: Type 1 and Type 2
Diabetes mellitus (DM) is a chronic medical condition marked by an inability to process glucose in the blood. When the pancreas fails to produce sufficient amounts of the hormone insulin, which sends signals to other body cells to absorb excess glucose, blood sugar levels rise.
Elevated blood sugar levels often can be controlled through medication and diet, but persistently high blood sugar levels may give rise to neuropathy (nerve damage) causing numbness, burning, and tingling in the extremities. Other complications of diabetes include cardiovascular disease, kidney problems, skin infections, and visual changes.
Type 1 diabetes, often referred to as insulin-dependent diabetes, typically manifests in childhood and requires daily insulin injections and monitoring of blood sugar levels. Individuals with Type 1 diabetes are unable to produce the insulin which regulates blood sugar levels. Only about five to ten percent of diabetic individuals suffer from Type 1 diabetes.
Type 2 diabetes, also called adult-onset diabetes, occurs when the body's cells become resistant to insulin and thus fail to process sufficient amounts of glucose. Type 2 diabetes is most common in those over 45, and it is strongly associated with obesity, high blood pressure, and a sedentary lifestyle. Genetic factors also play a role in the development of Type 2 diabetes.
Diabetes is generally treated by endocrinologists, who prescribe medication, blood sugar monitoring, and lifestyle changes to control the disease.
Diabetes and Social Security's Disability Listings
In 2011, Social Security removed its disability listing for endocrine disorders, including diabetes, from its Blue Book, a list of impairments that automatically qualify for disability. As a result, it's no longer possible to get approved for disability based on a disability listing specifically for diabetes, but you may be able to "meet" other listings in the Blue Book depending on the severity of your symptoms. For example, a person can match the requirements for Listing 11.14 for peripheral neuropathy, when he or she, in spite of treatment, experiences involuntary movements, tremors, or partial paralysis in two extremities that makes it difficult to walk or use his or her hands. Diabetic retinopathy that causes less than 20/200 vision in the better eye would meet Listing 2.02. (See our articles on disability for peripheral neuropathy and disability for low vision for the details.)
Note that diabetic children under 6 who require daily insulin or 24-hour supervision (depending on the age of the child) will be automatically found to meet Listing 109.08 until they reach age 6.
Qualifying for a Medical-Vocational Allowance Based on Diabetes
Getting a medical-vocational allowance is by far the more common way to get approved for disability benefits. If the symptoms of your diabetes prevent you from performing your past work or any other jobs in the economy, you can get approved for benefits under a medical-vocational allowance. A medical-vocational allowance takes into account your age, education, vocational history, and Residual Functional Capacity (RFC) in deciding whether you're capable of meeting the demands of any full-time work.
Your RFC is an assessment that how much you can still do despite your impairments. Social Security regulations require your RFC to be based on medical evidence, so you or your attorney should submit copies of your relevant medical records to demonstrate the extent of your functional limitations. What your records should include depends on the specific symptoms involved. For example, an individual with peripheral neuropathy might submit medical evidence mentioning an unsteady gait, poor fine motor control, or numbness and tingling in the extremities. Or an individual with chronic hyperglycemia might submit evidence from a psychiatrist documenting difficulty concentrating and fatigue that interferes with his or her ability to sustain full-time work.
Clinic notes from specialists are generally considered more persuasive than those from family physicians. For example, if you suffer from diabetic retinopathy, you should seek a referral to an ophthalmologist. Those with kidney disease should receive treatment from a nephrologist, while heart disease patients should consult a cardiologist, and so on.
In addition to clinic notes, you should ask your treating physician, preferably your specialist, to offer an opinion as to your work-related impairments. This is most easily done by providing the doctor with an RFC form addressing your abilities to sit, stand, walk, lift, and carry. The RFC form should also include postural limitations (bending, twisting, stooping), manipulative limitations (reaching, handling, fingering), and environmental limitations (noise, dust, extreme temperatures). Also ask your physician to note whether you would be expected to miss more than two days of work per month, a limitation that generally prevents any full-time work.
Finally, note that special SSA regulations known as the grid rules make it easier for older individuals to obtain a medical-vocational allowance. For example, a 50-year-old with a high school education but no transferable skills would be found disabled under the grids even if she is able to perform sedentary work. If this individual were over 55, she'd be found disabled even if she can do light work. The grid rules frequently come into play in cases involving Type 2 diabetes, which generally manifests during adulthood and tends to worsen as one ages. Learn more by reading our articles about the Social Security grid rules.