Chronic liver disease is a serious medical condition that can significantly impact an individual’s ability to work and maintain financial stability. For those struggling with the debilitating effects of this illness, Social Security Disability Insurance (SSDI) may provide crucial financial support.
Understanding Chronic Liver Disease
Chronic liver disease encompasses a range of liver conditions that persist over an extended period, typically over six months. These diseases can progressively damage the liver, leading to impaired liver function and life-threatening complications.
Common types of chronic liver disease include:
- Cirrhosis
- Hepatitis B and C
- Alcoholic liver disease
- Nonalcoholic fatty liver disease (NAFLD)
- Autoimmune hepatitis
- Primary biliary cholangitis
- Hemochromatosis
Symptoms of chronic liver disease can vary but often include:
- Fatigue and weakness
- Jaundice (yellowing of the skin and eyes)
- Abdominal pain and swelling
- Nausea and loss of appetite
- Itchy skin
- Easy bruising and bleeding
- Confusion or difficulty concentrating (hepatic encephalopathy)
- Fluid retention in the legs and abdomen (edema and ascites)
The impact of chronic liver disease on daily functioning can be severe. Many individuals experience difficulty with physical activities, cognitive tasks, and maintaining regular work schedules because of fatigue, pain, and other symptoms.
Social Security Disability and Chronic Liver Disease
To qualify for SSDI based on chronic liver disease, you need to meet the Social Security Administration’s (SSA) eligibility criteria through a five-step process:
- Provide proof that your current monthly income is at or below the Substantial Gainful Activity (SGA) level for the year you apply.
- Show that your chronic liver disease severely affects your ability to work consistently and perform basic job-related tasks, such as
- sitting
- standing
- reaching
- pulling or pushing
- lifting or carrying
- simple cognitive reasoning
- Provide documentation of diagnosis matching the SSA’s listings for chronic liver disease impairments. The SSA evaluates chronic liver disease under Listing 5.05 in the Blue Book. To meet this listing, you must provide medical evidence showing at least one of the following:
- Bleeding from esophageal, gastric, or ectopic varices, or portal hypertensive gastropathy confirmed by imaging, resulting in:
- Hemodynamic instability shown by symptoms such as pallor (pale skin), diaphoresis (heavy sweating), rapid pulse, low blood pressure, postural hypotension (significant drop in blood pressure when changing from lying down to standing), or syncope (fainting);
AND
- Causing hospitalization to transfuse at least two units of blood. Considered disabled for 1 year post-documentation of the transfusion, after which any residual disabilities should be assessed.
OR
- Ascites or hydrothorax that cannot be attributed to other causes, observed across two evaluations within 12 months and at least 60 days apart. Each assessment must confirm the presence of ascites or hydrothorax by 1, 2, or 3:
- Paracentesis; or
- Thoracentesis; or
- Imaging or physical examination with a or b:
- Serum albumin at 3.0 g/dL or lower; or
- INR of 1.5 or higher. OR C. Spontaneous bacterial peritonitis (refer to 5.00C2c) confirmed by peritoneal fluid containing a neutrophil count of at least 250 cells/mm³.
OR
- Hepatorenal syndrome (see 5.00C2d) evidenced by 1, 2, or 3:
- Serum creatinine levels elevated by at least 2 mg/dL; or
- Oliguria with a 24-hour urine output below 500 mL; or
- Sodium retention indicated by urine sodium lower than 10 mEq per liter.
OR
- Hepatopulmonary syndrome (refer to 5.00C2e) confirmed by 1 or 2:
- Arterial PaO2 from an ABG test, while at rest and breathing room air, less than or equal to: a. 60 mm Hg at altitudes below 3,000 feet; or b. 55 mm Hg at altitudes between 3,000 and 6,000 feet; or c. 50 mm Hg at altitudes above 6,000 feet; or
- Intrapulmonary arteriovenous shunting shown through contrast-enhanced echocardiography or a macroaggregated albumin lung perfusion scan.
OR
- Hepatic encephalopathy characterized by abnormal behavior, cognitive issues, changes in mental state, or altered consciousness (such as confusion, delirium, stupor, or coma), documented during two evaluations within a consecutive 12-month timeframe and spaced at least 60 days apart, and meeting one of the following criteria:
- A history of a trans-jugular intrahepatic portosystemic shunt (TIPS) or any other surgical portosystemic shunt or
- At least two evaluations, 60 days apart, within the same consecutive 12-month period that show one of the following:
- Asterixis or other fluctuating neurological symptoms; or
- EEG showing triphasic slow wave activity or
- Serum albumin level of 3.0 g/dL or lower; or
- INR of 1.5 or higher.
OR
- Two SSA CLD scores of 20 or more within a consecutive 12-month period, at least 60 days apart. Considered under disability from the date of the first score.
- Show that because of the symptoms and limitations of your chronic liver disease, you cannot perform any previous jobs or work again.
- Demonstrate the lack of alternative employment options based on age, education, prior work experience, and physical and mental capacities.
Getting Help with Your Disability Claim
If you have chronic liver disease and its complications significantly affect your ability to work, you may be eligible for SSDI benefits. However, the application process can be complex and challenging. This is where a knowledgeable disability attorney can provide invaluable help. They can provide the legal expertise and support necessary to get through the process, allowing you to focus on managing your condition and improving your quality of life.
Contact Brock and Stout’s disability lawyers if you would like help filing a disability claim for your chronic liver disease. Let our family help your family.