Diabetes by itself rarely qualifies for disability benefits. But when diabetes leads to serious complications, you may become eligible. Here's what you need to know.
In this article, we'll cover:
- When diabetes qualifies
- Diabetes complications that qualify
- How SSA evaluates diabetes claims
- Documenting your limitations
1. When Diabetes Qualifies
Diabetes alone:
- Usually doesn't qualify
- Millions work with diabetes
- Manageable with treatment
- SSA expects management
When it may qualify:
- Uncontrolled despite treatment
- Serious complications develop
- Multiple body systems affected
- Can't maintain employment
Type 1 vs. Type 2:
- Both can qualify
- Based on complications and control
- Not on type
- Severity matters most
Key factors:
- How well controlled?
- What complications exist?
- How do complications affect function?
- Can you work despite limitations?
2. Diabetes Complications That Qualify
Diabetic neuropathy:
- Nerve damage from diabetes
- Can affect hands, feet, legs
- Pain, numbness, weakness
- May meet neurological listings
Diabetic retinopathy:
- Vision loss from diabetes
- Can qualify under vision listings
- Visual acuity of 20/200 or less
- Or significant visual field loss
Diabetic nephropathy:
- Kidney damage
- Can lead to kidney failure
- May qualify under kidney listings
- Dialysis usually qualifies
Cardiovascular complications:
- Heart disease
- Peripheral arterial disease
- May qualify under heart listings
- Documented cardiac limitations
Diabetic foot problems:
- Ulcers that don't heal
- Infections
- Amputations
- Significant mobility limitations
Hypoglycemia:
- Frequent, severe low blood sugar
- Despite following treatment
- Causes seizures or altered consciousness
- Documented and severe
Important: The key is usually the complications, not diabetes itself. Document all complications thoroughly.
3. How SSA Evaluates Diabetes Claims
No specific diabetes listing:
- SSA doesn't have a "diabetes" listing
- Evaluates under complication listings
- Neuropathy, vision, kidney, heart, etc.
- Or through RFC assessment
Residual Functional Capacity (RFC):
- What can you still do?
- Physical limitations
- Need for breaks
- Treatment side effects
Multiple complications:
- Combined impact considered
- Even if none alone qualifies
- Total effect on functioning
- Report all complications
Treatment compliance:
- SSA expects you to follow treatment
- Non-compliance can hurt claim
- Unless good reason (can't afford, side effects)
- Document reasons if not compliant
4. Documenting Your Limitations
Medical evidence needed:
- Blood sugar logs (A1C results)
- Records of complications
- Treatment history
- Hospitalizations
For neuropathy:
- Nerve conduction studies
- EMG results
- Physical exam findings
- Functional limitations
For vision:
- Visual acuity tests
- Visual field tests
- Retinal exams
- Treatment records
For kidney:
- GFR results
- Creatinine levels
- Dialysis records if applicable
- Nephrology treatment
Your daily limitations:
- How diabetes affects daily life
- What activities are difficult
- Frequency of blood sugar problems
- Side effects of medications
Work limitations:
- Why you can't work
- What happens at work
- Need for breaks
- Episodes that affect work
Tips for Success
Document everything:
- Keep blood sugar logs
- Note symptoms and episodes
- Track doctor visits
- Record hospitalizations
Report all complications:
- Not just the main one
- Combined effect matters
- Secondary conditions count
- Don't minimize
Explain treatment failures:
- Multiple medications tried
- Why diabetes is uncontrolled
- Insulin resistance
- Side effects limiting treatment
Get specialist opinions:
- Endocrinologist
- Specialists for complications
- Detailed letters about limitations
- Functional assessments
Common Challenges
"Just lose weight/exercise":
- SSA may think you should do more
- Document all efforts
- Explain why not successful
- Medical barriers to exercise
Controlled diabetes:
- If A1C is good, harder to qualify
- Focus on complications
- Function despite numbers
- Daily impact matters
How Purple Helps
Purple supports those with chronic conditions:
- Track medical expenses
- Budget for medications
- Manage benefit deposits
- Simple financial management
- Less health-related stress