November 21, 2018

3 FACTORS THAT COULD DETERMINE IF CHILDREN WITH DIABETES QUALIFY FOR SOCIAL SECURITY DISABILITY

How does the Social Security Administration determine what is and isn’t a disability for a child with diabetes?  The SSA does not list Diabetes as a “Listed Impairment  for adults (a condition that automatically is considered a disability); only some of the complications qualify. (To learn about adult Diabetes and SSA, click here.)

But for children, it’s not a simple yes or no.

The Social Security Admin takes a somewhat different approach to awarding disability benefits to Juvenile Diabetics than adults.  When our clients that come to us to help them file their disability claims for their children, we look at the 3 factors that will determine the outcome.

THE 3 DETERMINING FACTORS FOR DIABETIC CHILDREN WHEN FILING FOR DISABILITY BENEFITS:

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WHEN DOES HIRING A LAWYER MAKE SENSE WHEN FILING FOR SSD?

 

Many applicants for Social Security Disability realize that they need an attorney when their claim for benefits is denied. A denial means that you must file an appeal to obtain disability benefits. The appeal begins a process which can last 1-2 years and is somewhat complicated. At this point you will become aware of the fact that the Social Security Administration (SSA) is not going to be as helpful and understanding as you initially hoped and that you at risk of not getting the medical and monetary benefits that you so desperately need.

First, let’s briefly review the application and appeals process. The initial application is generally made online, although you can apply in person at the closest Social Security office. SSA will interview you personally and attempt to obtain your medical records. They may also send you to a physician for an evaluation or have a physician or medical professional review the medical and other records. These are some excellent tips on how to improve the odds of your being awarded your social security disability benefits.

WHAT IS THE APPEALS PROCESS LOOK LIKE WHEN FILING FOR SOCIAL SECURITY DISABILITY?

The initial application process generally will take 3-6 months. If you are turned down, the first level of appeal is called “Reconsideration”. A Request for Reconsideration must be filed within 60 days of the denial of the initial claim. If you fail to file for Reconsideration timely, you will have to file a new application, which generally means that you have lost past benefits and may lose your fully insured status. Entitlement to benefits is based on contributions made into the social security system. To get disability benefits you are required to have worked 20 out of the 40 quarters before the date you became disabled, i.e., 5 out of 10 years before you became disabled.

The Reconsideration process will generally take 2-4 months.

If you are denied at the Reconsideration level (a very high percentage will be denied as the Reconsideration application is re-evaluated by the same state agency that denied the initial claim), the next level of appeal requires a “Request for Hearing” to have your case heard by an Social Security Judge. A Request for Hearing must be filed within 60 days of the denial of Reconsideration. If you fail to file timely, you will have to start the process over with the potential loss of past benefits, the inevitable delay and the possibility that you will lose your fully insured status.

Know that if you do not get an approval at the initial application level, it will be approximately 2 years before you will have a chance to present your case in front of a judge and get a disability award. We recommend that you retain an attorney early in the process, including at the initial application level, so that you have the best chance of winning the case at the earliest time.

You may need help understanding your rights and how SSA decides whether you are disabled. When brought into the case at the initial level, our office, for example, will make every effort to assure that SSA has all necessary medical records. Often, we send out questionnaires to treating doctors tailored to your most disabling condition(s) which we will file with SSA. We will assist SSA in determining whether you “grid out”, that is meet the disability standards set out in guidelines used by SSA based on age and education. We will attempt to show to SSA that you have a “Listed Impairment”, that is, have an impairment which SSA determines to be automatically disabling.

Remember, your attorney will get paid only if you win your case and fees are based on back benefits only – none of your future lifetime benefits are affected or reduced. If you intend to file a disability claim, we recommend strongly that at very least, you consult with an experienced social security attorney. A consultation, whether by phone or in person, is always without charge.

Read here what to look for when hiring a Social Security attorney.

DIABETES AND SSD: IT’S NOT SO SIMPLE

DIABETES AND SOCIAL SECURITY: WHAT IS AND WHAT ISN’T A DISABILITY?

With close to 10% of Americans dealing with some form of Diabetes, it is no wonder that our attorneys are often asked if having Diabetes will qualify for Social Security Disability benefits.

The answer is yes, and no.

Since 2011, the Social Security Disability Administration recognizes Diabetes only as a potential cause of disability, and not as a disability in itself. Before 2011, diabetes was considered a ‘Listed Impairment’, or the inability to work. It was included in the list of conditions that automatically established that an individual is disabled if he/she meets all the criteria in the Listing. Since then, Diabetes is no longer a Listed Impairment.

Diabetes is a chronic condition that results from the body’s inability to produce or use insulin. Although Diabetes usually requires lifelong treatment, medical advances in the diagnosis and treatment of Diabetes have resulted in better management of the disease in adults and children.

But some of the complications that arise from Diabetes are known to be disabling including: diabetic retinopathy (eye damage to the small blood vessels in the retina); cardiovascular disease (Diabetes can accelerate the development of artery disease or peripheral arterial disease which can lead to amputations); diabetic nephropathy and diabetic neuropathy (organ and nerve damage); and more.

HOW SSA EVALUATES DIABETIC COMPLICATIONS WHEN DETERMINING IF YOU QUALIFY TO COLLECT SOCIAL SECURITY DISABILITY BENEFITS

SSA will examine the complications of your Diabetes to see if it has caused a Listed Impairment. Some of this include:

    • Amputation of an extremity, under the musculoskeletal system Listings
    • Diabetic retinopathy( (eye damage to the small blood vessels in the retina) under the special senses and speech Listings
    • Hypertension, cardiac arrhythmias, and heart failure, under the cardiovascular system Listings (Diabetes can accelerate the development of artery disease or peripheral arterial disease which can lead to amputations);
    • Gastroparesis and ischemic bowel disease (intestinal necrosis), under the digestive system Listings
    • Diabetic nephropathy, (organ and nerve damage);  under the genitourinary impairments Listings
    • Slow-healing bacterial and fungal infections, under the skin disorders Listings
    • Diabetic neuropathy, under the neurological Listings
    • Cognitive impairments, depression, anxiety, and eating disorders, under the mental disorders Listings

Establishing Diabetes as a cause of disability in your social security disability case requires a thorough understanding of the disease and resulting complications. To win your disability case, you must be able to prove not only that you have Diabetes, but that the disease has resulted in serious damage which meet a Listing or are otherwise disabling

3 tips on improving your chances of being awarded your social security disability benefits can be found here.