Qualifying for Social Security Benefits with Kidney Disease

Have you been diagnosed with kidney disease? If so, you might be eligible for Social Security disability benefits. The Social Security Administration (SSA) offers monthly financial aid for people who are unable to work. Kidney disease does not automatically qualify for benefits, but thousands of people who are out of work for a year or more due to kidney disease may be eligible for assistance.

Medically Qualifying with Kidney Disease

The SSA maintains its own guide of qualification criteria, known colloquially as the Blue Book. The Blue Book outlines exactly what symptoms or test results you’ll need to qualify with kidney disease. There are three listings for people with kidney disease:

1. Chronic kidney disease with chronic hemodialysis or peritoneal dialysis. If your ongoing dialysis has lasted or is expected to last for at least one year, you’ll qualify for disability benefits.

2. Chronis kidney disease with kidney transplant. You’ll be considered disabled for one full year after the transplant—after 12 months, the SSA will review your claim and determine if you still need aid. Keep in mind that you won’t “automatically” meet a kidney disease listing if you’re on the transplant list, but you will definitely meet another disability listing and still qualify.

3. Chronic kidney disease with impairment of kidney function. This listing is complicated and requires specific medical tests, but is as follows:

Two laboratory findings of one of the following:

  • Serum creatinine of 4 mg/dL or greater, OR
  • Cretinine clearance of 20 ml/min or less, OR
  • Estimated eGFR of 20 ml/min/1.73m2 or less

In addition to one of the above test results, you must also prove one of the following:

  • Severe bone pain and abnormalities such as osteitis fibrosa or osteomalacia
  • Peripheral neuropathy
  • Fluid overload syndrome with high blood pressure or vascular congestion
  • Weight loss with a BMI of 18.0 or less

The entire Blue Book can be found online, so you can review the kidney disease listings with your doctor to determine if you qualify.

End Stage Renal Disease and Medicare

Unfortunately, there is a 24-month wait period for most people who qualify for disability benefits before they’re enrolled onto Medicare. This makes it very challenging for many disability recipients to receive affordable healthcare without a spouses’ employer. For those with End Stage Renal Disease (ESRD), the wait should be significantly shorter.

ESRD is one of two conditions that “skip” the 24-month waiting period and are enrolled onto Medicaid immediately. If you have ESRD and apply for disability benefits, you should be enrolled onto Medicaid at the same time as your application approval. This makes it much easier for people requiring immediate assistance to receive quality healthcare.

Starting Your Application

Most people can apply online on the SSA’s website. If you’d prefer, you can also apply for disability benefits in person with a Social Security representative. Make an appointment to apply at your local SSA office by calling the SSA toll-free at 1-800-772-1213. If you can, try calling one of your offices’ local numbers—it’s much easier to get through to someone when not calling the main phone number.

Most claims are approved within three to five months, but those with ESRD could be approved in as little as 10 business days.

Resources Found Via:

This article was written by the Outreach Team at Disability Benefits Help. They provide information about disability benefits and the application process. To learn more, please visit their website at https://www.disability-benefits-help.org/ or by emailing them at help@ssd-help.org