Social Security Disability and SSI for Kidney Disease

Individuals suffering from kidney disease may qualify for Social Security Disability or Supplemental Security Income (SSI) benefits. A very important feature for claimant’s qualifying for disability due to kidney or renal disease is that the usual two-year waiting period for Medicare eligibility is waived and coverage begins when the claimant becomes a beneficiary. The Social Security Administration recognizes the serious consequences of kidney disease and has created a “listing” describing how one can qualify due to renal disease.

Appendix 1 to Subpart P of Part 404 of The Code of Federal Regulations, in Section 6.00 states that claimants can qualify for disability if the following requirements are met:

• Chronic hemodialysis or peritoneal dialysis necessitated by irreversible renal failure; or
• Kidney transplant. Considered to be under a disability for twelve (12) months following surgery; or
• Persistent elevation of serum creatine to 4 mg. per deciliter (100 ml.) or greater or reduction of creatinine clearance to 20 ml. per minute (29 liters/24 hours) or less, over at least three (3) months, with one of the following:
  • Renal osteodystrophy manifested by severe bone pain and appropriate radiographic abnormalities (e.g., osteitis fibrosa, marked osteoporosis, pathologic fractures); or
  • A clinical episode of pericarditis; or
  • Persistent motor or sensory neuropathy; or
  • Intractable pruritus; or
  • Persistent fluid overload syndrome resulting in diastolic hypertension (110 mm. or above) or signs of vascular congestion; or
  • Persistent anorexia with recent weight loss with persistent weight below the level listed in 5.08, Table III or IV; or
  • Persistent hematocritis of 30 percent or less.
• Nephrotic Syndrome, with significant anasarca, persistent for at least three months despite prescribed therapy will be considered disabling if it meets one of the following criteria:
  • Serum albumin of 3.0 gm. Per deciliter (100 ml.) or less and proteinuria of 3.5 gm. Per 24 hours or greater; or
  • Proteinuria of 10.0 gm. Per 24 hours or greater.

If a claimant is suffering from kidney disease, but it does not rise to the required severity, then he or she may still be found disabled if the resulting symptoms (and perhaps symptoms from other conditions or diseases) prevent him or her from working.

If you need more information about Social Security Disability/SSI, personal injury, EEOICPA, long or short-term disability, or workers compensation, please contact the Law Offices of Tony Farmer and John Dreiser for a free case evaluation. We can be reached at (865) 584-1211 or (800) 806-4611, or through our website.  We handle claims throughout East Tennessee.