Diabetes and Qualifying for Disability Benefits

Summary: Can I get disability benefits if I am suffering from the effects of Diabetes?

According to the National Diabetic Statistics Report for 2022, cases of diabetes are rising at an alarming rate. It’s estimated 37.3 million people in the U.S. have diabetes and 8.5 million who have diabetes, but have not been diagnosed. Diabetes Mellitus is a term for several chronic conditions involving problems with the hormone insulin. Insulin helps regulate blood sugar (glucose) levels, providing energy to body cells and tissues. The pancreas produces insulin and releases insulin in the body to store and use fat and sugar from food. Diabetes occurs when the body in unable to create or properly use insulin; if the body doesn’t use insulin properly, too much glucose can be released into the blood resulting in high blood sugar. High blood sugar is a serious condition; left untreated, it can damage nerves, eyes, kidneys and other organs. If you are suffering from the effects of Diabetes you may qualify for disability benefits.

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If you are suffering from a Diabetes and have been denied disability don’t give up, almost 70% are denied initially! Just call 512-454-4000 for a free, no obligation consultation to learn what your options are.

There are two main types of diabetes.

Type 1 diabetes is an autoimmune disease where the immune system attacks and destroys cells in the pancreas. It is unclear why this occurs, but genetics and some viruses may contribute to Type 1 diabetes. Type 1 diabetes usually appears during childhood or adolescence; however, it can develop in adults. About 5-10% of people have this type of diabetes.

Type 2 diabetes occurs most often in people age 40 or over, but has become more common in children over the past 20 years.

In this type of diabetes the pancreas either doesn’t produce enough insulin or the body doesn’t use the insulin properly, resulting in too much blood sugar circulating through the body and leading to disorders of the circulatory, nervous, and immune systems. 90-95% of people have Type 2 diabetes.

How can I qualify for SSDI if I have diabetes?

Though many cases of diabetes are managed well with medication and lifestyle changes, others can cause long-lasting health problems that interfere with a person’s ability to maintain full-time employment.

Some complications that may arise from diabetes include:

•    Loss of feeling or weakness in hands or arms
•   Seizures resulting from extremely high or low blood sugar levels
•   Weakening vision
•   Heart, liver or kidney disease
•   Anxiety and depression

Social Security has created a manual called the Blue Book which lists impairments Social Security considers disabling and may automatically qualify for benefits.

Diabetes does not have a specific listing; however, you may be able to qualify if you have uncontrolled diabetes that has severely limited your functional abilities or complications from diabetes match the requirements of a listed impairment. For example, your medical condition may be similar to the requirements of the following listed impairments

•    Diabetic nephropathy (Listing 6.06). Kidneys no longer working properly, requiring daily dialysis.
•   Diabetic peripheral neuropathies (Listing 11.14). Nerve damage impacting ability to walk, stand or use hands.
•   Poorly healing skin and bacterial infections (Listing 8.04).
•   Cardiovascular problems (Listings 4.02, 4.04, 4.05, 4.12). Coronary artery disease, chronic heart failure, peripheral vascular disease, and irregular heartbeat.
•   Diabetic retinopathy (Listing 2.00). Blurred vision or poor visual acuity.

If your symptoms don’t meet the criteria of another listing, you must prove that your symptoms are so severe you are unable to work at your old job or any job.

If diabetes has caused skin problems, nerve conditions or organ damage that limits your ability to stand, walk or use your hands, you may be eligible. Social Security will perform a Residual Functional Capacity (RFC) assessment to evaluate how diabetes limits your functional abilities to determine if there is any job you can do taking into consideration your age, education and whether or not you can drive. Social Security will consider how well you use your arms, hands and legs, if nerve pain interferes with your abilities, and if you can walk or stand without a cane. They will also evaluate your cognitive, emotional, and sensory limitations. For example, do you get along with others, can you concentrate on tasks, or do you have problems with your vision. If your vision is poor, you may not be able to drive or work around hazardous machinery. Social Security will review:

•   Your medical records;
•   Results from laboratory tests;
•   Doctors’ statements regarding your limitations;
•   Statements from your family, friends and co-workers regarding your limitations;
•   Your own statements describing how diabetes has impacted your job and daily activities.

Social Security gives a lot of weight to doctors’ opinions.

You need to show that you are receiving regular medical treatment and following your doctor’s instructions. A written statement from your doctor regarding your diagnosis and outlook for your recovery is extremely helpful. Even better, ask your doctor to fill out an RFC form. If Social Security decides you cannot do your old job or don’t have the skills to perform a new job, you may be approved for a Medical-Vocational Allowance.

If you are 55 or older or have another medical condition you may get approval.

Social Security follows a set of rules to determine when the agency expects an applicant to learn a new job.

Applicants who are 55 or older often fall under a grid rule, which means they are not expected to learn a new job. For example, a 55-year-old applicant with no transferable skills might be found disabled. If you can’t go back to your old job, and you don’t have the skills to learn a new one, Social Security will likely grant you disability benefits.

Disability for those over 55 –>

You may also be eligible for Social Security Disability benefits if you have another medical condition.

People with diabetes often suffer from other conditions such as skin problems, kidney disease and digestive problems. One disorder alone may not meet the criteria of an impairment as stated in Social Security’s Blue Book, but if you have more than one medical condition, Social Security must consider how those health issues combined limit your ability to hold a job and perform necessary daily tasks.

Disability for Multiple Impairments –>

Social Security also has basic financial requirements.

Before you are eligible for Social Security disability benefits, you must satisfy some basic financial requirements.

You must: 1) have a disability that has lasted or is expected to last 12 months; and 2) you must have worked in a job where you paid Social Security taxes long enough and recently enough; and 3) you must not earn more than Substantial Gainful Activity (SGA), which is $1,620 per month in 2025 for nonblind applicants and $2,700 per month for blind applicants.

What if I don’t qualify for SSDI?

If you haven’t worked long enough to earn enough work credits, or if you earn too much income, you may be eligible for disability benefits through another Social Security program, such as Supplemental Security Income (SSI), or from a long-term disability insurance plan through your employer or a privately purchased policy.

SSI is a program that pays monthly benefits to people with limited income and resources who are disabled, blind, or age 65 or older. SSI is based on income instead of work credits, and is financed by general funds of the U.S. Treasury.

If you are suffering from Diabetes and have been denied disability don’t give up, almost 70% are denied initially! Just call 512-454-4000 for a free, no obligation consultation to learn what your options are. Have some questions? just give us a call, we love to help folks just like you!

I have long-term disability insurance – should I file a claim?

Yes, you should file a claim as soon as you become disabled.

Long-term disability insurance (LTD) is coverage that protects your income if you are unable to work due to illness or injury and is purchased as part of a group employment plan or privately through an insurance company. Policies pay between 50-60% of your salary and benefits continue until you return to work or for the number of years stated in the policy. However, LTD coverage is good only as long as you are employed, so do not quit your job before you file a claim, and be sure to check your policy’s definition of “disabled” as each policy will state the definition of “disabled” which is in use. Additionally, be aware that long-term disability insurance companies can require a claimant to also apply for SSDI.

LTD Disability–>

How do I file for Social Security Disability benefits?

You can apply for Social Security Disability benefits online, over the phone, or in person at your local Social Security Administration office.

Don’t be discouraged if your initial application is denied – most are – and you will have the opportunity to appeal. There are four steps to the Social Security appeal process:

1.   File a Request for Reconsideration with the Social Security Administration to completely review the case.
2.   If you don’t agree with SSA’s response to your Request for Reconsideration, you can request a hearing before an Administrative Law Judge (ALJ). ALJs are attorneys who work for the Social Security Administration; they review SSDI cases and either uphold or overturn decisions to deny SSDI benefits. If you are not represented by an attorney at this point, now is the time to obtain legal counsel. This is a critical point in the process and will raise your chance for success.
3.   If an ALJ does not grant your claim, you can request that the Appeals Council review your case.
4.   Federal Court review. The final step in the appeal process is filing suit in U.S. District Court.

SSDI Appeals Process –>

Do I need a disability attorney for SSDI?

If you have diabetes and cannot work, you may be eligible for Social Security Disability benefits, but applying for SSDI is a long and complex process that can take several months to years.

Many applicants with diabetes do not qualify because diabetes is considered a manageable condition and therefore not disabling. Your chances for approval are increased significantly if you have legal representation. At each potential stage of the process, from the initial application stage, the reconsideration stage and the ALJ hearing stage, an attorney can assist you in completing the detailed forms and questionnaires required by Social Security, collecting and submitting relevant medical evidence, and preparing questionnaires for your doctors. At the ALJ hearing phase an attorney will not only continue to assure that the evidence is complete, but prepare you for questioning by the ALJ, prepare an argument on your behalf and question any doctors or vocational experts selected by the ALJ to testify at the hearing. At the Appeals Council and federal court level, a lawyer can present legal arguments to show your case was wrongfully denied. Fees charged by disability attorneys are regulated by federal law and are usually 25% of disability backpay you are owed. There are no out-of-pocket costs, and if you don’t win your case, you won’t be charged anything.

Do I need an SSDI attorney–>

Do I need a disability attorney for a long-term disability insurance claim?

Whether you have a long-term disability insurance policy purchased through a private insurance broker or a group policy purchased with your employer, filing a claim for long-term insurance is a complicated process.

The wording of LTD policies can be confusing and the laws and regulations which affect the two types of LTD insurance differ in their procedures for filing claims and appeals. An experienced LTD attorney with thorough knowledge of ERISA laws and regulations will avoid mistakes and increase your chance of success. An attorney will act on your behalf, completing your application and filing your claim in a timely manner. They can also negotiate a settlement or file an appeal for you. If it becomes necessary to file suit, an LTD attorney can prepare your case against an insurer. Most LTD attorneys handle cases on a contingency basis and charge approximately 25%-40% of a claimant’s past due benefits. You do not pay an attorney’s fee unless the attorney wins your case.

Do I need an LTD attorney–>

Author: Attorney Lonnie Roach has been practicing law for over 29 years. He is Superlawyers rated by Thomson Reuters and is Top AV Preeminent® and Client Champion rated by Martindale Hubbell. Through his extensive litigation Mr. Roach obtained board certifications from the Texas Board of Legal Specialization. Lonnie is admitted to practice in the United States District Court - all Texas Districts and the U.S. Court of Appeals, Fifth Circuit. Highly experienced in Long Term Disability denials and appeals governed by the “ERISA” Mr. Roach is a member of the Texas Trial Lawyers Association, Austin Bar Association, and is a past the director of the Capital Area Trial Lawyers Association (Director 1999-2005) Mr. Roach and all the members of Bemis, Roach & Reed have been active participants in the Travis County Lawyer referral service.