Should I Apply for Disability if I Have Diabetes Mellitus (Type 1 or 2)
How the Social Security Administration Evaluates Claims for Diabetes Mellitus under Social Security Ruling SSR 14-2p
According to the 2022 National Statistics Diabetes Report published by the Centers for Disease Control and Prevention (CDC), more than 37 million adults in the United States have diabetes (11.3% of the US population). In addition, approximately 96 million adults in the country have prediabetes (38% of the US adult population).
Diabetes is a potentially devastating disease that can affect many parts of the body, including your:
- Blood vessels (resulting in myocardial infarction (heart attack) or stroke)
- Eyes (diabetic retinopathy can cause vision loss)
- Feet (diabetes may cause reduced circulation in your feet, resulting in the need for amputation of one or more toes)
- Gums and teeth
- Kidneys (diabetic nephropathy)
- Nerves (diabetic neuropathy)
In turn, diabetes (and its complications) may limit your ability to work or perform activities of daily living.
And if the impact is significant enough, applying for Social Security disability benefits may be your best option to get the income you need to survive.
This article will answer your questions about diabetes mellitus and the impairments and limitations it causes. In addition, I will explain how the Social Security Administration (SSA) evaluates diabetes when determining disability claims under titles II and XVI of the Social Security Act and the different disability benefits available to you if you have diabetes.
Keep reading to learn more.
And if you have questions about your eligibility for Social Security disability insurance (SSDI) benefits or Supplemental Security Income (SSI), call us at (804) 251-1620 or (757) 810-5614 or fill out our online contact form.
We have helped thousands of people in Virginia and Maryland win their claims at a disability hearing before an administrative law judge (ALJ).
And we want to start helping you today.
What is Diabetes?
Diabetes mellitus is an endocrine disorder (hormonal imbalance) characterized by continuous hyperglycemia (high blood glucose levels) due to your body’s inability to produce or use insulin efficiently. Insulin is a hormone made by your pancreas that regulates your blood sugar levels.
If your pancreas does not make enough insulin, your doctor may prescribe human-made insulin. You take insulin by giving yourself an injection using an insulin pen or a vial and syringe or receiving doses through an insulin pump attached to your body.
Diabetes mellitus often requires lifelong treatment. And if left uncontrolled, chronic high blood sugar can cause severe damage to multiple body parts, especially the nerves and blood vessels. Indeed, severe diabetes may cause glycosuria (sugar in the urine), ketoacidosis, dehydration, and even death.
Types of Diabetes
There are different types of diabetes.
Type 1 Diabetes Mellitus
Type 1 diabetes (insulin-dependent or juvenile diabetes) occurs when the pancreas does not make insulin or makes an inadequate amount. Without insulin, blood sugar builds up in your bloodstream because it cannot get into cells. In turn, this high blood sugar damages your body.
Common symptoms of Type 1 diabetes include:
- Blurred vision
- Constant hunger/increased appetite
- Extreme thirst
- Fatigue
- Polyuria (increased or excessive urination)
- Unexplained weight loss
This form of diabetes is less common than Type 2 diabetes. And it usually develops in children and young adults, though it can happen later in life too.
Unfortunately, the medical community does not know how to prevent Type 1 diabetes. But you can control this disease with proper care, which includes taking daily insulin (sometimes a combination of rapid-acting, short-acting, intermediate-acting, and long-acting insulin) and monitoring your blood sugar frequently.
Type 2 Diabetes
Type 2 diabetes (formerly called adult-onset or non-insulin-dependent diabetes mellitus) is the most common type of diabetes, affecting more than 90 percent of diabetic patients.
You have Type 2 diabetes when the pancreas does not produce enough insulin compared to high blood sugar levels, or your body’s cells do not respond well to insulin (called insulin resistance).
The symptoms of Type 2 diabetes are similar to those of Type 1 diabetes, but the symptoms usually develop gradually or are not as severe. Therefore, it can take months (or years) for people with diabetes to seek treatment and get a diagnosis.
In addition, Type 2 diabetes may cause:
- Numbness and tingling in the hands and feet
- Recurrent infections of the skin, bladder, or gums
- Slow-healing cuts or bruises
Type 2 diabetes is more common in people with obesity and those who have a sedentary lifestyle. These factors explain why diet and exercise are the first things your doctor will ask you to focus on to control the condition. But if these lifestyle changes do not help, your physician may prescribe daily insulin or oral medication to manage blood sugar levels.
What are Common Diabetes Complications?
In addition to the symptoms discussed in the above section, diabetes can have chronic long-term impacts on your body.
Common diabetes health complications include:
- Cardiovascular disease, including heart disease, stroke, and blood vessel disease: Type 2 diabetics often have high blood cholesterol and fat levels. These conditions can accelerate the development of or worsen cardiovascular diseases such as coronary artery disease (the buildup of plaque in the walls of the coronary arteries) or peripheral arterial disease (the buildup of plaque in the arteries in your legs and feet).
- Diabetic neuropathy is permanent nerve damage. It comes in two forms: peripheral and autonomic. Peripheral neuropathy (sensorimotor neuropathy) is nerve damage affecting the feet, legs, or hands. If you suffer from peripheral neuropathy, you may have trouble holding objects, using zippers or buttons, or walking without a cane. Autonomic neuropathy affects the heart, blood vessels, urinary tract, and digestive system.
- Problems with the feet: If you have diabetes, your feet are particularly vulnerable to problems. Diabetic neuropathy affects your peripheral nerves, resulting in a loss of sensation. This loss may cause you to stumble or fall when walking or sustain a crush or burn injury without knowing. In addition, diabetes may reduce blood flow to the feet, resulting in foot ulcers, infections (cellulitis, gangrene, sepsis, etc.), and sometimes amputation.
- Heart disease
- Ocular complications: Diabetes mellitus is a common cause of vision loss, even blindness. Chronically elevated blood glucose levels may cause diabetic retinopathy (damage to the small blood vessels in the retina), the growth of abnormal new blood vessels in the eye, or even the leakage of blood into the eye. All of these conditions can affect your vision. In addition, people with diabetes may develop glaucoma, macular edema, or cataracts sooner.
- Chronic kidney disease (diabetic nephropathy): Chronic hyperglycemia damages your kidneys. And damaged kidneys may have difficulty removing waste from the bloodstream or leak protein into the urine.
- Oral health: High blood sugar weakens your white blood cells, which fight infections in the mouth. Weakened white cells may result in difficulty fighting off oral infections. In addition, high sugar levels in your saliva can cause tooth decay, cavities, gum disease, and tooth loss.
- Mental health: The data shows that people with diabetes are more likely to have depression.
- Hearing loss: Diabetes mellitus can cause damage to the blood vessels and nerves in the inner ear, resulting in hearing loss.
- Diabetic ketoacidosis (DKA): This condition occurs when ketones build up in the bloodstream and is potentially life-threatening. Ketones are chemicals produced when your body’s cells burn fat instead of glucose for energy due to insulin resistance.
- Hypoglycemia (abnormally low blood sugar)
- Chronic fatigue interfering with your ability to concentrate or maintain time or attendance in the workplace.
How Do I Prove that I am Disabled Due to Diabetes Mellitus?
Social Security Ruling (SSR) 14-2p explains how the SSA evaluates adult disability claims based on diabetes.
As with all claims for SSDI or SSI, the Social Security Administration follows the five-step sequential evaluation process described in 20 CFR 404.1520 when determining diabetes disability claims.
You Cannot be Performing Substantial Gainful Activity When You Have Diabetes.
At step one, the SSA determines whether you are working with diabetes and, if so, whether the work is substantial gainful activity (SGA). If you are not performing SGA, Social Security goes to step two.
Your Medical Reports and Other Evidence Must Show that Diabetes and Its Effects Significantly Limit Your Physical or Mental Ability to Work.
At step two, the SSA evaluates the medical evidence to determine whether your diabetes qualifies as a medically determinable severe impairment.
This step involves reviewing your medical reports and the noted signs, symptoms, and laboratory findings (including blood sugar levels and HbA1c scores). In addition, the SSA will review your answers to the disability function report and other submitted evidence to determine if diabetes, alone or combined with other impairments, significantly limits your physical or mental ability to do basic work activities.
How Do I Meet Social Security’s Listings Associated with Diabetes Mellitus?
Step three requires the Social Security Administration to determine whether the effects of your diabetes mellitus meet or medically equal a condition in the Listing of Impairments.
The Listing of Impairments describes medical conditions and criteria considered enough to prevent you from doing any gainful activity.
The Social Security Administration has not had a listing specific to diabetes mellitus since 2011. Instead, it evaluates the effects of endocrine disorders such as diabetes under listings for other body systems.
For example, depending on how diabetes affects you and what other impairments you have, multiple Social Security listings may apply:
- Listing 1.20 (Amputation due to any cause): For example, you meet this listing if diabetes results in amputation of one or both lower extremities with an inability to use a prosthesis and a documented medical need for a walker, bilateral canes, bilateral crutches, or a wheelchair involving the use of both hands to operate.
- Listings 2.02, 2.03, or 2.04 if diabetic retinopathy or other complications affect your vision.
- Listings 4.02, 4.05, and 4.12 for diabetes accelerating or exacerbating chronic heart failure, recurrent cardiac arrhythmias, or peripheral arterial disease
- Listing 5.00 for diabetic gastroparesis resulting in abnormalities
- Listings 6.03, 6.04, 6.05, 6.06, or 6.09 for diabetes resulting in or contributing to chronic kidney disease and its complications
- Listing 8.04 for chronic infections of the skin or mucous membranes when diabetes causes slow healing
- Listings 11.02 or 11.14 for seizures (epilepsy) or peripheral neuropathy
- Listing 12.04 for depressive, bipolar, and related mental disorders
I recommend reviewing these listings and their criterion to determine what medical evidence, testimony, and doctor disability letters you need to prove that you are disabled under the Social Security Act.
Assessing Residual Functional Capacity (RFC) When You Have Diabetes
The effects of your diabetes may not meet or medically equal the criteria of a listing.
But that is ok.
You can still qualify for SSDI or SSI at steps four and five of the evaluation process. Indeed, many persons with diabetics who receive Social Security disability benefits did not qualify at step three.
At step four, the SSA assesses your residual functional capacity (RFC), which is the most you can do physically and mentally in a full-time work setting despite your medical conditions.
To ensure that your RFC assessment is accurate and includes all your limitations from diabetes and its complications, I recommend submitting testimony and evidence about the problems you have completing ordinary living tasks.
For example, your evidence should address any of these effects of diabetes that apply and limit your ability to function:
- Abdominal pain
- Anxiety
- Balance problems (including resulting problems)
- Bedwetting
- Blood glucose levels (bring attention to your typical blood sugar levels and HbA1c scores if they are high)
- Blurred vision episodes (including eye floaters)
- Chest pain
- Depression
- Difficulty lifting or carrying objects
- Dizziness
- Dropping things (glasses, plates, toothbrush, etc.)
- Fatigue (including the need to take naps during the day)
- Headaches (including their frequency, how long they last, and what you do to relieve the pain)
- Hot flashes
- Inability to use your hands for fine manipulation
- Increased heart rate or sweating, particularly with exertion
- Insomnia
- Insulin shock
- Leg cramping
- Limited walking or standing due to pain, fatigue, or muscle weakness
- Obesity (height, weight, and any weight gain or loss)
- Pain (including radiating pain into the arms, legs, hands, or feet)
- Periods of hypoglycemia (including episodes where you passed out)
- Sensitivity to heat, cold, light, vibration, or loud noise
- Skin infections and sores (including the time it takes for wounds to heal)
- Swelling in the legs or feet
- Thirst
- Trouble concentrating
- Urination frequency
- Vision loss (including changes in prescriptions for glasses or contact lenses)
Top-Rated Disability Lawyers Who Can Help Win Your Claim Based on Diabetes and Its Effects
The consequences of diabetes can severely impact your health and day-to-day life, robbing you of your livelihood and even causing death.
Fortunately, you may qualify for Social Security disability benefits for diabetes, including cash payments and medical coverage (through Medicare or Medicaid).
But navigating the disability maze can be challenging.
And that’s where our top-rated Virginia disability law firm steps in.
We help people with diabetes win their claims and get the financial support and medical care needed to increase their quality of life. And we want to get started with your case.
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