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December 28, 2004

Other

Question from New York, New York, USA:

Is diabetes considered a disability? I was denied SSI because according to them, it is not a disability.

Answer:

The definition of disability under Social Security is different than other programs. Social Security pays only for total disability. No benefits are payable for partial disability or for short-term disability.

Disability under Social Security is based on your inability to work. Social Security considers you disabled under Social Security rules if you cannot do work that you did before and they decide that you cannot adjust to other work because of your medical condition(s). Evidence of substantial income through work (as little as $800 a month) will result in a determination that you are not disabled. Your disability must also last or be expected to last for at least one year or to result in death.

Social Security works with an agency in each state, usually called a Disability Determination Service (DDS), to evaluate disability and SSI claims. At the DDS, a disability evaluation specialist and a doctor follow a step-by-step process that applies to all disability claims, thus assuring a consistent national approach to evaluating disability.

First, the DDS specialists decide whether your impairment is severe. This simply means the evidence must show that your disability interferes with your ability to work.

The next step in the process is deciding whether the disability is included in a list of impairments. This list describes, for each of the major body systems, impairments that are considered severe enough to prevent an adult from doing any substantial work, or in the case of children under the age of 18, impairments that result in marked and severe functional limitations.

A list of disabling diseases and impairments that have been judged to be an automatically disabling impairment has been developed to guide DDS evaluators. Diabetes is not an impairment that automatically qualifies as a disabling impairment.

Those denied disability or SSI by Social Security have substantial appeal rights. I recommend that you consult an attorney in your area who has experience in pursuing SSI disability appeals for advice and assistance.

DSH
Additional comments from Shirley Goodman, diabetes nurse specialist:

In my experience, usually the children with diabetes that have qualified for SSI had another qualifying medical condition. Diabetes alone did not meet the level to receive financial support through SSI. If a child has asthma or a seizure problem, or if their diabetes had caused complications like kidney problems, then the child is more likely to meet the standards for receiving financial support. Sometimes, this means you need more than one doctor’s office to complete the health forms, so that all the health problems your child has can be reported to the case worker for SSI.

Under the American Disability Act, diabetes does qualify as a disability. But my understanding is that, under SSI, a certain level of health problems needs to be proven before you can qualify for SSI support.

SG