Liver Disease / Cirrhosis and Qualifying for Disability Benefits
Author: Attorney Lonnie Roach
Updated: 7/19/2024
Can I get disability benefits if I am suffering from the effects of Liver Disease / Cirrhosis?
Individuals with cirrhosis or chronic liver disease may qualify for disability benefits if their condition is severe enough to impact their ability to work. The SSA’s Blue Book outlines specific criteria for liver diseases that may qualify for benefits, such as cirrhosis, hepatitis, liver failure, and liver cancer. Meeting these requirements can be complex and technical, requiring medical documentation of specific complications like fluid buildup, infections, or kidney disorders. Following your doctor’s treatment plan is essential, as non-compliance, such as continuing to drink alcohol after being advised not to, may affect your eligibility for benefits.
Approximately 100 million people in the United States suffer from some form of liver disease. Chronic liver disease (CLD) is a category of diseases that includes medical conditions such as cirrhosis, hepatitis, alcoholic liver disease, liver failure, and liver cancer. CLD can be inherited or caused by viruses, environmental toxins, alcohol and drug abuse, or autoimmune disorders. If left untreated, chronic liver disease can be debilitating and become life threatening. If you are suffering from the effects of Liver Disease you may qualify for disability benefits.
Symptoms and signs of liver disease vary from person to person and commonly include:
- Jaundice
- Abdominal pain and swelling
- Extreme fatigue
- Nausea, vomiting, loss of appetite
- Enlargement of liver or spleen
- Swelling in ankles and legs
- Mental disorientation
- Dark urine, blood in stool
- Bruising easily
- Itchy skin
These symptoms can cause you to miss work and jeopardize your ability to maintain employment.
Can I qualify for Social Security Disability if I have cirrhosis or chronic liver disease?
Cirrhosis or chronic liver disease can impact a person’s ability to perform their job, but an applicant’s liver disease must be severe in order to qualify for Social Security Disability benefits.
Social Security has created a manual called the Blue Book which lists impairments Social Security considers disabling and may automatically qualify for benefits. Chronic liver disease is recognized as an impairment under Section 5.05.
Some diseases which may qualify under this listing include:
- Cirrhosis
- Hepatitis B or C
- Autoimmune hepatitis
- Liver failure
- Alcoholic liver disease
- Liver cancer
- Hepatoma (most common type of primary liver cancer)
One way to qualify for SSDI would be to match the requirements of this listing; unfortunately, the requirements are quite complex.
In addition to having a diagnosis of end stage liver disease or chronic liver disease lasting at least six months, you must have medical documentation of at least one of the following:
- Blood loss from a rupture in the digestive system requiring a blood transfusion;
- Fluid buildup in the abdomen;
- Fluid buildup around the lungs
- Spontaneous bacterial peritonitis – an infection characterized by a buildup of white blood cells around the abdomen;
- Hepatorenal syndrome – a kidney disorder that occurs in people with liver damage;
- Hepatic encephalopathy – temporary accumulation of toxins in the brain resulting from liver damage;
- End stage liver disease with CLD scores of 20 or greater. This is a calculation Social Security performs based on the levels of bilirubin and creatinine—two chemical compounds that are the natural byproducts of liver functioning—in your system and multiplies it by numbers that reflect the normal amount of these compounds in the body.
The criteria of this listing are both technical and complicated.
If you have doubts about whether you’ve had one of the above complications, ask your doctor to look at the listing with you. In order to prove that your condition is severe enough to prevent you from working you will need to provide documented medical evidence of the symptoms mentioned above. Your complete medical records should include:
- A diagnosis of liver disease by your doctor;
- A full liver panel to show how the liver is working;
- Imaging tests such as x-rays, MRIs, sonograph, and CAT scans;
- Results of liver biopsy;
- Records of blood transfusions;
- Surgery reports and hospitalization records;
- Medications you take;
- Treatments that have been attempted and your response;
- Notes from your physician and medical providers detailing your symptoms and how they impact your daily life as well as your response to treatment.
Be sure you are carefully following your doctor’s treatment plan.
For example, if your doctor has advised you not to drink alcohol and you continue to do so, Social Security may not approve your claim.
Liver transplants are listed separately under Section 5.09, in the Blue Book.
If you have had a liver transplant for any reason, you will be approved automatically for disability benefits for one year from the date of the transplant; after one year, your case will be re-evaluated.
If your symptoms don’t meet the criteria of Section 5.05, you may still qualify for Social Security Disability benefits if you can show that your functional limitations are so severe they prevent you from working at your job or any job.
Chronic liver disease can cause pain that keeps you from walking, lifting or carrying objects. You may have difficulty focusing or remembering instructions or you may need frequent rest breaks. Social Security will conduct a Residual Functional Capacity (RFC) assessment to evaluate your physical and mental capabilities to determine if there is any job you can do, taking into consideration your age, education and whether or not you can drive. If Social Security determines 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. Your doctor can help you by filling out an RFC form, being specific about your limitations and how they impact your daily life, and documenting your medications and treatments. Note that Social Security gives more weight to the records and opinions provided by specialists, so work with a gastroenterologist or hepatologist when gathering your medical evidence. Once Social Security determines the limitations caused by your condition, they will employ a vocational expert to assess whether a person with these limitations is employable.
“Once Social Security determines the limitations caused by your condition, they will employ a vocational expert to assess whether a person with these limitations is employable. Most vocational experts will find a person to be unemployable if their condition or the treatment rendered for the condition causes the person to regularly be absent two or more days a month or be “off-task” 15% or more of the workday.”
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Disability Benefits FAQs
Social Security has some 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 $1,550 per month in 2024 for nonblind applicants and $2,590 per month for blind applicants.
Basic SSDI Requirements –>
You may also be eligible for Social Security Disability benefits if you have another medical condition.
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 –>
If you are 55 or older or have another medical condition you may get approval.
Applicants who are 55 or older often fall under a grid rule, which means they are not expected to learn a new job.
Disability for those over 55 –>
You may also be eligible for Social Security Disability benefits if you have another medical condition.
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 –>
Should you file a claim?
If you believe that you meet Social Security’s medical and financial requirements, you should apply for benefits. If you are still unsure or would like to talk to someone, please contact us at 512-454-4000. We are always ready to take your call and discuss your options with you free of charge. We are happy to help folks just like you find the best solution for their personal situation.
How do I file for Social Security Disability benefits?
Once you have decided to file a claim, you can take the first step and apply for Social Security Disability benefits in person at your local Social Security Administration office, online, or over the phone.
How to Apply for SSDI –>
Appealing denied benefits
Most who file are denied initially. That doesn’t mean you won’t qualify; you just need to file an appeal.
There are four steps to the Social Security appeal process.
SSDI Appeals Process –>
Do I need a disability attorney for SSDI?
You may certainly file a claim on your own, but evidence shows that your chances for approval are increased significantly if you have legal representation.
Do I need an SSDI attorney–>
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.
What is Supplemental Security Income or SSI?–>
I have long-term disability insurance – should I file a claim?
Absolutely – you should file a claim as soon as you become disabled.
LTD Disability Appeals Process–>
Disability benefits are an important source of income for those who are unable to work. If you are not able to work due to accident or illness, you may be eligible for Social Security Disability or Long Term Disability benefits. If you have applied for benefits and been denied, contact the attorneys at Bemis, Roach and Reed for a free consultation. Call 512-454-4000 and get help NOW.
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.
