Diabetes happens when the body doesn't produce enough insulin to process glucose. Diabetes can often be controlled with treatment -- a combination of medication and diet. As a person gets older, sometimes diabetes can't be controlled, and then it can cause damage to internal organs and other problems.
Symptoms and Complications of Adult Diabetes
Symptoms of both diabetes type 1 and diabetes type 2 include frequent urination, unusual thirst and hunger, and extreme fatigue. People with type 2 diabetes also can suffer from tingling or numbness in the hands and feet, frequent infections, and cuts that are slow to heal.
Complications from diabetes include:
- retinopathy (eye and vision problems)
- nephropathy (kidney disease)
- neuropathy (nerve damage) in feet or hands that disrupts your ability to stand, walk, or use your hands
- hypertension (high blood pressure)
- heart disease
- gastroparesis (a type of nerve damage that interferes with digestion)
- peripheral arterial disease (reduced blood flow to your limbs)
- cellulitis (skin infections), and
Qualifying for Disability Benefits with Diabetes
If you have uncontrolled diabetes and you have been prevented from working for at least 12 months, or you expect that you won't be able to work for at least 12 months, then you may be eligible for Social Security disability (SSDI/SSD) benefits or Supplemental Security Income (SSI) benefits. But to qualify for disability benefits, the damage caused by your diabetes must severely limit what you can do, or you must have complications that fulfill the requirements of one of Social Security's disability listings.
If your diabetes is uncontrolled because you don't follow your doctor's prescribed treatment, you won't be eligible for disability. For more information, see our article on failing to comply with treatment orders.
Meeting a Disability Listing for Diabetic Complications
The Social Security Administration (SSA) has a Listing of Impairments (the "Blue Book") that tells you how severe an illness must be to qualify for disability benefits. Unfortunately, diabetes is no longer included as a separate disability listing, so showing you have been diagnosed with diabetes won't automatically get you disability benefits. But, if you have complications arising from your diabetes that fall under a disability listing, you might get approved for benefits. If your complications meet the requirements of a listing, you will automatically be approved for disability benefits before Social Security even develops your RFC.
Following are some listing that people with complications from diabetes (hyperglycemia and hypoglycemia) often suffer from:
- Diabetic retinopathy (Listing 2.00). If you have blurred vision or poor visual acuity (between 20/100 and 20/200 in your better eye), or poor peripheral vision from surgery to correct your central vision, you can qualify for disability benefits under this listing. More about disability for vision loss.
- Diabetic nephropathy (Listing 6.06). If your kidneys are no longer filtering properly and you require daily dialysis or there is evidence of too much protein or creatine in your plasma, you may be able to qualify for benefits. More about disability for kidney disease.
- Diabetic peripheral neuropathies (Listing 11.14). Most people with diabetes have some form of nerve damage in their hands, feet, arms, or legs. But to qualify for benefits under this listing, you have to show that your neuropathy causes a significant disruption of your ability to walk, stand, or use your hands in a skilled way. More on disability for peripheral neuropathy.
- Cardiovascular problems. Diabetes can lead to coronary artery disease (listing 4.04), chronic heart failure (listing 4.02), peripheral vascular disease (listing 4.12), and an irregular heartbeat (listing 4.05). More about disability for heart problems.
- Poorly healing skin and bacterial infections (Listing 8.04). If you have ulcerating skin lesions that last for three months despite treatment and make it difficult for you to walk or use your hands, you can qualify for benefits under the listing for chronic skin infections.
- Amputation of an extremity (Listing 1.05). If you've had a foot amputated due to nerve damage and poor circulation caused by diabetes, you may be able to get benefits if you have other limitations as well. More about disability for amputation.
Because Social Security's disability listings require that the preceding complications be quite severe to qualify for disability, Social Security finds that most people who apply for disability due to diabetes do not meet a listing. The agency then goes on to do an RFC analysis (see below).
If you have diabetes and another impairment, such as depression or obesity, Social Security must consider the combined effects of your impairments when considering if your condition is equal to a listing and when doing your RFC analysis. For more information, see our article on combining multiple impairments for disability.
How Limiting Is Your Diabetes?
If you don't meet the requirements of a listing, to determine whether your diabetes limits your functioning so much that you can't work, the SSA will assess your residual functional capacity (RFC). Your RFC is a measurement of the level of activity that you can do despite your illness. For instance, an RFC can be for medium work, light work, or sedentary work. To determine your RFC, the SSA will review your medical history, your doctor's opinion (if it details your functional limitations and is backed up by medical evidence), and statements from you, your family, and your friends.
The SSA will look for information that shows how well you can use your arms and hands, stand, and walk. For instance, if you have peripheral sensory neuropathy that limits the sensation in your legs or feet, you may have difficuly walking or using foot controls. The SSA is also interested in whether you can focus on tasks, get along with others, and come to work on a regular basis. For instance, if you have poor control over your glucose levels during the day, the SSA might find that you are unable to concentrate for long periods of time. If you suffer from depression or extreme fatigue, your RFC might state that you are unable to perform work on a consistent and regular basis. If you have neuropathy in your legs from your diabetes, you might be unable to stand and walk for long periods of time. If you have blurred vision, your RFC should say that you can't perform jobs in which vision is important.
The SSA will then look to see whether your RFC is limiting enough that, given your age, the jobs you have held in the past, and your education level, you can't be expected to work. For example, if your visual acuity is 20/70 or worse, your RFC might note that you can't drive or work around hazardous machinery. If your prior jobs all required driving or working around hazardous machinery, and you have little education or skills you could transfer to another job, it’s possible that the SSA might find that there is no work you could be expected to do. However, this is likely only if you are 55 or older. If you are younger, the SSA will say there are plenty of unskilled jobs you could learn to do that don’t require driving or working around hazardous machinery.
Learn more about residual functional capacity and when it is limiting enough to get you disability benefits.
Appealing a Denial of Benefits
Most people who apply for disability based largely on diabetes are denied benefits the first time around and need to file an appeal to get a hearing in front of an administrative law judge. A disability lawyer can help you at a hearing by using strategies like combining the effects of multiple impairments, showing you have reduced productivity, proving you can't do sedentary work, and cross-examining Social Security's vocational expert at the hearing. Contact a local disability attorney here.