Can You Get Disability for Cirrhosis?

Cirrhosis (sir-OH-sis) is a disorder that causes healthy liver tissue to be replaced by fibrous scar tissue, resulting in a progressive loss of liver function that may eventually require a liver transplant. The condition is often caused by long-term alcohol abuse, chronic infections of hepatitis B or C, or a serious form of non-alcoholic fatty liver disease known as steatohepatitis. Less common causes include autoimmune dysfunctions, such as primary biliary cirrhosis, and certain genetic disorders that affect how the liver works, like hemochromatosis.

Cirrhosis can be considered a disability when it results in a significant loss of liver function, resulting in symptoms that interfere with your ability to work full-time. During early stages of liver disease, you might not have any symptoms. But a cirrhosis diagnosis means that your liver is in a late stage of scarring that can cause fatigue, nausea, and swelling in your legs and feet. If your symptoms keep you from performing basic job tasks (such as standing and walking) on a regular basis, it's important to learn when and how you can qualify for disability benefits.

When is Liver Cirrhosis a Disability?

Social Security provides disability benefits for people with medically determinable impairments that prevent them from engaging in substantial gainful activity for at least twelve months. Depending on the type of disability benefit you're applying for (SSDI or SSI), you'll need to meet specific non-medical qualifications, such as having enough work credits to qualify for SSDI or limited resources for SSI.

Once Social Security determines that you're legally allowed to receive at least one type of benefit, the agency will review your medical records for evidence that you either meet a Blue Book listed impairment or that you have so many functional limitations that no jobs exist that you can perform given your cirrhosis symptoms.

How to Qualify for Disability by Meeting the Cirrhosis Listing

Social Security's "listing of impairments" is a group of medical disorders that the agency considers especially severe. If your medical records contain tests or lab results that meet the requirements of a "listing," the agency can award you benefits automatically without needing to determine that you can't do any work.

Cirrhosis is evaluated underListing 5.05 for chronic liver disease. To qualify for disability automatically under this listing, you need lab test results showing levels of blood protein or oxygenation that are below certain specific levels. The details of the listing are complicated, so it's a good idea to have your doctor write a medical source statement explaining how your test results meet the listing requirements. (If your cirrhosis has progressed to the point where you need a liver transplant, you'll be found disabled automatically for one year under listing 5.09.)

How to Qualify for Disability by Showing You Can't Work Due to Cirrhosis

Few disability applicants ("claimants") are found disabled under a listing unless they have very advanced cirrhosis. But you can still be found disabled without having the specific test results required by the listing if you can show that symptoms from your cirrhosis prevent you from working at any job.

To determine what, if any, jobs you can do, Social Security looks at your medical records and your activities of daily living report to assess your residual functional capacity (RFC). Your RFC is a set of limitations that reflects the most you're capable of doing, physically and mentally, in a work environment. For example, if your cirrhosis symptoms cause your feet to swell after 15 minutes of standing, your RFC might state that you're limited to a sit-down job where you can elevate your legs to relieve pain.

Social Security then compares your current RFC with the demands of your past work to see whether you could still do those jobs today. The agency then determines if any other jobs exist that you can do despite your RFC, taking into account factors such as your age, education, and skill set. If the restrictions in your RFC rule out all jobs, your disability claim will be approved. (For claimants under 50 years of age, this usually means that you can't do even the simplest sedentary work, while those 50 and older may qualify under the medical-vocational grid rules.)

Medical Evidence You'll Need to Get Disability for Cirrhosis

The quantity and quality of your medical records help Social Security determine whether you meet a listing or aren't able to do any sort of job. It's very difficult to get disability benefits without having seen a doctor, so it's important that you provide evidence showing that you've had regular treatment for cirrhosis.

Less advanced cases may be treated with lifestyle changes, such as cutting out salt from your diet or losing weight. Medications called diuretics that help remove fluid and salt from your body may also be prescribed. More severe cases of cirrhosis can require surgery to place a stent in the liver in order to relieve a backup of blood flow in the veins, or even a liver transplant. Social Security will look for this evidence in your record, as well as additional documentation like:

• progress notes from your doctors, preferably those who specialize in liver conditions
• blood and urine tests showing the levels of liver proteins such as albumin or creatinine
• pulse oximetry tests that measure the amount of oxygen in your blood
• physical exams showing signs of liver disease like ascites (fluid buildup in the abdomen) or jaundice (yellowing of the skin and eyes), and
• mental exams showing cognitive changes that can result from poor liver function.

The above list isn't exhaustive—your record might also include documentation of a biopsy (a sample of tissue taken from your liver) or a blood transfusion. Make sure that you let Social Security know the dates and locations of any treatment you've been receiving for your cirrhosis so the agency can obtain all the records from your medical providers.

Can I Get Disability for Alcoholic Cirrhosis?

If your cirrhosis disease was caused by long-term alcohol abuse and you haven't stopped drinking despite your doctor's orders, Social Security can deny your claim if the agency determines that your cirrhosis would improve if you stopped drinking. But if you've had a long period of sobriety and your cirrhosis didn't improve, the agency will likely find that your alcohol abuse isn't "material" to a finding of disability. For more information, see our article on getting disability when you've used alcohol or drugs.

What Are the Benefit Amounts for Cirrhosis?

Social Security doesn't award benefits based on the type of medical condition you have. Instead, the amount you'll receive if you're approved will depend on whether you're eligible for SSDI or SSI. You can learn more—and calculate your estimated benefit—in our article on SSDI and SSI monthly check amounts.

How to Apply for Social Security Disability

Applying for Social Security benefits is a relatively straightforward process. You can choose from one of several methods to begin your application.

• File online at Social Security's official website. Applying online has many benefits, such as giving you the option to save your application and return to it later.
• Call Social Security's national number at 800-772-1213 (TTY 800-325-0778) from 8:00 a.m. to 7:00 p.m., Monday through Friday, to speak with a representative.
• Visit your local Social Security field office. You can use the locator toolhere to find the office closest to you.

If you aren't sure which method you'd prefer, or you're on the fence between two options, you may find our article on the best way to apply for disability benefits to be helpful.

What if I Don't Qualify for Benefits?

Only about one-third of disability claimants are approved on their first try. Fortunately, you can submit an appeal within 60 days of receiving the denial letter. You'll probably have to appeal twice before you can have a hearing with an administrative law judge, which is where you have your best chances of getting approved for benefits.

Consider contacting an experienced disability attorney or advocate for help with your appeal. Your lawyer can help sort through your medical records, strengthen any weaknesses in your application, and cross-examine the vocational expert who'll likely be present at your disability hearing. Most disability attorneys offer free consultations, so don't hesitate to ask around until you find a lawyer who meets your needs.