Can I Get Social Security Disability or SSI for End Stage Renal Disease?

End-stage renal disease, or ESRD, affects more than 800,000 people in the United States, according to the CDC. ESRD is kidney disease that has progressed to the point that dialysis or a kidney transplant is needed to survive.

ESRD is most commonly caused by other medical conditions, including:

• hypertension
• diabetes
• glomerulonephritis, and
• polycystic kidney disease.

Once you're diagnosed with ESRD, your ongoing medical needs will probably mean that you can't work enough to support yourself. But it also means you'll likely qualify for Social Security disability benefits.

Is End-Stage Renal Disease Disabling?

End-stage renal disease is when your kidneys, either because of disease or damage, can no longer function. ESRD patients require treatment to make up for the lack of function of the kidneys. Currently, there are two renal replacement treatment options:

• dialysis to cleanse the blood, or
• replacement therapy (a kidney transplant).

If you're receiving long-term dialysis for end-stage renal disease, your ESRD is automatically disabling. There are two types of dialysis:

• hemodialysis, which removes toxins from the blood with a machine that acts as an artificial kidney, and
• peritoneal dialysis, in which dialysate is added to and removed from the peritoneal cavity.

Although dialysis can prolong your life indefinitely, it severely limits your quality of life and your ability to function day-to-day. If you can no longer work because of your ESRD symptoms or treatment, the Social Security Administration (SSA) will consider you disabled.

How Does End-Stage Renal Disease Qualify for Disability?

Generally speaking, end-stage renal disease always qualifies for Social Security disability benefits. Your ESRD should meet the medical requirements for Social Security disability insurance (SSDI) or Supplemental Security Income (SSI) disability benefits if you're receiving frequent dialysis or you're on an organ transplant list.

Chronic kidney disease is included in Social Security's Blue Book, a list of impairments considered severe enough to qualify automatically for benefits. To meet the requirements of the listing covering ESRD (listing 6.03), you'll need a report from your doctor or another acceptable medical source that says:

• your renal disease is end-stage
• you're currently receiving ongoing peritoneal dialysis or hemodialysis, and
• you're expected to be on dialysis for at least 12 months (or the rest of your life).

Learn about how Social Security evaluates other types of kidney disease in disability claims.

How Can I Qualify for Immediate Disability Benefits With ESRD?

Even when you have an impairment that easily meets the criteria of a disability listing, it can take several months for Social Security to finish reviewing your application. The long wait can create financial hardship for disability applicants with few resources.

So, Social Security offers temporary disability payments, called "presumptive disability" (PD) benefits, to some disability applicants with qualifying conditions. PD is available only if you're applying for SSI disability benefits or SSDI and SSI together. Presumptive disability benefits aren't available for those applying for SSDI alone.

To qualify for PD, you must have a medical condition that's likely to meet Social Security's definition of disabled. An ESRD diagnosis with the required dialysis regimen meets the criteria. You must also meet the financial requirements of the SSI program (low income and few assets).

You can apply for presumptive disability benefits when you apply for SSI. Learn more about how to get presumptive disability pay.

Do I Have to Wait Two Years to Get Medicare If I Have ESRD?

When you apply for Social Security disability benefits for ESRD, you automatically apply for Medicare. If you meet the work requirements for SSDI, you'll automatically be approved for Medicare Part A (which costs you nothing) and Medicare Part B (which has a monthly premium) when Social Security approves your disability benefits. You can opt out of Part B coverage if you want to.

Your Medicare coverage will automatically begin four months after you start dialysis treatments or, if you do self-dialysis at home, in the first month (under certain circumstances). Your coverage will continue until 12 months after you stop receiving dialysis.

Learn more about getting Medicare when you have ESRD, including program limitations.

How to Apply for Disability Benefits for ESRD

How you apply for Social Security disability benefits can depend on the type of disability benefits you're applying for.

Apply for SSDI Online

The fastest way to apply for SSDI is to complete the online application. You apply online for SSDI alone or SSDI and SSI together.

You can file an online application from the comfort of your own home—or anywhere in the world—at a time that's convenient for you. And you can pause the application process as often as you need to, then pick back up where you left off.

Using the SSI Online Form

You can start an SSI disability application online, but you'll need to speak with a Social Security representative to complete the process. Once you fill out the online form, Social Security will contact you with an appointment to finish your application.

Other Ways to Apply for SSDI or SSI

Whether you're applying for SSDI, SSI, or both, you can call the national office at 800-772-1213 (TTY 800-325-0778) to make an appointment to apply by phone. Or contact your local Social Security office to apply in person.

Learn more about the Social Security disability application process.