Win Chronic Liver Disease Disability Benefits Using SSA Listing 5.05

Tips for a Successful Claim for Chronic Liver Disease Disability Benefits under Social Security

If you have chronic liver disease, you know just how serious it is. You feel weak and tired. You lose weight, partially because you’re either vomiting or feeling nauseous most of the time. And you can develop jaundice.

Needless to say, maintaining gainful employment often isn’t an option. All of your focus has to be spent on getting through the day.

Thankfully, the Social Security Administration understands this and has chosen to recognize chronic liver disease as a condition eligible for Social Security disability benefits – if you meet the specific requirements that they set down. What are these requirements and how do you meet them?

There are two ways to qualify for disability benefits.

One is to meet the specific criteria for your particular issue as laid out in the Listings of Impairments, a compendium of debilitating conditions recognized by the SSA and the medical requirements you must meet to get benefits.

The second method should only be used if you can’t qualify through the first. If you are unable to match the criteria for a listing, it is possible to still get benefits if you can prove that your condition is the equivalent of a condition already in the listings. Before you go down that much more complex and confusing road, let’s look at SSA’s medical criteria for qualifying with chronic liver disease.

Requirements for Chronic Liver Disease Disability Benefits under SSA Listing 5.05

The criteria for getting Social Security disability benefits for chronic liver disease are quite thorough and specific. Your condition has to involve one of seven things:

1. Gastric, esophageal, or ectopic hemorrhaging, or hemorrhaging from portal hypertensive gastropathy that has:
   1. Shown up in imaging deemed medically acceptable
   2. Resulted in hemodynamic instability
   3. Necessitated a blood transfusion of at least two units, requiring hospitalization

If you can prove these things, you qualify for disability for 12 months after your last documented transfusion. After that, you will be reevaluated to see if you are still eligible for chronic liver disease disability benefits.

1. Hydrothorax or ascites that:
   1. Are unable to be attributed to other causes, despite continuing prescribed treatment
   2. Show up on two or more evaluations within a 6-month period that are 60 or more days apart
   3. Are documented by:
      1. Thoracentesis or paracentesis
      2. Physical examination or medically accepted imaging in addition to one of these:
         1. 0 g/dL or less serum albumin
         2. An INR (international normalized ratio) of 1.5 or higher
      3. Spontaneous bacterial peritonitis where the peritoneal fluid has an absolute neutrophil count of 250 cells/mm³ or more.
      4. Hepatorenal syndrome where one of these is present:
         1. Urine sodium below 10mEq per liter when there is sodium retention
         2. 24-hour urine output below 500 mL with oliguria
         3. An elevation of serum creatinine of 2 mg/dL or more
      5. Hepatorenal syndrome where:
         1. You have arterial oxygenation on room air of:
            1. When test sites are less than 3000 feet above sea level, 60 mm Hg or below
            2. When test sites are at 3000-6000 feet, 55 mm Hg or below

• When test sites are above 6000 feet, 50 mm Hg or below

1. Intrapulmonary arteriovenous shunting that has been documented by macroaggregated albumin lung perfusion scan or contrast-enhanced echocardiography
2. Hepatic encephalopathy with one of these:
   1. Changes in mental status, cognitive dysfunction, abnormal behavior, coma, confusion, stupor, or delirium that has been documented in two or more evaluations within a 6-month period that are at least 60 day apart
   2. A history of TIPS or any surgical portosystemic shunt
   3. One of these that occurs on two or more evaluations within a 6-month period that are at least 60 days apart:
      1. INR of at least 1.5
      2. 3.0 g/dL or lower of serum albumin

• Triphasic slow wave activity as shown by an EEG

1. Fluctuating physical neurological abnormalities such as asterixis
2. SSA CLD scores on end stage liver disease of at least 22; you will be considered disabled from the first date of the score, if not earlier.

How do you prove these things? Testing.

Here are medical tests that the SSA accepts in order to qualify for chronic liver disease disability benefits:

• Abdominal Ultrasound (Sonogram)
• Alpha-Fetoprotein (AFP)
• Antimitochondrial Antibodies (AMA)
• Antismooth Muscle Antibodies
• Biliary Scan
• Biopsy
• Cryoglobulins
• Cytokeratin 18 Test for Non-Alcoholic Steatohepatitis
• Echocardiography
• Elafin Test for Graft vs. Host Disease
• Estrogens
• Hepatitis A Virus (HAV) Antibodies
•  Hepatitis B Virus (HBV) Antibodies
• Hepatitis B Virus (HBV) Antigens
• Hepatitis C Virus (HCV) Antibodies
• Hepatitis D Virus (HDV) Antibodies
• Herpes Simplex Virus (HSV) Antigen
• Immunoglobulins
• Intracranial Pressure (ICP) Monitoring
• Liver Biopsy
• Liver and Spleen Scan
• Paracentesis
• Percutaneous Transhepatic Portal Venography
• Percutaneous Transhepatic Cholangiography (PTC)
• Polymerase Chain Reaction (PCR)
• Prothrombin Time (PT)
• Serum Protein Electrophoresis (SPE)
• Ultrasound Elastography of Liver

If you receive positive results on any of these tests, you will help your case immensely.

For a free legal consultation, call 800-562-9830

When You Can’t Meet SSA’s Listing for Chronic Liver Disease

Never forget that there is a secondary method by which you can qualify for chronic liver disease disability benefits: equivalency. In order to prove equivalency, you’ll need to use the Five Step Sequential Evaluation Process and prove that your specific ailment has kept you from being able to work for at least 12 consecutive months.

As mentioned above, this isn’t an easy road. Depending on the particular symptoms you’re suffering from, proving equivalency might be very different for you than it would be for someone else – even if they are also suffering from liver disease. Because of this, you will absolutely need to work with a seasoned social security disability attorney who knows what the SSA is looking for and can make sure you provide it.

For individual legal advice about your case, contact the disability team at Marc Whitehead & Associates. We take care of the Social Security disability paperwork and process, whether you are first filing for SSD benefits or you need to appeal a denial of your claim.

See what we do to win your SSDI claim.

Call or text 800-562-9830 or complete a Free Case Evaluation form