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The Social Security Administration (SSA) is very familiar
with the Hepatitis disease. In fact, SSA considers Hepatitis
to be such a potentially serious medical condition that
federal law provides that if their hepatitis is advanced,
a person can be found disabled based on laboratory test
results alone!
Step 1 Having a Liver Transplant is not a prerequisite
to Winning your Disability Claim
While your hepatitis or liver disease must be at a relatively
advanced stage, you can win your disability case even if
you have not had a liver transplant.
Step 2 Find a compassionate, supportive Gastroenterologist
It has been said that many are not compassionate.
A supportive gastroenterologist is important for two reasons.
First, they are the doctors SSA views as the specialists
trained to diagnose and treat hepatitis. Second, SSA gives
the most weight to the disability opinions are rendered
by a claimant’s treating physician. Furthermore, SSA gives
even more weight to the disability opinions rendered by
a specialist such as a gastroenterologist.
Step 3 You must Undergo the Battery of Tests to Confirm
the Hepatitis diagnosis and to Determine the Severity of
the Disease
One key to winning your Hepatitis case is good laboratory
testing. However, laboratory testing alone is not enough
to win your case; once the testing is done, the issue will
then be how advanced is the disease
The information SSA uses to approve a claim based solely
on laboratory testing is contained at Listing 5.05 (Specifically
5.05(F)) of the Administration’s criteria for Digestive
disorders.
F. Confirmation of chronic liver disease by liver biopsy
and one of the following:
Ascites not attributable to other causes, recurrent or
persisting for at least 3 months, demonstrated by abdominal
paracentesis or associated with persistent hypoalbuminemia
of 3.0 gm per deciliter (100 ml.) or less; or
Serum bilirubin of 2.5 mg. per deciliter (100 mg.) or
greater on repeated examinations for at least 3 months;
or
Hepatic cell necrosis or inflammation, persisting for
at least 3 months, documented by repeated abnormalities
of prothrombin time and enzymes indicative of hepatic dysfunction.
many people win their disability case based on meeting
the criteria in #3. The reason is that necrosis or
inflammation can be confirmed by liver biopsy, and prothrombin
time and liver enzyme abnormalities can be measured by a
simple blood panel.
Experts say in order to have any chance of winning your
hepatitis disability case, you should have a relatively
recent liver biopsy performed and have blood work dating
back for at least 6 months prior to the date you allege
you became disabled.
One benefit many hepatitis claimants have is they usually
have undergone all the required medical testing prior to
or during the time their disability claim with SSA is pending.
Thus, if your Hepatitis is at an advanced and serious
stage, winning your claim may be as simple as obtaining
(or having SSA obtain) your relevant medical records and
submitting them to SSA for review to see if it meets the
criteria.
Step 4 If your Hepatitis is not advanced enough to meet
the SSA Criteria, you can still win your Disability Claim
(i.e. Don’t Quit!)
It is important to understand that if your Hepatitis does
not meet the criteria set forth above, you can still win
your disability case. How? By proving that you are unable
to work full-time in an unskilled sedentary (sit down) job.
Alternatively, if you have other medical and/or psychological
disorders in addition to Hepatitis, SSA will consider the
combined effects of your symptoms and limitations from all
your medical diagnoses. It is common for many Hepatitis
patients to also have a depressive or anxiety disorder.
It is possible for the combination of the Hepatitis and
psychological problems to equal in severity the criteria
listed above. If SSA deems this to be the case, your
claim would likely be approved.
It is also possible for you to be unable to work due
to severe side effects from taking
medications to treat the Hepatitis. Many
people are unable to work during the time and for a significant
time thereafter they have received interferon treatment.
The side effect of overwhelming fatigue from medication
can also help you to equal in severity the criteria listed
above.
Step 5 Be Free from any Alcohol or Illegal Substance
Abuse
As of 1996, a person cannot be approved for disability
benefits based on alcoholism and/or substance abuse. In
fact, your claim will be denied by SSA if alcoholism or
substance abuse is a material factor in your inability to
work. You can be sure SSA will likely scrutinize your disability
claim because Hepatitis can be contracted through alcoholism
or substance abuse. If either of these conditions is a part
of your past, to have your best shot at winning, you should
be prepared to show that it is not a material factor in
your inability to work.
Most improtant thing to remember when going after social
security disability benefits is don't give up.
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