Anyone who has been diagnosed with hepatitis C is encouraged to eat right and make good food choices for their body. Although eating healthy is always important, if your liver is not operating properly it becomes even more so. For instance, healthy eating not only decreases some of the symptoms of your condition, but it may also help improve or repair some of the damage from the disease.
Recently on our disability forum we had a claimant ask how much they could expect to receive for Social Security Disability Insurance (SSDI) if they had Hepatitis C. This blog will address how the Social Security Administration determines payment for your disability and how you will be paid if the SSA agrees you are disabled and unable to work or perform substantial gainful activity.
How does SSDI differ from Workers’ Compensation or VA Disability benefits?
If you have been injured at work or in the military you may be familiar with permanent partial disability benefits. Workers’ Compensation and the Veteran’s Administration both offer partial disability payments to claimants who are not totally disabled.
Although the process is a bit different for each program, the general gist is that a doctor will use their clinical judgment and freedom, maybe with certain guidelines or charts, to estimate the percentage of disability and assign each disabled worker a disability rating. Claimants are then paid a benefit which corresponds to that partial disability rating.
For Workers’ Compensation the impairment percentages are determined by medical specialists and reflect “the severity of the medical condition and the degree to which the impairment decreases an individual’s ability to perform common activities of daily living (ADL), excluding work.”
Social Security Disability Insurance (SSDI) and payments for Hepatitis C
The Social Security Administration does not provide any type of partial disability benefits, and claimants will not be given a disability rating. This means claimants will not be paid for partial or short-term conditions. The SSDI applicant will, however, be expected to prove that they are 100% disabled and they are not able to work for at least 12 continuous months.
Whether or not the applicant is disabled will be determined by reviewing the SSDI applicant’s current medical records. The applicant is not generally sent to a consultative examiner (an independent contractor who is hired by the SSA to evaluate disability applicants) unless they do not have sufficient medical evidence to prove their case.
So if the SSA is not going to give you a disability rating than how will they determine how you are paid? Social Security Disability Insurance Benefits or SSDI is based on the claimant’s average earnings and payroll tax contributions to Social Security. The more the claimant has paid into Social Security system, the more in monthly benefits they may be entitled to receive. There is not a set amount. If they qualify for Social Security Disability Insurance they can review their Statement of Earnings which is sent to workers each year by the Social Security Administration (SSA) for an estimated payment amount. Claimants can also contact the SSA at 1-800-772-1213 for specific information.
How much will I get for Hepatitis C?
First, you will have to prove that you have a severe condition that is expected to last for 12 continuous months, it is so severe that you cannot work and that you are insured for SSDI benefits. Unlike SSA retirement benefits, SSDI is not an entitlement program, and most applicants are denied benefits the first time they apply.
As mentioned above, the amount you will receive for Hepatitis C will not be based on your condition or the severity of your condition but on how much you have paid into the SSA system through your employment taxes
Hepatitis is the swelling of the liver which impairs its ability to remove toxins from the body, digest food properly or store energy.
Claimants who have hepatitis can have an inflamed liver and other symptoms including fatigue, abdominal pain, abnormal liver functioning, fever, loss of appetite, diarrhea or jaundice. Hepatitis is most commonly caused by the hepatitis A virus (HAV), the hepatitis B virus (HBV), or the hepatitis C virus (HCV). Claimants with Hepatitis C usually contract the disease after coming into contact with contaminated blood. Hepatitis C can cause severe liver damage.
How does the SSA determine disability for Hepatitis?
Claimants may win SSI or SSDI benefits for hepatitis by meeting a listing on the Social Security Administration’s Listing of Impairments (also known as the Blue Book this list outlines the conditions and symptoms that are disabling according to the Social Security Administration) or by proving, through a medical vocational allowance, that the claimant does not have the ability or residual work capacity to perform what the SSA considers “substantial gainful activity.”
Winning SSDI or SSI for Hepatitis by meeting or exceeding a listing
The Social Security Administration does have a listing for Hepatitis C. Hepatitis C is listed under the Social Security Administration’s Listing of Impairments under the category called the Digestive System – Medical Listing 5.05 (chronic liver disease).
If a SSI or SSDI claimant’s condition meets or exceeds the SSA listing they may be found automatically disabled. This listing is fairly complicated and if you have questions it is best to either discuss your case with your medical doctor or contact a disability lawyer and have them review your medical records to determine if you have enough medical evidence to prove that your condition meets or exceeds a listing.
Winning SSDI or SSI for Hepatitis through a Medical Vocational Allowance
If a claimant’s condition does not meet a listing, they may still be considered disabled if their hepatitis C interferes with their ability to work. Most claimant’s, especially if they are older than 55 years of age, will most likely qualify for SSI or SSDI by proving that they do not have the ability to work. The SSA uses what they call GRID rules to identify claimants who are not able to work.
As mentioned before, the older the claimant the greater chance they will have to prove they cannot work. Claimants should focus on making sure their medical evidence clearly states why they are not able to work. For example, medical records should clearly state the claimant’s ability to:
- Walk, stand, sit, lift, push, pull, reach, carry or handle objects
- See, hear and speak
- Understand/carry out and remember simple instructions
- Respond appropriately to supervision, co-workers and usual work situations
- Deal with changes in a routine work setting
To make a medical vocational decision the SSA will review the claimant’s age, education, work experience and physical/mental condition to determine what other work, if any, the person can perform. If the SSA decides that the person’s condition is so severe they are unable to work their current job, any previous job (past 15 years) or be retrained for other work, they will find them disabled.