Is Diabetes Considered a Disability by the SSA?
Yes, diabetes does qualify as a disability under Social Security Administration guidelines. But approval depends on how severely your condition affects your daily life and ability to work. At The Keener Law Firm, we’ve helped thousands of clients through the Social Security Disability process. So, we understand that this straightforward answer leads to many more questions about what qualifies and how to prove your case.
How to Qualify for Social Security Disability Benefits with Diabetes
The Social Security Administration operates two main disability programs: Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). Both programs require you to meet strict medical and financial criteria, though the financial requirements differ between the two.
To qualify for either program, your condition must prevent you from performing substantial gainful activity for at least 12 months or be expected to result in death. The SSA defines substantial gainful activity as earning more than $1,620 per month in 2025 (or $2,700 if you’re blind). This means your diabetes must be severe enough to prevent you from working at this minimal level.
How Social Security Evaluates Diabetes Disability Claims
The Social Security Administration follows a five-step evaluation process to determine if your diabetes qualifies for benefits. Here’s how they assess your case:
Step 1: Are you working? If you’re earning above the substantial gainful activity threshold, you typically won’t qualify regardless of your medical condition.
Step 2: Is your condition severe? Your diabetes must significantly limit your ability to perform basic work activities like walking, sitting, lifting, or concentrating.
Step 3: Does your condition meet a listing? The SSA maintains a “Blue Book” of medical conditions that automatically qualify for benefits if you meet specific criteria. Diabetes appears in Section 9.00 under Endocrine Disorders.
Step 4: Can you perform your past work? Step 4: Can you perform your past work? Even if your diabetes doesn’t meet a listing, the SSA considers whether you can still do jobs you’ve held in the past 5 years. This is a recent change from the previous 15-year lookback period, effective June 22, 2024.
Step 5: Can you perform other work? Finally, they determine if you can adjust to different types of work considering your age, education, work experience, and functional limitations.
Does Diabetes Qualify for Disability Benefits? Medical Requirements
As mentioned above, the SSA’s Blue Book lists several ways diabetes can qualify under the agency’s medical listings:
- Diabetic Ketoacidosis or Hyperosmolar Hyperglycemic State: If you’ve experienced these severe complications requiring hospitalization or equivalent treatment at least three times in a 12-month period with at least 30 days between episodes, you may automatically qualify.
- Severe Diabetic Peripheral Neuropathy: This involves significant nerve damage affecting your ability to walk effectively. The SSA looks for sustained disturbance of “gross and dexterous” movements. Gross movements involve functions like walking or standing. Dexterous movements are those involving finer, more precise movements like picking up small items.
- Diabetic Nephropathy: Kidney complications from diabetes that result in chronic kidney disease can qualify under the kidney disorder listings.
- Severe Diabetic Retinopathy: Vision problems caused by diabetes could qualify under visual disorder listings if they significantly impair your sight.
Can I Get Disability Benefits for Diabetes Without Meeting Blue Book Requirements?
Many people with diabetes don’t meet these specific listings but still qualify for benefits because their overall functional limitation is sufficient to meet the Social Security disability standard. This is where we assess your “residual functional capacity” – essentially, what you can still do despite your diabetes.
Common functional limitations from diabetes include:
- Fatigue and weakness from blood sugar fluctuations
- Frequent bathroom breaks affecting work attendance
- Difficulty concentrating during hypoglycemic episodes
- Physical limitations from neuropathy or other complications
- Medication side effects that impact your ability to work
The Social Security Administration considers how these limitations affect your capacity to maintain employment, both individually and in combination. For example, if you need frequent unscheduled breaks or miss work regularly due to your condition, most employers won’t accommodate these needs long-term.
SSDI vs SSI: Income and Asset Requirements for Diabetes Disability Claims
As with all disability claimants with a physical or mental impairment meeting Social Security’s medical eligibility criteria, you must meet financial criteria that differ between SSDI and SSI:
- SSDI Financial Requirements: You need sufficient work credits based on your age and work history. Generally, you need to have worked five of the last ten years before becoming disabled. SSDI has no asset limits, and the amount you receive depends on your lifetime earnings, not your current monthly income.
- SSI Financial Requirements: Unlike SSID, this is a needs-based program serving people with limited income and resources. Generally, you can have no more than $2,000 in available financial assets as an individual (or $3,000 as a couple). Your monthly income must also fall below specific thresholds, which vary by state.
Many people qualify for both programs, though your total monthly benefit amount may be reduced, depending on several variables. Your disability law attorney can explain these factors in detail for you.
What Medical Evidence Do I Need for a Diabetes Disability Claim?
Winning your diabetes disability case comes down to having the right medical records and making sure they are presented completely and understandably. You’ll need comprehensive documentation that clearly shows how your condition affects your daily life. You’ll should have:
- Regular treatment records showing your diabetes management history
- Blood sugar logs demonstrating poor control despite compliance
- Documentation of complications like neuropathy, retinopathy, or nephropathy
- Emergency room visits or hospitalizations related to your diabetes
- Statements from your doctors about your functional limitations
- Records of medication side effects
- Work attendance records showing diabetes-related absences
The key is demonstrating that your diabetes prevents you from maintaining full-time employment, despite following your treatment plan. Simply having a diabetes diagnosis isn’t enough – you must show how it functionally disables you.
Do I Need a Disability Lawyer for My Diabetes Claim?
Social Security Disability cases involving diabetes can be complex, particularly when your condition doesn’t neatly fit the Blue Book listings. Insurance companies and the Social Security often underestimate the disabling effects of diabetes, viewing it as a manageable condition when properly treated.
Having an experienced disability lawyer helps you gather your medical documentary evidence, prepare your claim package, and then file and argue for your approval can make a big difference in whether you win a benefits decision. Working with The Keener Law Firm ensures your case is presented with the strongest possible argument for approval. We know how to gather the right medical evidence, work with your doctors to document your limitations properly, and present your case in the most favorable light.
How to Apply for Diabetes Disability Benefits
If you believe your condition qualifies for automatic disability approval, start your application as soon as possible. The SSA doesn’t backdate benefits to when your condition begins, only to when you file your claim or the date determined to be your disability onset date. Timing matters significantly.
The Keener Law Firm offers free consultations to review your case and determine the best strategy for your specific situation. Our experienced attorneys understand the intricacies of Social Security Disability law and will guide you through every step of the process, from initial application through any necessary appeals.
Remember, having a qualifying condition is just the first step. Successfully proving your case requires the right medical evidence presented properly. Let our experienced team help you get the benefits you deserve. Contact The Keener Law Firm today for a free consultation. We’ll review your specific circumstances, help you understand your options, and guide you through every step of the process.
Remember, you don’t pay attorney fees unless we win your case, so you have nothing to lose by exploring your rights. Your diabetes may qualify as a disability under Social Security guidelines.