Considerations for those Suffering from Diabetes Mellitus Applying for Social Security disability

According to a release from the CDC (Centers for Disease Control), more than 100 million U.S. Citizens are suffering from either diabetes or prediabetes.   It is quite common in our practice to represent individuals who are either disabled from working either partly or wholly because of this condition.  For those considering an application for Social Security disability benefits, it’s important to keep a number of items in mind when proceeding with a claim that involves Diabetes Mellitus (DM).

There are two major categories of Diabetes Mellitus (DM): Type I, which is known as insulin dependent diabetes,results from a lack of insulin production in the pancreas as a result of what has been an autoimmune destruction of insulin producing cells.  In turn, the lack of insulin production results in increased blood glucose levels.  Symptoms associated with high glucose levels can include increased thirst, appetite, urination, unexplained weight loss, fatigue or drowsiness, trouble concentrating, headaches as well as blurred vision.   Type I diabetes, has also been known as juvenile-onset diabetes, as it presents most often with children (although it can rear its head at any age).

Type II DM, which has also been referred to as adult-onset diabetes (or non-insulin dependent) diabetes results from a lack of production of insulin by the pancreas, or one remains resistant to the transfer of insulin to one’s body cells (otherwise known as insulin resistant diabetes).  Symptoms can be similar to those present with Type I.  Type II DM is most common with those who are either obese or who have a family history of DM.  The condition can many times be treated through diet and exercise at earlier stages of the illness.  However, where diet and exercise are no longer proving fruitful, oral medication or daily insulin may need to be introduced.

As a Social Security lawyer in Maine, Massachusetts and New Hampshire, we frequently encounter individuals who have developed issues with diabetes as a result of a poor diet. which may or may include contributions to their disabling condition through alcohol abuse or by smoking tobacco.   As one’s weight is a significant contributing factor in controlling one’s diabetes, it is extremely important that one follow the advice of their doctor when it comes to alcohol consumption (and in terms of their diet generally).  There are two golden rules that come to mind rather immediately.  For one, if alcohol and/or drugs are deemed to substantially contribute to one’s disabling condition, then benefits are not payable.  And so the use of alcohol in a manner which is found to be contributing to the severity of one’s diabetes condition can, in and of itself serve as a basis for a denial of one’s claim.  Two, one needs to show as well that they remain disabled despite prescribed treatment.

Social Security regulation 20 C.F.R. §404.1530 provides that “[i]n order to get benefits, you must follow treatment prescribed by your medical source(s) if this treatment is expected to restore your ability to work.”  If one’s doctor is suggesting that one refrain from any alcohol consumption, even a small amount of alcohol may be deemed harmful to one’s condition (and may be cited as a reason for a denial, based on a determination that if one were indeed following their doctor’s advice, then they would be no longer disabled).  Similarly, the failure to test one’s sugar levels regularly and to adhere to the dietary recommendations being made generally by their physician can be deemed a failure to follow prescribed treatment.

Those suffering from diabetes will be familiar with a test of one’s A1C level, which is meant to provide a 3 month average as to one’s glucose levels.  A test result of below 5.7 percent is found to be normal, while a test result of 6.5 or greater is deemed to be an indicator that one is suffering from longer term glucose level issues that would correspond with diabetes.  A test result 8.0 or greater corresponds with very serious glucose level concerns.   On the bigger concerns that we see in our office is that many individuals who are long term smokers continue to smoke despite the warnings from their doctor that smoking has been associated with significantly higher A1C levels.

And so if you are considering an application for Social Security disability benefits as a result of health consequences associated with your diabetes condition, be prepared for questions to be asked as to whether you are doing everything you can (whether it be in terms of smoking, alcohol consumption, diet and treatment) so as to get better and return to some manner of work.  Assuming this still does not remain possible, contact the Law Offices of Russell J. Goldsmith at 1-800-773-8622 to see whether an application for Social Security disability is the correct route for you.






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