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How to Win Your Hepatitis Disability Case

Contrary to what many people suffering from Hepatitis believe, the Social Security Administration (SSA) is very familiar with the 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!

Use this article as the cornerstone to developing and winning your Social Security disability claim.

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

This may not come as a surprise for you to learn that gastroenterologists are often not overly compassionate with regard to their patients who have hepatitis. In my practice, I talk weekly with doctors of all medical specialties regarding their patients disability claims. Without trying to stereotype, I must confess that I have talked with many gastroenterologists who appeared to lack bedside manner and patient empathy. This is important, because if your gastroenterologist is not compassionate, he or she will likely also be reluctant to support your disability case.

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 a 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 it the disease is.

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.

Confirmation of chronic liver disease by liver biopsy and one of the following:

  1. 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
  2. Serum bilirubin of 2.5 mg. per deciliter (100 mg.) or greater on repeated examinations for at least 3 months; or
  3. Hepatic cell necrosis or inflammation, persisting for at least 3 months, documented by repeated abnormalities of prothrombin time and enzymes indicative of hepatic dysfunction.

In my experience, many people win their disability case based on meeting the criteria in Step 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.

In my opinion, 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 (e.g. 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.

Remember, one key to winning your disability case is to never quit and keep fighting for the benefits you deserve!

Best of luck to you and remember to keep fighting for the benefits you deserve!