Diabetes Disability Benefits: Medical Records Guide

Medical Evidence for Social Security Disability Benefits Due to Diabetes

Article Summary

This article provides a comprehensive guide on obtaining Social Security Disability benefits due to diabetes. It outlines essential medical evidence, including blood sugar control history, medication, complications, and physician statements. The article also discusses the importance of lab results, imaging studies, and documentation of secondary conditions like neuropathy, retinopathy, and kidney disease. Additionally, it offers tips on building a solid medical evidence packet and addresses common FAQs.

Diabetes Disability Benefits: Medical Records Guide

When applying for Social Security Disability Benefits due to Diabetes, no matter if you’re looking into Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI),  your claim will heavily rely on the strength and specificity of the medical evidence detailing your case. Diabetes, Type 1 or Type 2, is not an automatic qualifier for disability benefits. The Social Security Administration (SSA) requires detailed documentation proving that your condition substantially limits your ability to perform work-related tasks. 

Medical Records: The Foundation of Your Claim 

Comprehensive medical records are the bedrock of any successful SSDI or SSI claim. These records must reflect not just the diagnosis but the ongoing treatment and the impact of diabetes on your daily life. Essential elements include: 

  • Date of diagnosis (Type 1 or Type 2) 
  • Blood sugar control history: Hemoglobin A1c (HbA1c) levels over time help demonstrate long-term glucose management. A consistent HbA1c level above 7.0% may indicate poor control and an increased risk of complications. 
  • Medication history: Document any insulin or oral medications you take, including the dosages, frequency, and any side effects. 
  • Treatment plan: Include records of responses to different therapies, including insulin adjustments. 
  • Complications: Detail any diabetes-related complications, such as neuropathy, retinopathy, or kidney disease. 


According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), over 37.3 million Americans have diabetes, and approximately 1 in 3 adults will develop some form of diabetes-related complication.
 

Physician’s Statement (Medical Opinion) 

The SSA gives great weight to detailed medical opinions from your treating physician, known as “treating source statements.” Your doctor should describe: 

  • Limitations on physical activities like standing, walking, or using your hands due to nerve damage (neuropathy). 
  • Cognitive or psychological impairments resulting from blood sugar fluctuations, such as difficulty concentrating or memory lapses. 
  • Work-related limitations, such as needing frequent breaks for blood sugar monitoring or limitations on tasks due to complications like vision loss or amputation. 


Lab Results: Objective Evidence of Diabetes Impact
 

Laboratory results are crucial in substantiating your claim because they help establish the existence of a medical impairment that could cause the symptoms alleged. HbA1c (the test that measures a person’s average blood sugar levels over the past months), Urinalysis, Electromyography (EMG), and Retinal Exams are some of the most common screening tests for diabetes.  

Imaging Studies 

For those with advanced diabetic complications, imaging results can also provide tangible evidence: 

  • X-rays and MRIs: Can reveal joint damage or infections linked to diabetic neuropathy. 
  • Eye imaging: From your ophthalmologist can show the severity of diabetic retinopathy. 


Residual Functional Capacity (RFC) Assessment
 

The SSA may request an RFC assessment, which details your physical and mental limitations due to diabetes. This is often completed by your doctor and covers the following: 

  • Ability to perform physical tasks like lifting, sitting, or standing for extended periods. 
  • Cognitive impairments from blood sugar fluctuations. 
  • How frequently does your condition require medical appointments or hospitalization. 


Documentation of Complications
 

Diabetes often leads to secondary conditions that further impair your ability to work: 

  • Neuropathy: Descriptions of numbness, pain, and limitations on mobility or dexterity. 
  • Retinopathy: Eye exams showing vision loss that affects your ability to perform work tasks. 
  • Amputations: If diabetes leads to amputation, the SSA requires evidence of how this impacts daily activities and job performance. 
  • Chronic Kidney Disease (CKD): Document kidney function and complications, particularly if you require dialysis. 
  • Heart Disease: Records of any cardiovascular complications related to your diabetes. 


Mental Health Records (If Applicable)
 

If your diabetes exacerbates mental health conditions like depression or anxiety, include: 

  • Cognitive impairment reports: These demonstrate any effects from extreme blood sugar fluctuations. 
  • Psychiatric evaluations: Document how mental health conditions interfere with your ability to work and manage daily activities. 


Why Comprehensive Medical Evidence is Critical
for Your Social Security Disability Benefits Due to Diabetes

The SSA does not approve claims based solely on a diagnosis of diabetes. Instead, they need to see how the disease impacts your ability to engage in substantial gainful activity (SGA). By providing detailed medical evidence, you show the extent of your limitations and increase your chances of receiving benefits.

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Article Medically reviewed by Paige Polakow, President, Trajector Medical

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Tips for Veterans

Navigating the VA claims process can be challenging, but these tips can simplify your journey.

  • Maintain Medical Records: Keep detailed records of all treatments and symptoms.
  • Seek Medical Opinions: Ensure your doctor provides a clear link between your primary and secondary conditions.
  • Be Persistent: Many claims are approved after appeals.


Understanding and claiming VA benefits for secondary conditions can seem daunting, but you’re not alone. With proper medical evidence, support from accredited representatives, and persistence, you’re positioned to secure the benefits you deserve.

Discover how our medical evidence service is transforming lives

Clear and concise medical documentation is crucial for the success of any disability claim. If you’re unsure about your documentation, talk to one of our licensed medical experts for FREE.

And know that at the heart of everything we do at Trajector Medical are the stories of our clients. We are proud to say that we have surpassed 1,000 recorded testimonial videos on our YouTube Channel. Real people that we have helped by building supporting medical evidence that they used to pursue the disability benefits they choose.

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Related FAQs:

How important is HbA1c in a disability claim for diabetes?

HbA1c (the blood test that measures a person’s average blood sugar levels) are critical as they reflect long-term blood sugar control and indicate the likelihood of complications.


What complications of diabetes can qualify for disability?

Complications like neuropathy, retinopathy, amputations, chronic kidney disease, and heart disease can support your claim.


Can I get SSDI for diabetes?

Yes, but you’ll need to show that your diabetes significantly impairs your ability to work by providing comprehensive medical evidence.


*Trajector Medical is not an accredited attorney or agent and does not represent veterans before the VA. This article is provided as information only. For more information, see the Department of Veteran’s Affairs FAQs at https://www.va.gov/disability/how-to-file-claim/ or consult with a VSO or other accredited representative. For expert medical evidence development in support of your VA claims, contact Trajector Medical today.

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