If you or someone you know has an endocrine disorder such as diabetes mellitus, you may have a disability that meets the criteria established by the Social Security Administration’s (SSA) Listing of Impairments (the “Listings”). The Listing of Impairments lists impairments considered severe enough to prevent an individual from performing substantial gainful activity (SGA), which is work that earns income above a certain income threshold per month.

Diabetes Mellitus (DM) is the most common of any pancreatic gland disorder, It consists of two major types: type 1 and type 2, which are both chronic disorders that can have serious disabling complications that meet the duration requirement. Diabetes mellitus and other pancreatic gland disorders disrupt the production of several hormones such as insulin that regulate metabolism and digestion. Insulin is essential to the absorption of glucose from the bloodstream into body cells for conversion into cellular energy.

Type 1 DM, previously known as “juvenile diabetes” or “insulin-dependent diabetes mellitus” (IDDM) is an absolute deficiency of insulin production that commonly begins in childhood and continues throughout adulthood. Treatment of type 1 DM always requires lifelong daily insulin.

Type 2 DM, previously known as “adult-onset diabetes mellitus” or “non-insulin-dependent diabetes mellitus” (NIDDM), is a condition where the body’s cells resist the effects of insulin, impairing glucose absorption and metabolism. Treatment of type 2 DM generally requires lifestyle changes, such as increased exercise and a modified diet, and occasional insulin with other medications. While both types of DM are usually capable of being controlled by treatment, some individuals may continue to have problems because of hypoglycemia unawareness, affected blood glucose levels, mental disorders, or simply insufficient medical treatment.

Both types of DM cause hyperglycemia, an abnormally high level of blood glucose capable of causing both short-term and long-term complications. Short-term complications of hyperglycemia include diabetic ketoacidosis (DKA) while long-term complications include a multitude of conditions affecting many body systems.

DKA is an acute, potentially life-threatening complication of DM where the chemical balance of the body becomes hyperglycemic and acidic to the point of being dangerous. It typically results from a severe insulin deficiency and requires hospital treatment to correct short-term complications of insulin deficiency, dehydration, and electrolyte imbalances.

Individuals with DM may experience episodes of hypoglycemia, which may be treated by consuming substances containing glucose. Some individuals may not undertake this remedial action because of unawareness about their hypoglycemia. Severe hypoglycemia can lead to complications, including seizures or loss of consciousness, which are evaluated under neurological disorders, or altered mental status and cognitive deficits, which we evaluate under mental disorders.

Diabetes can ravage the body. I have had clients literally go blind. I have seen clients require amputations of toes and even a foot. I have seen clients with horrific ulcers that never seem to heal.  Some clients have terrible peripheral neuropathy that causes serious pain in their hands and feet. I have seen a person complain that their fingers have been stuck so many times, they cannot use them anymore. Some people get such bad neuropathy they cannot feel their feet and have to visually examine to make sure they did not step on a nail or injure the foot.

It is particularly important that diabetic patients work with their doctors and remain compliant.  In many cases, diabetes can be medically managed. If someone will not take their insulin or won’t stop eating sweets or drinking alcohol, it makes it hard to win the case. I have seen clients swear they take their insulin, only to get a pharmacy printout showing they rarely even buy it.  If there is a good reason for noncompliance (no money, no insurance) so be it, but just remember:  work with your doctor.

The Sullivan Law Office provides assistance in ensuring that all applicants and recipients receive all of the benefits to which they are entitled in all types of disability cases. These include Social Security Disability, long-term disability, short-term disability, state retirement and workers’ compensation. Every application for social security benefits requires the consideration of a substantial list of issues over the life of a case. It’s one matter to apply for and receive benefits, but it’s another to understand what happens after this occurs over the long road ahead. The Sullivan Law Office provides over twenty years of experience and can represent and assist you throughout the entire process in all disability cases.Identifying Your Disability Under The Listing Of Impairments: Adult Endocrine Disorders - Part 2