What this listing covers
Chronic liver disease involves the loss of liver function due to inflammation, scarring, or cell death that persists for more than six months. Common causes include long-term alcohol use or chronic infections like hepatitis B or C.
This condition often causes debilitating fatigue, nausea, and severe itching. As your liver struggles, you may experience fluid buildup, confusion, or internal bleeding, which makes maintaining a consistent work schedule or performing physical tasks difficult.
How SSA evaluates a claim under this listing
Under Listing 5.05, SSA evaluates the severity of your liver disease based on specific complications. They look for evidence of gastrointestinal hemorrhaging, fluid accumulation in the abdomen or chest, or infections like spontaneous bacterial peritonitis.
SSA also considers severe complications such as hepatorenal syndrome, hepatopulmonary syndrome, or hepatic encephalopathy. Alternatively, they may use a calculated score based on laboratory values like serum creatinine and bilirubin to determine if your impairment meets the required level of severity.
Evidence that strengthens a claim
Your claim is strengthened by detailed medical records that document your diagnosis and the specific complications listed in 5.05. This includes imaging reports, endoscopy results, and laboratory findings like serum albumin, INR, and creatinine levels.
Non-medical evidence is also vital, including a thorough treatment history and statements from your doctors regarding your functional limitations. Documentation of hospitalizations for transfusions or paracentesis procedures provides clear proof of the severity of your condition.
How an attorney helps
A disability attorney helps you organize your medical records to ensure they directly address the specific criteria in Listing 5.05. They can work with your medical providers to obtain detailed statements that clarify how your symptoms prevent you from sustaining work. By guiding you through the documentation process and preparing you for potential hearings, an attorney ensures your claim presents the strongest possible case for benefits.
Frequently asked questions
Cirrhosis may qualify under Listing 5.05 if it results in severe complications like internal bleeding, fluid retention, or cognitive impairment. SSA requires medical documentation of these specific issues over a 12-month period. An attorney can review your medical records to see if your condition aligns with these requirements.
SSA reviews laboratory results such as serum albumin, INR, serum creatinine, and bilirubin levels. These values are often used to calculate a severity score or to document specific complications like hepatorenal syndrome. Having these reports readily available is essential for your application.
Hepatic encephalopathy is a recognized complication under Listing 5.05F when it causes documented cognitive dysfunction or changes in mental status. You must provide evidence of these episodes occurring at least 60 days apart within a year. A disability attorney can help you gather the necessary neurological and clinical reports.
If your claim is denied, you have the right to request a reconsideration and, if necessary, a hearing before an ALJ. You must file your appeal within the specific timeframe provided in your denial notice. An attorney can help you identify missing evidence and strengthen your case for the appeal process.
