What this listing covers
Chronic kidney disease is a condition where your kidneys gradually lose their ability to filter waste and excess fluid from your blood. Over time, this damage can lead to the buildup of toxins, which may cause significant health complications throughout your body.
This condition often impacts your ability to perform daily tasks, such as maintaining a consistent work schedule due to fatigue, fluid retention, or the need for frequent medical treatments. Severe symptoms like bone pain, nerve damage, or persistent swelling can make it difficult to sit, stand, or concentrate for extended periods.
How SSA evaluates a claim under this listing
Under Listing 6.05, the SSA evaluates your kidney function through specific laboratory findings. They look for evidence of reduced glomerular filtration, such as an eGFR of 20 ml/min/1.73m2 or less, or serum creatinine of 4 mg/dL or greater, documented on at least two occasions at least 90 days apart within a 12-month period.
Beyond lab results, the SSA requires evidence of a severe complication, such as persistent bone pain, nerve damage, fluid overload, or significant weight loss due to loss of appetite. These conditions must be documented as lasting or expected to last for at least 12 months, demonstrating that your impairment prevents you from engaging in substantial work.
Evidence that strengthens a claim
Your claim is strengthened by consistent medical records that document your kidney function over time. This includes pathology reports from any kidney or bone biopsies, detailed reports of your response to treatment, and specific laboratory findings like serum creatinine or eGFR levels.
Documentation of hospitalizations for complications like heart failure or hypertensive crisis, along with reports describing your daily limitations, helps provide a complete picture of your health to the SSA. A disability attorney can help you gather this evidence to support your claim.
How an attorney helps
A disability attorney helps by ensuring your medical records clearly map to the specific criteria in Listing 6.05. They can assist in gathering necessary lab reports and physician statements that document your functional limitations, which are often the missing pieces in a claim. By organizing your evidence and preparing you for potential hearings, an attorney can help you navigate the complex SSA process with a focus on presenting your case accurately.
Frequently asked questions
No, there is no automatic qualification. You must prove that your kidney function meets the specific laboratory thresholds in Listing 6.05 and that you suffer from a qualifying complication like neuropathy or fluid overload. An attorney can review your medical records to see if they meet these requirements.
The SSA looks for evidence of reduced glomerular filtration, such as a serum creatinine of 4 mg/dL or greater, or an eGFR of 20 ml/min/1.73m2 or less. These findings must be documented on at least two occasions at least 90 days apart. A disability attorney can help ensure your lab reports are properly submitted.
If you are on chronic hemodialysis or peritoneal dialysis, the SSA evaluates your condition under Listing 6.03. You must show that your dialysis is expected to be ongoing for at least 12 months. An attorney can help you document your treatment history to align with SSA standards.
If your claim is denied, you have the right to appeal through the reconsideration process and, if necessary, a hearing before an ALJ. You must file your appeal within the designated timeframe. An attorney can help you identify why your claim was denied and strengthen your evidence for the next stage.
