SSA Listing-5.05 Chronic Liver Disease
Chronic liver disease can significantly impact an individual's health, functionality, and ability to work. For those seeking Social Security Disability benefits, it is crucial to understand how the Social Security Administration (SSA) evaluates chronic liver disease cases. In this blog post, we will explore the different criteria outlined in listing 5.05 for chronic liver disease and the considerations made for disability purposes.
Evaluation Criteria for Chronic Liver Disease
The SSA utilizes listing 5.05 to evaluate chronic liver disease cases for disability purposes. The listing consists of several subsections, each with its own set of criteria. Let's take a closer look at each subsection:
A. Hemorrhaging from Varices or Portal Hypertensive Gastropathy: This subsection requires documented evidence, such as endoscopy, x-rays, or other medically acceptable imaging, showing hemorrhaging from esophageal, gastric, or ectopic varices or portal hypertensive gastropathy. The hemorrhaging should result in hemodynamic instability, requiring hospitalization and transfusion of at least 2 units of blood. Individuals meeting this criterion are considered disabled for one year following the last documented transfusion. Residual impairments are evaluated thereafter.
B. Ascites or Hydrothorax: This subsection focuses on the presence of ascites (abnormal fluid accumulation in the abdominal cavity) or hydrothorax (abnormal fluid accumulation in the chest cavity). To meet the criteria, these conditions must persist despite prescribed treatment and be documented in at least two evaluations, spaced at least 60 days apart within a consecutive 6-month period. Evaluation can be done through paracentesis or thoracentesis, or through appropriate imaging or physical examination accompanied by specific laboratory findings related to serum albumin levels or the International Normalized Ratio (INR).
C. Spontaneous Bacterial Peritonitis: This subsection requires the presence of spontaneous bacterial peritonitis, confirmed by peritoneal fluid analysis showing an absolute neutrophil count of at least 250 cells/mm3.
D. Hepatorenal Syndrome: Individuals must demonstrate hepatorenal syndrome with specific criteria, including elevated serum creatinine levels, oliguria (low urine output), or sodium retention with low urine sodium levels.
E. Hepatopulmonary Syndrome: This subsection focuses on arterial oxygenation levels (PaO2) and the documentation of intrapulmonary arteriovenous shunting through specific tests like contrast-enhanced echocardiography or macroaggregated albumin lung perfusion scan.
F. Hepatic Encephalopathy: This subsection requires documentation of abnormal behavior, cognitive dysfunction, or changes in mental status on at least two evaluations, at least 60 days apart within a consecutive 6-month period. Additional criteria include a history of specific medical interventions, fluctuating physical neurological abnormalities, abnormal electroencephalogram (EEG) results, or specific laboratory findings related to serum albumin levels or INR.
G. End Stage Liver Disease (ESLD): This subsection considers SSA CLD scores of 22 or greater calculated as described in 5.00D11. Disability is considered from at least the date of the first score.
Conclusion
Navigating the Social Security Disability process for chronic liver disease requires a comprehensive understanding of the specific evaluation criteria outlined in listing 5.05. Whether it involves hemorrhaging, ascites, bacterial peritonitis, hepatorenal syndrome, hepatopulmonary syndrome, hepatic encephalopathy, or end-stage liver disease, meeting the criteria and providing proper documentation is crucial for disability consideration.
If you or a loved one is affected by chronic liver disease and believes you meet the criteria outlined in listing 5.05, it is essential to gather all relevant medical evidence and work with a qualified disability advocate or attorney to ensure a comprehensive and strong disability claim. Understanding the evaluation process can help individuals navigate the complexities of the SSA's disability system and increase their chances of receiving the support they need.