Hepatitis C is a viral infection that is contracted by exposure to infected blood. Those most at risk of contracting Hepatitis C are people on long-term kidney dialysis, people who have regular contact with blood in the workplace, and people who engage in unprotected sex or who share needles with someone infected with the virus.
Most people who have been recently infected by the Hepatitis C virus have no symptoms. However, a chronic infection may lead to abdominal pain and swelling, internal bleeding, fatigue, itching, jaundice (yellowing of the skin), and nausea. More severe cases of Hepatitis C can result in cirrhosis of the liver or liver cancer, either of which may ultimately require a liver transplant.
Hepatitis C can be treated with a combination of medicines, but the side effects of these medications are often quite severe. It is important that a doctor closely monitor a patient’s medications and side effects when treating someone for Hepatitis C.
Qualifying for Disability Benefits With Hepatitis C
If you have been diagnosed with Hepatitis C and your symptoms are severe, you may qualify for Social Security disability benefits (either SSI or SSDI) if your illness meets the criteria established by the Social Security Administration’s (SSA) Listing of Impairments (Listing 5.05 Chronic Liver Disease), or if the SSA finds that because of the disabling effects of your illness there are no jobs you can be expected to do. Also, your impairment must have lasted at least a year, or be expected to last at least a year (unless you are terminally ill).
Qualifying Under the SSA Listing for Chronic Liver Disease
To meet the requirements of Listing 5.05 and be automatically approved for disability benefits, you must be diagnosed with chronic liver disease (as defined by the SSA) and have experienced one of the following complications:
- gastrointestinal hemorrhage
- ascites (excess fluid in the peritoneal cavity) or hydrothorax (fluid in the pleural cavity)
- spontaneous bacterial peritonitis
- hepatorenal syndrome
- hepatopulmonary syndrome
- hepatic encephalopathy, or
- end-stage liver disease.
The full Listing requirements for Hepatitis C are complicated; it may be helpful to ask your physician whether your illness meets the criteria of listing 5.05, Chronic Liver Disease.
If you don't meet the requirements of listing 5.05, the SSA will not automatically approve you based on your Hepatitis C infection. However, if you are able to show that, because of the symptoms of the infection or the side effects from medication, your level of functioning (your "residual functional capacity" (RFC), discussed below) is so low that you can't do any work, you may still qualify.
Medical Evidence Required to Support Hepatitis C Disability Claim
The more medical evidence you have when you apply for disability, such as lab work, x-rays, ultrasounds, biopsies, and doctor’s records, the more likely it is you will be approved. When you apply, be sure to provide the SSA with the names of all the doctors you have seen for treatment for your Hepatitis C, and all the hospitals or labs that have performed blood work, scans, or other tests to treat or diagnose your Hepatitis C, and a complete list of the medications you are taking.
Side effects from medications are important information that applicants often overlook when applying for disability. In particular, the mental side effects of the medications for Hepatitis C can be especially debilitating. Many people on interferon, a drug commonly used to treat Hepatitis C, experience difficulty thinking or with memory, severe depression, mood swings, and suicidal thoughts.
Some people also have significant physical side effects from some drug treatments for Hepatitis C; they include chest pain, heart attacks, inflammation of the bowels, and autoimmune disorders (where the immune system attacks one or more parts of your body). If you suffer from any of these side effects, it is important that you keep you doctor informed so that she may document them in your medical records and treat you accordingly.
Qualification Based on a Reduced Residual Functional Capacity
If you aren't able to qualify for disability for your Hepatitis C based on the listing 5.05 requirements, you may be able to qualify for disability if you can show that the combined effect of your illness and side effects from medications make it impossible for you to perform any jobs. This route is easier for individuals over the age of 50 and for those who don't have much education.
The term residual functional capacity (RFC) means what you are able to do, both mentally and physically, despite the symptoms of your impairment and medication side effects. Your doctor is the most important source of information in determining your RFC. Be sure that your doctor notes in your records any specific physical limitations you have as a result of your impairment or from the side effects from medications. The side effects of Hepatitis C treatment are often the most debilitating part of the disease, so it is important that you report all of your symptoms to your doctor (and to the SSA). The SSA prefers medical evidence from doctors who are specialized in treating your illness.
When determining your physical RFC, the SSA will look at such factors as how long you can walk, sit or stand; how much you can lift, push and pull; and whether you have any significant problems hearing, seeing, or communicating.
For example, if the SSA determines that you are only able to sit or stand for 10 minutes at a time and lift no more than 10 pounds, then your physical RFC should be “less than sedentary.” This RFC would prevent you from doing any jobs and the SSA would find you disabled. However, if the SSA determines you are able to sit or stand for 6 hours or more and lift at least 20 pounds on a regular basis, your RFC would probably be for light work, which would be high enough to allow you to do most jobs. However, if you are over 50 or have little formal education, you might qualify for a medical-vocational allowance.
To determine your mental RFC, the SSA will consider such things as how your impairment or side effects from medication impact your ability to get along with others, make decisions, maintain focus, follow directions, remember job instructions, and be reliable. For example, if your medication makes it extremely difficult to focus on, remember instructions for, and follow through on even simple job tasks (like placing a box on a conveyor belt), then the SSA will consider you to have a reduced mental RFC. A low mental RFC makes it less likely you can perform even the most basic jobs, and more likely that you will qualify for disability. If your Hepatitis C or side effects from medication cause significant mental impairments, it is important to seek medical care from a psychiatrist or other doctor specializing in mental health.
How to Apply for Disability Benefits for Hepatitis C
If you are applying for SSDI only, you may be able to apply for benefits online at http://www.ssa.gov/pgm/disability.htm. You can also call 800-325-0778 or go directly to your local SSA field office to apply for SSI or SSDI. Office locations can be found at http://www.ssa.gov/regions/.
Remember that people are often denied simply because they fail to provide adequate medical information to the SSA; therefore it is important to give as much medical information as possible when you first apply. The SSA will also ask for financial information and for your work history.
If you do not meet the listing requirement for Hepatitis C, and need to qualify for disability benefits under an RFC or medical-vocational allowance (which is how most people qualify), the process can take well over a year before a final decision is made in your case. Don’t forget that most applications are denied initially and that you have a right to appeal that denial. Pay attention to all deadlines for appealing SSA decisions, or you may have to start the process all over again.