Getting Disability Benefits and Payments for Hepatitis C

The hepatitis C virus (HCV) infection is one of the most common chronic infections in the United States.  Approximately 3.2 million people are living with this disease each day.  The infection is transmitted through large or repeated exposure to infected blood or through the use of injecting drugs and is the leading cause of liver cancer.  Many individuals do not know that they have become infected, as they are not clinically ill.  Each year, more than 17,000 people become infected with hepatitis C and serve as a source of transmission to others. 

Symptoms and Impairments

HCV can be detected in blood within one to three weeks after exposure.  The average time from exposure to antibody

The following symptoms can occur with the hepatitis C infection:

• Abdominal pain (right upper abdomen)
• Ascites (excess fluid between the abdomen and peritoneal cavity)
• Bleeding varices (dilated veins in the esophagus)
• Dark urine
• Fatigue
• Generalized itching
• Jaundice
• Loss of appetite
• Low-grade fever
• Nausea
• Pale or clay-colored stools
• Vomiting

The majority of people infected with hepatitis C can lead normal healthy lives.  However, some will develop serious liver disease that will dramatically affect their quality of life.  Currently, there is no cure for hepatitis C; however, medications in some cases may be able to suppress the virus for lengthy periods of time.  However, some of the drugs, such as Interferon have serious side effects and leave patients with flu-like symptoms early on.

Patients with chronic hepatitis C infection frequently experience the following impairments:

• Fatigue and lack of energy
• Physical or mental weariness
• Depression
• Inability to function effectively

Chronic hepatitis C is a serious condition, which damages the liver and can lead to fatal liver diseases such as cirrhosis of the liver, liver failure, and liver cancer and is the most common reason for needing a liver transplant.

Getting Disability Benefits for Hepatitis C

For People Who Are Employed

If you have been infected with hepatitis C, you may need to take several weeks or months off from work, or you may have to stop working altogether because symptoms from the infection or side effects from treatment have become disabling.  You may qualify for short-term or long-term disability coverage, depending your individual situation.  You will need to complete the appropriate claim forms and submit them through your employer.  The amount of money you’ll receive is a percentage of your salary at the time of disability with a maximum cap paying benefits of up to five years.

Self-Employed or Unemployed

If are self-employed or your employer doesn’t offer disability insurance, you can purchase an individual disability insurance policy.  If you are not working, the Social Security Administration provides programs for people who cannot work due to a medical condition.  The Social Security Disability Insurance program pays benefits to you if you have worked in the past and paid Social Security taxes.  You can apply directly online at the Social Security Administration website.

To qualify for disability, your infection must have disabled you to such a degree that you are unable to work.  Your doctor’s report will be the most important evidence of this.  The amount of Social Security Disability benefits an individual will receive depends on how much they worked and earned in the past.  A disabled person may be eligible to receive up to $579 per month.  Social Security Disability Insurance pays a monthly benefit based on the amount of FICA payroll taxes the individual has paid into Social Security over his/her working career.  The benefit may be anywhere from one dollar per month to around $1939 per month.

Why a Claim is Denied and How to Appeal

Don’t be surprised if you are denied at the initial stage.  Only 40% of claims are approved at this stage.  This denial may mean that you or your healthcare provider did not provide enough information needed to prove your claim.  After you receive your letter of denial, you have 60 days from that date to ask Social Security to reconsider its decision.  You must submit the “Reconsideration Disability Report” and the “Request for Reconsideration” forms.  You should attach medical records that show your symptoms are more severe than the original medical records stated, any new medical records that provide proof of your condition, and any documentation that shows your condition meets one of the listings of impairments used by Social Security.

Your claim will be assigned to a disability analyst.  If your reconsideration appeal is denied, the next level of appeal is a hearing before an Administrative Law Judge (ALJ).  You will be given an opportunity to present your case and the judge will decide whether your claim should be approved or denied.  If your case is denied at the ALJ level, you may appeal to Appeals Council.  You do not appear before the council.  It reviews your file and the transcript of the ALJ hearing in order to make a decision.

Getting Help from a Disability Lawyer

The SSDI and SSI application process is extremely long and complex and only 35% of all claims are approved at their initial filing.  Hiring an experienced Social Security Disability attorney can help you through this process and will be able to assist you with the necessary appeals.  A legal professional can assist you in obtaining financial assistance through the government and are paid only if SSD or SSI benefits are awarded.  The fees are regulated by the Social Security Administration and are limited to 25% of retroactive benefits or $6,000; whichever is less.  They can review your application before you submit and can provide a free legal consultation of your individual case.