Get Social Security Disability & SSI: Liver Disease & Cirrhosis

Winning Your Case

What Does Social Security Look For With Liver Disease

Liver disease is a complex Social Security & SSI disability case. Liver disease (also called liver cirrhosis) is scarring of the liver. It is due to many causes including high cholesterol, high blood pressure, alcohol use, hepatitis, a virus, an autoimmune disorder, drug/medicine use, and a wide variety of toxins. The more liver tissue that turns to scar tissue, the more abnormally the liver functions.

Liver disease is diagnosed by blood tests and a liver biopsy (a small needle is injected into the liver and a tissue sample is removed). A doctor may also perform a CT, MRI, or ultrasound to view your liver. Liver treatment is quite limited, and it primarily includes immunosuppressants and stopping the cause of the cirrhosis. Vaccines are prescribed if a virus is present. Liver damage can improve somewhat. But, if you reach stage 4 liver disease, a liver transplant will be necessary.

Social Security appreciates that common symptoms vary based on the stage of liver disease, but usually include the following:

1. Fatigue,
2. Nausea,
3. Stomach ascites (fluid buildup),
4. Varices (enlarged veins),
5. Edema,
6. Pain,
7. Weight loss,
8. Easy bruising, and
9. Jaundice (yellow skin).

There are four stages of liver cirrhosis:

1. Stage 1 - Minimal liver dysfunction and mild symptoms or no symptoms,
2. Stage 2 - Moderate liver dysfunction and mild to moderate symptoms,
3. Stage 3 - Moderate-severe liver dysfunction and moderate-severe symptoms,
4. Stage 4 - Severe liver dysfunction with severe symptoms and fatality without a transplant.

If your medical treatment shows you have typical diagnostic testing with severe findings (stage 4 liver disease/cirrhosis), ongoing treatment, and you have serious symptoms reported by your doctor, you will be found disabled. If your medical treatment demonstrates all the same testing, treatment, and symptoms, but you have stage 3 liver disease/cirrhosis, you will usually need to meet a grid rule to be found disabled (over age 50). Stage 1 and stage 2 liver disease/cirrhosis alone is rarely a basis for Social Security disability benefits; you will need to suffer other medical conditions as well.

The Liver Disease & Cirrhosis Social Security & SSI Listing

The Adult Listing 5.05 is satisfied if an adult meets any one of criteria one to seven. The Child Listing 115.05 is satisfied if a child meets any one of criteria one through eight.

1. Hemorrhaging from esophageal, gastric, or ectopic varices from portal hypertensive gastropathy,
2. Ascites or hydrothorax,
3. Spontaneous bacterial peritonitis,
4. Hepatorenal syndrome,
5. Hepatopulmonary syndrome,
6. Hepatic encephalopathy,
7. End-stage liver disease, or
8. Extrahepatic biliary atresia.

If you need a liver transplant, the listing is Adult Listing 5.09 and Child Listing 105.09. Social Security will consider you or your child disabled for one year following the transplant. Then, Social Security will re-evaluate you or your child to determine if disability continues.

TERI: Terminal Disease Case

With stage 4 liver disease, Social Security can classify your disability case as a TERI case - the liver disease is a terminal impairment, it is untreatable, and it is expected to result in death. Social Security will speed up the adjudication process in a TERI case - Expedited Cases.