When it comes to evaluating disability for persons who have diabetes, either Type I or Type II, Social Security regulations have undergone significant changes in the last 10 years. For many years, the Social Security Administration had a specific “listing of impairment” that included diabetes mellitus. However, about 10 years ago they dropped diabetes from their listings of impairments and merely instructed their judges that they should recognize that diabetes will eventually affect other body systems such as the eyes (diabetic retinopathy), the hands and feet (diabetic neuropathy), or the kidneys (diabetic nephropathy) and to merely look at the listings of impairments for those body parts that corresponded with the eventual damage from the diabetes.
The Social Security Administration has recently published an advisory ruling that guides their Administrative Law Judges and staff in assessing disability with persons suffering from diabetes mellitus. It is SSR 14–2p.
Within SSR 14-2p, adjudicators and judges are reminded that the combined effect of diabetes mellitus, and other impairments can be greater than the effects of each of the impairments considered separately. For example, adults with diabetes mellitus with resulting neuropathy may have considerable difficulty walking, operating foot controls, or manipulating objects because they lost the ability to sense them with the hands or feet. Adults with chronic hypoglycemia from diabetes may experience fatigue or difficulty with concentration that interferes with their ability to perform activity on a sustained basis.
The new regulations specifically recognize that diabetes mellitus, or DM, can cause autonomic neuropathy wherein nerves are damaged that effect the heart, blood vessels, digestive system, and urinary tract, which thereby produces problems with dizziness, fainting, nausea, vomiting and infrequent or frequent urination. It doesn’t take much imagination to see how this would affect someone’s ability to work.
The new regulation also reminds the Social Security Administration staff, and Administrative Law Judges, that hypoglycemia is also a common result of being insulin-dependent. It is a term to describe when someone has an abnormally low level of blood glucose, sometimes known as an insulin reaction. It can cause signs and symptoms of weakness, hunger, sweating, trembling, nervousness, palpitations, and difficulty with concentration.
These are often signs and symptoms that the Social Security Administration, or even the Administrative Law Judges hearing the cases, forget to consider when addressing someone’s disability.
We are certainly glad to see that the Social Security Administration has taken steps to educate their staff and Administrative Law Judges.