Cirrhosis, Hepatitis, and Liver Damage

Cirrhosis, hepatitis and liver damage have different initial causes but often the same or similar symptoms of chronic abdominal pain, fatigue and malaise (feeling sick).  If you feel sick and tired all the time, chances are you are not going to be able to attend work regularly or concentrate on work when you are there.  In most cases, this is exactly what we need to get your doctors to say to get you approved for benefits.  It is very important that you are compliant with treatment.

In many (but not all!) cases, liver problems stem from substance abuse.  If you have had a substance abuse problem, it is very important that you get sober.  Although the issue is the extent of the damage done so far, the judges still want to see that you are doing everything you can do to help yourself.  As with any disability case, compliance with recommended treatment, such as quitting drinking, is going to be critical in proving your case.

There are regulations that govern whether or not your liver disease is severe enough for you to be considered disabled on the basis of your liver disease alone.  I have copied these regulations here:

5.05  Chronic liver disease, with:

  1. Hemorrhaging from esophageal, gastric, or ectopic varices or from portal hypertensive gastropathy, demonstrated by endoscopy, x-ray, or other appropriate medically acceptable imaging, resulting in hemodynamic instability as defined in 5.00D5, and requiring hospitalization for transfusion of at least 2 units of blood. Consider under disability for 1 year following the last documented transfusion; thereafter, evaluate the residual impairment(s).

OR

  1. Ascites or hydrothorax not attributable to other causes, despite continuing treatment as prescribed, present on at least 2 evaluations at least 60 days apart within a consecutive 6-month period. Each evaluation must be documented by:
  2. Paracentesis or thoracentesis; or
  3. Appropriate medically acceptable imaging or physical examination and one of the following:
  4. Serum albumin of 3.0 g/dL or less; or
  5. International Normalized Ratio (INR) of at least 1.5.

OR

  1. Spontaneous bacterial peritonitis with peritoneal fluid containing an absolute neutrophil count of at least 250 cells/mm3.

OR

  1. Hepatorenal syndrome as described in 5.00D8, with on of the following:
  2. Serum creatinine elevation of at least 2 mg/dL; or
  3. Oliguria with 24-hour urine output less than 500 mL; or
  4. Sodium retention with urine sodium less than 10 mEq per liter.

OR

  1. Hepatopulmonary syndrome as described in 5.00D9, with:
  2. Arterial oxygenation (PaO2) on room air of:
  3. 60 mm Hg or less, at test sites less than 3000 feet above sea level, or
  4. 55 mm Hg or less, at test sites from 3000 to 6000 feet, or
  5. 50 mm Hg or less, at test sites above 6000 feet; or
  6. Documentation of intrapulmonary arteriovenous shunting by contrast-enhanced echocardiography or macroaggregated albumin lung perfusion scan.

OR

  1. Hepatic encephalopathy as described in 5.00D10, with 1 and either 2 or 3:
  2. Documentation of abnormal behavior, cognitive dysfunction, changes in mental status, or altered state of consciousness (for example, confusion, delirium, stupor, or coma), present on at least two evaluations at least 60 days apart within a consecutive 6-month period; and
  3. History of transjugular intrahepatic portosystemic shunt (TIPS) or any surgical portosystemic shunt; or
  4. One of the following occurring on at least two evaluations at least 60 days apart within the same consecutive 6-month period as in F1:
  5. Asterixis or other fluctuating physical neurological abnormalities; or
  6. Electroencephalogram (EEG) demonstrating triphasic slow wave activity; or
  7. Serum albumin of 3.0 g/dL or less; or
  8. International Normalized Ratio (INR) of 1.5 or greater.

OR

  1. End stage liver disease with SSA CLD scores of 22 or greater calculated as described in 5.00D11. Consider under a disability from at least the date of the first score.

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