Making a Living with Diabetes: Disability

Working a job with diabetes can be tough, sometimes impossible. If you run out of work options, you may qualify for disability pay. Here are some things to consider.


The Social Security Administration (SSA) has two disability programs: Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). SSDI is insurance most workers pay into through payroll taxes. Depending on how much you’ve paid into it, your monthly payments might range from about $700 to about $1,700 per month.

SSI is not insurance. It’s a need-based program for people who haven’t paid payroll taxes. SSI maxes out at about $730 per month for an eligible person and $1,100 per month for an eligible person with an eligible spouse.

Here’s a calculator that will give a very rough estimate how much you might get on SSDI. There are also private disability insurance plans you can buy into, or your employer may provide. Having one could make your life much easier, if you qualify as disabled.

Should you consider disability?
Nobody wants to go on disability. Work is too important a part of most people’s lives. Some people may feel they will be freeloading if they receive disability benefits. People will say you’re not contributing.

I reject those thoughts totally. I relied on SSDI for 15 years, since I could no longer work as a nurse. I have always regarded it as government paying me to do good things. I write books and health articles; I volunteer. I take care of myself and try to be of service. Like most people on disability, I spent all the payments on necessities, helping keep the economy going.

Being disabled might be embarrassing, but it can be lifesaving. A Forbes magazine piece quoted one woman with lung disease. “Emotionally, going on disability insurance was a Godsend, knowing I had the money coming in; it’s like going from drowning to taking a deep breath,” she said.

Disability doesn’t pay as much as a job. You’ll have to cut back on many things. But it does come with Medicare, so you will have health insurance.

You are allowed to earn limited amounts of money while on disability. The SSDI limit is about $1,100 per month. SSI has no limit but subtracts part of your earnings from your SSI payments.

Qualifying for disability
Having diabetes does not qualify you for disability, but symptoms or complications might. You must be “significantly impaired,” meaning unable to do “substantial” paid work.

• People with diabetes often qualify because of neuropathy. According to Social Security Disability Help (SSDH), nerve damage “must significantly affect two extremities to the extent that a person experiences a ‘sustained disturbance’ of movement of those extremities, or in walking, or in simply standing.”

• Poor glucose control might qualify you. If you go into acidosis that “occurs at least once in every two months and which is documented by blood tests,” you should qualify.

• If fatigue prevents you working a whole shift, or if health-related problems mean you will miss more than two days of work per month; that limitation may help you qualify for disability.

• According to SSDH, eye damage resulting in “a significant loss of peripheral vision or a significant loss of visual acuity in the better of the two eyes [qualifies you.]”

• Complications such as kidney failure, heart disease, or limb amputation could meet Social Security’s standards.

How to apply
You have to carefully fill out an application documented with all the medical records you can find. You have to convince them you can’t work like you used to. According to Nolo’s Aaron Hotfelder, “When filing for disability benefits for diabetes, it’s important to list all your symptoms and diagnoses, even those unrelated to your diabetes.”

Records from specialists seem to count more than from family doctors. Vision problems should be seen by an ophthalmologist, heart problems by a cardiologist, and so on. The idea is to document how your symptoms affect your work capacity.

“Getting a medical-vocational allowance is the most common way to get approved for disability benefits,” writes Hotfelder. “A medical-vocational allowance [starts with] your Residual Functional Capacity (RFC).”

SSA puts your RFC on an elaborate disability decision “grid.” They look at your “exertional” limitations — how much can you walk, lift, bend, sit, push, pull, and other physical things. They also examine your “non-exertional” limitations, like use of the hands, mental issues, and fatigue. They look at your age — it’s easier to qualify for disability if you’re older — skills and work experience, and combine it all to qualify you or reject you.

Get help
It’s hard to get disability. You will have a better chance with an advisor, who may be an attorney. Advisors’ fees are set by SSA, are only charged if you win, and are quite reasonable.

There are also many helpful websites such as Disability Benefits Help and Social Security Disability Resource Center (SSDRC).

You might need to bring your doctor forms like an RFC evaluation that you can get online here or from an advisor. SSA might insist you be evaluated by their doctors, a hassle you’ll have to put up with.

It’s normal to be rejected the first time you apply. SSDRC advises: Don’t file a new application; get some help and appeal. Applicants usually win eventually.

Applying for disability is a big decision. Don’t rush into it. Check out some of the links here and other sources. Talk to an advisor. Remember, long-term disability doesn’t have to mean permanent disability. Social Security will help you learn new skills and find new work if that is appropriate. Your health might improve. Your life might change for the better. If it seems like a match, go for it.

Want to learn more about diabetes and money matters? Read “Do’s and Don’t’s for Saving Money With Diabetes” and “Healthy Eating on a Budget.”

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  • Lorraine Starsky

    This is a good article by David Spero. However, based on my experience with family members, I would clarify a few things about Medicare. According to Social Security regulations, there can be up to a two-year wait for Medicare benefits even if you are deemed eligible for Social Security Disability Insurance (SSDI) if you are under 65. This can be quite a hardship for many people who are unable to work, because it means that they have to find insurance in the Marketplace, which can be quite costly, unless they are lucky enough to have a spouse whose employer offers a health plan that provides coverage. If you do not qualify for SSDI, because you do not have enough work quarters, then SSI is all that you are eligible for. Unfortunately, SSI doesn’t mean you qualify for Medicare (unless you are 65 or older). You may be eligible for your state’s Medical Assistance program (Medicaid). However, if you have a spouse who works, but doesn’t have employer provided health insurance, you may find that your state considers that your income exceed guidelines for your state’s Medical assistance program. That will throw you into the Marketplace, which happened to my cousin’s son and his wife. He is disabled and she workers as a server without health insurance. They applied for Medical Assistance in New Mexico and were denied as having too much income. The cheapest plan they could find in the Marketplace for the two of them was $450/month with a $5,000 annual deductible, which they can’t afford. They decide to go without health insurance and will pay the fine. This is outrageous, which is why as a nurse, I support a single payer health system. The “Affordable Care Act” is leaving too many sick and vulnerable people at the mercy of our the broken health system.

    • Thanks Lorraine for those important clarifications. We so need single payer in this country. Medical costs are not only impoverishing people but breaking up families like your cousin’s.