Edema and SSDI/SSI

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By Kimberly BishopJanuary 22, 2024

This post discusses disability for edema (Social Security Disability Insurance and Supplemental Security Income). If edema is preventing you from working, read on for how the Social Security Administration will evaluate your claim for disability benefits.

The Bishop Law Firm has represented Social Security disability clients since 2009. Call us for a free case review at 919-615-3095 or start online now.

What is edema?

Edema is excessive fluid that has built up in your tissues. Commonly edema occurs in your extremities (hands, feet, and legs). However,  edema can also be in your lungs (pulmonary edema), in the deep veins of your leg (deep vein thrombosis), and eyes (macular edema) among other places.

Edema is classified as pitting or non-pitting. Pitting edema (most common form) can be demonstrated by applying pressure to the swollen area by depressing the skin with a finger. If the pressing causes an indentation that persists for some time after the release of the pressure, the edema is referred to as pitting edema.

Doctors usually categorize pitting edema on a 1 - 4 scale (with level 4 taking more than 30 seconds for the skin to rebound). Non-pitting (brawny edema) does not result in a persistent indentation and is common in those assessed with lymphedema (Via Medicine.Net).

The first step for anyone suffering from symptoms of edema is to visit a doctor and find out what is causing it. There are many underlying conditions that cause edema and the condition must be treated as well as the edema.

Some examples of health conditions that can cause edema are cancer treatment, congestive heart failure; liver damage; kidney disease; chronic venous insufficiency and lymphatic system issues, to name a few (Via The Mayo Clinic).

Also read: Cancer and Disability; Congestive Heart Failure and Disability; Disability for Kidney Disease;

Lymphedema occurs when the body's lymphatic system does not drain properly. Damage to lymph nodes or anything that blocks a lymph node can cause lymphedema (Via The Mayo Clinic).

Radiation kills healthy tissue as well as cancer. Unfortunately, this can damage lymph nodes and block drainage of lymph fluid (via NIH).

Extreme obesity can cause lower extremity lymphedema and in some cases the lymphedema does not resolve even with substantial subsequent weight loss (via NIH).

Also read Obesity and Social Security Disability

Many times a diagnosis of lymphedema is given based on signs and symptoms during physic exam, but Stanford University has found a way to test the blood to adequately predict lymphedema.

With lymphedema, early detection can make all the difference.

Treatment for edema is based on the underlying cause of the edema. Lasix (furosemide) is frequently prescribed for those suffering from heart disease related edema. Blood thinners are often given to those whose edema stems from blood clots. Sodium restricted diets are also recommended. For lymphedema: wrapping, physical therapy, compression garments, massage and even surgery are options (Via WebMD).

Types of Social Security Benefits for the Disabled

The first step to attaining Social Security Disability benefits is to apply for benefits online or at your local SSA office. When you apply for benefits, the SSA office will determine which of two (generally) types of benefits you are eligible to apply for (SSDI or SSI).

You must be found disabled before you are entitled to either benefit.

Social Security Disability Insurance (SSDI)

SSDI (Social Security Disability Insurance) is based on the credits from the work you have done in your life. You must be found disabled before your date last insured (DLI) to be found eligible for SSDI. Your DLI is calculated by counting your “quarters of coverage” from your earnings record. You must have 20 “quarters of coverage” of the last 40 quarters. Simply put, you must have worked 5 years of the last ten years (in general). In addition, Adult Disabled Children can be eligible for benefits off their parent’s account.

Supplemental Security Income (SSI)

SSI (Supplemental Security Income) is a need-based program and you must meet income/asset standards in addition to being found disabled under the five steps above. In 2024, SSI is $943 a month for an individual and $1,415.00  for an eligible couple. SSI will be reduced by 1/3 if you are receiving financial help from others. In NC, SSI recipients are also entitled to Medicaid.

Disability benefits for edema

Is edema a disability? The Social Security Administration does not have a listing specifically for edema but your disability claim may be approved based on the underlying cause of your edema.

This is why medical evidence diagnosing the cause as soon as possible is imperative, both for your health and your disability case. Medical records are required to prove your disability to SSA.

The Social Security Administration can evaluate your claim for disability under the impairment that is causing your edema using the Listing of Impairments. The listings are usually difficulty to meet but can be helpful in some cases.

If you are over 50 years of age, the Grids (Medical Vocational Guidelines) may prove more helpful if your edema prevents you from doing worker at higher than the sedentary level.

For those under 50, even sedentary work requires standing and walking for 2 hours out of an eight hour day. Severe swelling in the legs can cause limited mobility even when following prescribed treatment that makes walking 2 hours a day impossible.

Range of motion can be significantly limited by severe cases of swelling, tightness, and pain.

In my clients with edema, diuretics, elevation, and compression stockings usually help to relieve the swelling but this is a daily time-consuming battle. Also, the swelling can increase with walking, sitting, or standing for even short periods.

If edema is preventing you from working, file your claim for Social Security Disability benefits as soon as possible and schedule an appointment with your doctor to find out what medical condition is causing swelling.

If you have been denied benefits, be sure to appeal the denial within 60 days or you will have to start your claim over at the being.

The Bishop Law Firm represents Social Security Disability clients in RaleighDurhamFayettevilleCaryRocky MountWilsonSmithfieldLouisburgChapel HillRoanoke RapidsWinston SalemGarnerGreensboroGreenville and surrounding areas in North Carolina. Call us today for a free case review, (919) 615-3095 or start online now.

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