Social Security Disability, End Stage Renal Disease, and Going Back to WorkExcerpt from below: Social Security considers End Stage Renal Disease to be a severe impairment, which could reasonably cause an individual to have significant limitations. In fact, an individual that has to have chronic hemodialysis or peritoneal dialysis due to irreversible kidney failure is an automatic approval for Social Security Disability. Additionally, an individual who has had a kidney transplant is an automatic approval for disability for at least twelve months. After twelve months, Social Security will review the individual's disability claim to ascertain if the individual has had medical improvement. Medical improvement depends upon various factors such as post transplant renal function, the occurrence and severity of renal infections, rejection crisis, or incidence of systemic complications (anemia, neuropathy, etc.), or even the side effects of medication such as corticosteriods and immune suppressant medications. Consequently many individuals who have kidney transplants continue to receive disability benefits. Recently, someone asked the following question, 'Should I refuse my Social Security Disability approval that is based upon End Stage Renal Disease and return to work because I am feeling better at this particular time?' She went on to state that she has End Stage Renal Disease that currently does not require dialysis, however she has had the surgery to place the dialysis access and has had the final tests for a kidney transplant should a kidney become available. In this situation, she filed for Social Security Disability thinking it would take many months to be approved for disability. However, she was surprised when she was approved on her initial disability application. She is in a quandary, because she would like to return to work. Should she refuse her Social Security Disability benefit and return to work or should she just count herself lucky and hang on to her disability benefit because she may not be so fortunate the next time she files for disability? Sometimes it's impossible to advise someone as to what would best suit his or her individual life situation. However, I can explain the criteria used to establish disability based upon End Stage Renal Disease, how work might affect her ability to remain entitled to disability, and what she should do prior to making any decisions with regard to her disability. Firstly, Social Security considers End Stage Renal Disease to be a severe impairment, which could reasonably cause an individual to have significant limitations. In fact, an individual that has to have chronic hemodialysis or peritoneal dialysis due to irreversible kidney failure is an automatic approval for Social Security Disability. Additionally, an individual who has had a kidney transplant is an automatic approval for disability for at least twelve months. After twelve months, Social Security will review the individual's disability claim to ascertain if the individual has had medical improvement. Medical improvement depends upon various factors such as post transplant renal function, the occurrence and severity of renal infections, rejection crisis, or incidence of systemic complications (anemia, neuropathy, etc.), or even the side effects of medication such as corticosteriods and immune suppressant medications. Consequently, many individuals who have kidney transplants continue to receive disability benefits. Secondly, how does Social Security view a return to substantial gainful work activity within the first twelve months of disability? If an individual returns to work and their earnings exceed the substantial gainful activity amount (each year Social Security sets a monthly amount that is considered to be substantial work activity), they may have their disability approval reopened to a denial based upon their work activity. If their disability claim were reopened and denied, the individual would have to return any benefits that they received. In this case, she should contact Social Security for an explanation of how her return to work could affect potential Medicare entitlement. Generally, Social Security will take a disability claim and an End Stage Renal Disease Medicare claim at the same time if an individual is not working. There are special rules that apply to Medicare based upon End Stage Renal Disease. It would be advisable for her to contact Social Security prior to returning to work, so that she can make an informed decision. In conclusion, this individual would have no problem being approved for disability provided that she continues to need dialysis or has some post kidney transplant complications that preclude her from continuing work at a substantial level. However, before returning to work, I would suggest that she contact Social Security for more information about work and potential Medicare entitlement. About the Author: Tim Moore is a former Social Security Disability Examiner in North Carolina, has been interviewed by the NY Times and the LA Times on the disability system, and is an Accredited Disability Representative (ADR) in North Carolina. For assistance on a disability application or Appeal in NC, click here. 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