From a Notice of Proposed Rule-Making (NPRM) in the Federal Register today:
Because of advances in medical treatment and detection, most endocrine disorders do not reach listing-level severity because they do not become sufficiently severe or do not remain at a sufficient level of severity long enough to meet our 12-month duration requirement. This is true even for people who have recurrent episodes of hypoglycemia or of diabetic acidosis (also called diabetic ketoacidosis, or DKA), a serious outcome of uncontrolled blood glucose levels. Current listings 9.08B and 109.08A, which provide criteria for people who have recurrent episodes of DKA, and listing 109.08B, which provides a criterion for children who have recurrent episodes of hypoglycemia, reflect an earlier view that people with wide fluctuations in their blood glucose levels had uncontrollable DM. We consulted with endocrinologists, diabetologists, and other medical experts who treat DM, and they indicated that the current listings reflect only inadequate glucose regulation. The information we obtained from these experts and relevant medical references demonstrates that adequate glucose regulation is achievable with improved treatment options, such as a wider range of insulin products.
For these reasons, we believe that, with one exception, we should no longer have listings in sections 9.00 and 109.00 based on endocrine disorders alone, and we are proposing to remove all such current endocrine listings. The sole exception is for children under age 6 who have DM and require daily insulin.
4 comments:
I have just learned that repeated episodes of ketoacidosis or hypoglycemia resulting from chronic severe diabetes is no longer sufficient to support a listing and will therefore not be a basis for awarding DIB benes on these episodes alone.
So, here we are in the middle of the HCR Senate battle while millions of people in this country die every year from common treatable disorders like diabetes because they can't afford treatment/medication. They can't work, of course, because they suffer from repeated episodes of DKA/hypoglycemia which will kill you right off (or eventually, anyway, through strokes, mutltiple heart attacks, multiple amputations, etc.
And, with its usual brilliance, SSA has concluded that we can just move along, nothing to see here, folks.
This is wrong, monstrously so and enough to make even me weep. Nothing else to say.
This seems reasonable. They are not precluded from being allowed. They can still be approved if they meet the grid rules.
This is probably way too simplistic for a non-DDS type but I have a brother in law with lifelong diabetes who has significant health problems as a result of the diabetes who is working but who I can see in the near future needing to stop. Not due to the diabetes but due to the impact of it on his life. Vision, circulation problems etc. And I work with a number of diabetics who live perfectly normal lives, some with insulin and some without. Makes sense to me that given the reach of medicine today that diabetes alone isn't a disabling condition but instead may lead to disabling conditions. So if people cannot work due to the effects of diabetes, that seems to still be covered, just not giving the disease itself status as being disabling.
If that's what this means, what's the issue?
Nancy isn't an expert in Disability, and may have had a bit of a visceral reaction to this NPRM. As you and the previous poster note, this does not mean that someone with diabetes will not be found disabled; they just won't be found so at step 3 based solely on a diagnosis of diabetes (ant that's a simplification as well).
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