Chronic liver disease is listed under SSA Medical Listing 5.05, the category of impairments known as the Digestive System (5.00). As a Louisiana Social Security disability lawyer, I know people who live with chronic liver disease may be entitled to benefits. When considering an application for Social Security Disability benefits based on chronic liver disease, the severity and duration of your disease along with prescribed treatments are evaluated. This includes the effects of medication, therapy, surgery, laboratory results, and any other form of treatment you receive, as well as any side effects of your treatment that further limit your functionality.
What Is Chronic Liver Disease?
Chronic liver disease is characterized by liver cell necrosis, inflammation, or scarring (fibrosis or cirrhosis), due to any cause that persists for more than 6 months. It may result in portal hypertension, cholestasis (suppression of bile flow), extrahepatic manifestations, or liver cancer.
Significant loss of liver function may be manifested by hemorrhage from varices or portal hypertensive gastropathy, ascites (accumulation of fluid in the abdominal cavity), hydrothorax (ascitic fluid in the chest cavity), or encephalopathy. There can also be progressive deterioration of laboratory findings that are indicative of liver dysfunction. Liver transplantation is the only definitive cure for end-stage liver disease (ESLD).
Examples of chronic liver disease include but are not limited to, chronic hepatitis, alcoholic liver disease, non‑alcoholic steatohepatitis (NASH), primary biliary cirrhosis (PBC), primary sclerosing cholangitis (PSC), autoimmune hepatitis, hemochromatosis, drug‑induced liver disease, Wilson’s disease, and serum alpha‑1 antitrypsin deficiency. Acute hepatic injury is frequently reversible, as in viral, drug‑induced, toxin‑induced, alcoholic, and ischemic hepatitis. In the absence of evidence of a chronic impairment, episodes of acute liver disease do not meet 5.05.
Symptoms may include, but are not limited to, pruritis (itching), fatigue, nausea, loss of appetite, or sleep disturbances. Symptoms of chronic liver disease may have a poor correlation with the severity of liver disease and functional ability.
Signs may include, but are not limited to, jaundice, enlargement of the liver and spleen, ascites, peripheral edema, and altered mental status.
Laboratory findings may include, but are not limited to, increased liver enzymes, increased serum total bilirubin, increased ammonia levels, decreased serum albumin, and abnormal coagulation studies, such as increased International Normalized Ratio (INR) or decreased platelet counts. Abnormally low serum albumin or elevated INR levels indicate loss of synthetic liver function, with increased likelihood of cirrhosis and associated complications. However, other abnormal lab tests, such as liver enzymes, serum total bilirubin, or ammonia levels, may have a poor correlation with the severity of liver disease and functional ability. A liver biopsy may demonstrate the degree of liver cell necrosis, inflammation, fibrosis, and cirrhosis. Imaging studies (CAT scan, ultrasound, MRI) may show the size and consistency (fatty liver, scarring) of the liver and document ascites.
SSA guidelines regarding chronic liver disease are extremely detailed. If you have a chronic liver disease and are in need of disability benefits, you should consult with an experienced Louisiana Social Security Disability Benefits attorney who can work with your doctors and your medical records to build your case.