Do You Qualify for Benefits if You’ve Had an Organ Transplant?

Organ transplants have saved the lives of countless people.  However, transplants are not without their risks and medical complications.  After undergoing surgery, organ recipients are vulnerable to infection and rejection, and must take care to avoid putting strain on the new heart, lung, kidney, or other organ.  If you cannot work because you received a transplant, you may be able to qualify for monthly disability benefits to help with your daily expenses.  Our Philadelphia disability benefits lawyers explain how the Social Security Administration evaluates organ transplant claims.

SSA Eligibility Requirements for Disability Claimants

Before we look at the criteria specific to organ transplants, we need to make sure you pass the basic requirements that apply to all disability claimants.  In order to qualify, you will have to meet the following criteria:

• It’s important to note that you can qualify for disability while working, as long as your monthly earnings do not surpass a certain threshold.
• You must not be earning too much money on a monthly basis.  If your monthly earnings are too high, the SSA will determine that your application should be rejected because you are well enough to support yourself through consistent employment.
• Your disability must be long-term, which can have three meanings:
• Your condition has already lasted for at least one year.
• Your condition is expected to last for at least one year.
• Your condition is expected to result in death.
• Your condition must be considered severely disabling, which means you will need to supply medical evidence like x-rays, CAT scans, or MRI scans.
• If you do not supply sufficient evidence, your claim can be denied.  It’s important to keep in communication with your physician to make sure the SSA receives all the documentation it requests.

Most people whose disability claims are denied get rejected because the SSA decides that the claimant’s condition is not severe enough.  Fortunately, the medical standards for organ recipients are fairly  straightforward, as we will discuss next.

How to Qualify for Benefits if You’ve Received an Organ Transplant

SSA medical examiners evaluate claimants against a catalog of medical symptoms called the Listing of Impairments.  (Note there is a separate Listing of Impairments for children.  For the purposes of this article, we will refer to the adult Listing of Impairments.)

Claimants do not necessarily have to match the Listing standards, which can be extremely elaborate and complicated for certain conditions.  However, the standards for organ transplants are quite simple.  In most instances, people who have received organ transplants within the past year should be able to qualify based on the relevant portion of the Listing.

The Listing of Impairments does not have a section dedicated to organ transplants.  Instead, each transplant listing is located under the section for that corresponding body system.  For instance, the heart transplant listing is found under Section 4.00, which deals with cardiovascular diseases.

You potentially qualify for disability benefits if you have received any of the following types of organ transplants:

• Heart Transplants (Section 4.09, under Cardiovascular System)
• A heart transplant is considered a disability for one year after surgery.
• After one year passes, the claimant will be evaluated “under the appropriate listing” (e.g. ischemic heart disease, recurrent arrhythmias, aortic aneurysm).

• Kidney Transplants (Section 6.04, under Genitourinary Disorders)
• A kidney transplant is considered a disability for one year after surgery.
• After one year passes, the claimant will be evaluated “under the appropriate listing.”  The SSA will look at “post-transplant function, any rejection episodes you have had, complications in other body systems, and any adverse effects related to ongoing treatment.”

• Liver Transplants (Section 5.09, under Digestive System)
• After one year passes, the “residual impairment(s)” will be reevaluated.  These impairments might include issues with liver rejection, antiviral therapy, and comorbid (coexisting) complications.
• A liver transplant is considered a disability for one year after surgery.

• Lung Transplants (Section 3.11, under Respiratory System)
• A lung transplant is considered a disability for one year after surgery.
• After one year passes, the claimant will be reexamined for “residual impairments” like rejection, negative reactions to immunosuppressive drugs, or other respiratory conditions.  Some of the other conditions under Section 3.00 include asthma, cystic fibrosis, and chronic pulmonary insufficiency.

Not all transplants involve organs.  You could also qualify for benefits if you’ve received a bone marrow transplant or stem cell transplants as treatment for cancer, an immune system disorder, or a hematological disorder (blood disease).

If you received an organ transplant from a donor, you may be a good candidate for disability benefits.  To learn more about how to qualify for benefits, or how to appeal a disability denial, call the Pennsylvania social security attorneys of Young, Marr, Mallis & Associates at (609) 755-3115 in New Jersey or (215) 701-6519 in Pennsylvania today.  Your consultation is completely free of charge, and we will keep your information private.  We represent residents of Pennsylvania and New Jersey.