If you suffer from Hepatopulmonary Syndrome (HPS), then you are undoubtedly disabled, and the Social Security Administration (SSA) recognizes this. HPS automatically meets the SSA’s medical criteria for receiving Social Security Disability (SSD) benefits, though you must still submit an application and thoroughly document the diagnosis and severity level of your condition in order to be approved for benefits.
Disability Programs
The SSA has two programs for which you may qualify:
- Social Security Disability Insurance (SSDI) – which provides benefits to qualified disabled workers, and on rare occasions, to their dependents.
- Supplemental Security Income (SSI) – which is a need-based program for which there are strict income and financial resource limitations.
To receive benefits through either program, you must meet both the medical eligibility and the technical and financial criteria.
Medical Evidence and Required Documentation
When applying for benefits, you must ensure that your medical records meet the SSA’s evidentiary requirements for proving your diagnosis and the severity level of your HPS.
The minimum evidence that must be in your application and medical records includes:
- A thorough clinical history that describes the diagnosis and progression of your liver disease.
- Physical examination reports that detail the clinical features of your HPS, including the complications you experience.
- Breathing function test and pulmonary exam results, including arterial blood gas studies and spirometry tests among others.
- Imaging test results and reports, including x-rays, CTs, and transthoracic echocardiography (TTE)
To establish the diagnosis of HPS, a contrast enhanced ECG or echocardiogram that shows intrapulmonary vascular dilation is usually enough. However, an even stronger case can be built through the inclusion of the pulmonary and imaging test results mentioned above.
The specific findings the SSA will be looking for in the physical examination reports include:
- The presence of liver disease
- Low blood oxygen levels due to impairment in the pulmonary system
- Abnormalities in the intrapulmonary vessels
To establish the severity level necessary for disability qualification, the SSA may utilize the listing in its Blue Book, which appears in Section 5.05E. However, this listing essentially reports the same information found above regarding the tests and exam results required for approval of your application.
Compassionate Allowances
Hepatopulmonary Syndrome is part of the SSA’s Compassionate Allowances (CAL) program, which ensures that your application for benefits will be reviewed more quickly. The average application takes at least four months to go through the first review. Your application however, will be reviewed in just a matter of weeks, provided your medical records and other documentation are thorough.
Applying for Benefits
Although denials of HPS applications for disability benefits are rarely denied, they can be delayed by insufficient information or lack of appropriate medical records. You should collect as many of your medical records as possible before applying for this reason. Those records should be submitted along with your application in order to speed up the review and approval.
You can complete your application via the SSA’s website or you can schedule an appointment and complete your application at your local SSA office. To arrange an appointment, call 1-800-772-1213.
