If you or a loved one cannot work and earn a living because of symptoms and complications related to phenylketonuria (PKU), one possibility for getting the income necessary to make ends meet is Social Security Disability benefits for phenylketonuria. Depending on your work history and financial situation, they may qualify for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI).
The Pittsburgh, PA disability team from Berger and Green is here to help you understand your options, file your claim, and fight a denial if necessary. We can walk with you through the process. Call our Pittsburgh office today at (888)-392-8307 to get started.
Understanding Social Security Disability
Social Security offers disability payments under two separate programs. Most people qualify under one or the other, and occasionally someone may qualify for benefits from both programs. Depending on when your disability began, your work history, and your financial situation, you are eligible to apply for Social Security Disability Insurance or Supplemental Security Income.
Social Security Disability Insurance
SSDI is only available to adults who work and pay Social Security taxes or have worked in the recent past. If you have never worked, you cannot qualify for this type of benefit. However, many people who have PKU develop complications later in life. If this happened to you and you cannot work anymore, you may be able to get benefits through this program.
You could also qualify for “auxiliary benefits” if:
- You are over age 18; and
- You had a qualifying disability before age 22; and
- One of your parents receives SSDI or Social Security Retirement benefits
Supplemental Security Income
If you never worked or do not have the required work credits, you could qualify for SSI. This is a need-based program with no work credit requirement. However, you must provide evidence you meet strict income and asset limits. SSI also provides healthcare coverage through Medicaid in Pennsylvania.
You could qualify for SSDI and receive only a small monthly payment based on very low income and still be eligible for SSI in some cases.
Proving You Have a Qualifying Impairment Based on Your PKU Diagnosis
The Social Security Administration’s Blue Book of qualifying impairments mentions phenylketonuria under Section 10.01 – Congenital Disorders That Affect Multiple Body Systems. However, it does not outline any specific criteria you must meet to get approved based on your diagnosis. Instead, it acknowledges that this condition affects everyone differently, and it is impossible to create criteria that takes into consideration how it affects any one individual.
For this reason, they evaluate applicants with phenylketonuria based on their specific functional limitations and the progression of those limitations. There are a number of symptoms and complications related to PKU that could prevent you from working. This includes:
- Intellectual disabilities
- Difficulty focusing and completing tasks
- Changes in emotional state or social abilities
- Damage to a body system
Your doctor can help you identify your specific condition and determine if you may meet the applicable impairment listing. To prove you meet the criteria, the disability examiner who handles your case will need to see medical evidence such as medical imaging, laboratory tests, and clinical assessments.
They gain access to this evidence by requesting your medical records. As part of the application process, you will need to provide complete and accurate contact information for all your doctors and other care providers. We will help you compile this information and review it before we file your claim.
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Getting Approved for Disability Without an Impairment Listing
Sometimes people living with phenylketonuria cannot work but do not meet the criteria under any one impairment listing in the Blue Book. When this happens, they can still get approved for benefits, but it requires a residual functional capacity (RFC) assessment.
An RFC assessment considers:
- Your experience, education, and training.
- Your age.
- Your abilities despite your impairments.
- The type of work you can do.
- How often you can work.
- How long you can work.
If the assessment finds you cannot get and keep any job you might qualify for, you will likely get approved for benefits. You may also get approved for SSDI if you can work but require accommodations.
The staff from the Office of Disability Determination Services will assess your abilities to arrive at your RFC in one of three ways:
- A doctor from their office will look at your medical evidence and claim information.
- Your doctor will complete a form based on your medical records and their knowledge of your abilities.
- They will ask you to attend a consultative exam they schedule and pay for.
We Can Help You Fight for the Benefits You Deserve
The Social Security Administration is notorious for denying disability claims at a high rate. Many more claimants receive denials based on their initial application than get approved. If this happened to you, we may be able to help you get social security disability for phenylketonuria.
If you received a letter of denial, reach out to us right away. You only have a limited time to appeal the decision. We can handle requesting a hearing for you if there is sufficient time to do so. We will also:
- Answer your questions and concerns.
- Investigate why the Social Security Administration denied your disability.
- Collect evidence and build a strong case for approval.
- Represent you before the Administrative Law Judge during your hearing.
- Aggressively pursue your monthly benefits and full back pay.
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Getting Social Security Disability for Phenylketonuria (PKU) in Pittsburgh, PA
If you or a loved one cannot work because of phenylketonuria complications, the Berger and Green team can help you file a claim for social security disability for phenylketonuria in Pittsburgh, PA. We can also navigate the appeals process for you if the Social Security Administration already denied your initial claim.
Call or text us today at (888)-392-8307 for a free case review.