Social Security Administration just came out with a new regulation on how to evaluate diabetes mellitus.
Type 1 DM. In Type 1 DM, previously known as juvenile-onset DM or insulin-dependent DM, the pancreas does not produce insulin due to an autoimmune destruction of the insulin-producing cells. This results in increased blood glucose levels.
Type 2 DM. In Type 2 DM, previously known as adult-onset DM or non-insulin-dependent DM, the pancreas does not produce enough insulin, or there is failure in the transfer of insulin into the body cells (insulin resistance).
At step 2 – Is DM severe?
When we evaluate the severity of DM, we consider any symptoms, such as fatigue or pain, that could limit functioning. If the effects of DM, alone or in combination with another impairment(s), significantly limit an adult’s physical or mental ability to do basic work activities, we find that the impairment(s) is severe.
At Step 3- DM is not a listed impairment for adults.
However, the effects of DM, either alone or in combination with another impairment(s), may meet or medically equal the criteria of a listing in an affected body system(s). /9/ Below are some examples of the effects of DM and the body systems under which we evaluate them:
* Amputation of an extremity, under the musculoskeletal system listings (1.00).
* Diabetic retinopathy, under the special senses and speech listings (2.00).
* Hypertension, cardiac arrhythmias, and heart failure, under the cardiovascular system listings (4.00).
* Gastroparesis and ischemic bowel disease (intestinal necrosis), under the digestive system listings (5.00).
* Diabetic nephropathy, under the genitourinary impairments listings (6.00).
* Slow-healing bacterial and fungal infections, under the skin disorders listings (8.00).
* Diabetic neuropathy, under the neurological listings (11.00).
* Cognitive impairments, depression, anxiety, and eating disorders, under the mental disorders listings (12.00).
Steps 4 and 5 remain the same
SSA considers all work-related physical and mental limitations, whether due to an adult’s DM, other impairment(s), or combination of impairments.
Use the RFC assessment to evaluate whether an adult is capable of performing any past relevant work (PRW) as he or she actually performed it or as the job is generally performed in the national economy. If an adult’s RFC precludes the performance of PRW (or if there was no PRW), we use the RFC assessment to make a finding at step 5 about his or her ability to perform other work that exists in significant numbers in the national economy. The usual vocational considerations apply.