Endocrine System Disorders and Disability Benefits

The endocrine system is responsible for regulating our body's functioning. Specialized organs known as glands produce chemicals called hormones and release them into our bloodstream, where they travel to different organs in the body. Disorders can result if the level of hormones in our body is out of balance.

Major endocrine system regulators include the pituitary, thyroid, and adrenal glands, which control our growth, metabolism, and stress responses. An organ called the pancreas is responsible for releasing insulin to manage blood sugar levels, while the pineal gland modulates sleep cycles by releasing melatonin.

Qualifying for Disability Benefits Based on Endocrine Disorders

You may qualify for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) disability benefits if your endocrine disorder keeps you from working full-time for at least one year. You'll need to provide medical evidence documenting that your glandular condition results in significant functional limitations.

Applicants who satisfy the financial eligibility criteria for the specific disability program they're applying for (SSDI or SSI) can get benefits in one of two ways:

• meet or equal the requirements of a medical listing, or
• be unable to work at any job full-time in the national economy.

Social Security uses a method called the sequential evaluation process to evaluate disability claims. At each step, the agency will determine whether to proceed with the analysis of your case. For example, if you don't have any severe impairments ("Step 2"), Social Security will deny your application without seeing whether you can do your past work ("Step 4"). On the other hand, if you meet a listing ("Step 3"), the agency will award you benefits without needing to see whether any jobs exist that you can perform ("Step 5").

Meeting a Disability Listing for Endocrine Disorders

Social Security's Listing of Impairments—also known as the "Blue Book"—describes various medical conditions that the agency considers especially severe. If your medical records contain evidence required by a listing, you will qualify for benefits. The Blue Book is divided into 14 sections corresponding to each body system (a group of organs that work together to perform a specialized role or function). Each section contains specific disorders within that system known as listed impairments ("listings").

Section 9.00 of the Blue Book addresses endocrine disorders. However, because many endocrine disorders can be controlled with medication, Social Security considers endocrine dysfunction disabling only when the disorder is uncontrolled with medication and has caused damage to other body systems.

Here's how the agency evaluates endocrine dysfunction based on the type of gland or system affected.

Pituitary Gland Disorders

Social Security recognizes that pituitary gland disorders can vary in severity based on which hormones are involved. For example, a pituitary gland disorder can disrupt kidney function and lead to diabetes insipidus, a fluid imbalance with symptoms including dehydration and excessive thirst. In such cases, Social Security will evaluate a disability application for a pituitary disorder under the Section 6.00 listings for kidney diseases.

Thyroid Gland Disorders

Disorders of the thyroid gland can affect metabolism—the process by which the body gets energy from food—and the sympathetic nervous system, which is responsible for changes in blood flow. Social Security reviews thyroid-related changes in other body systems as follows:

• Arrhythmias (irregular heart beats) and other cardiac disorders are evaluated under Section 4.00 for the cardiovascular system. In order to qualify under the cardiovascular listings, you should provide the agency with evidence such as an electrocardiogram (ECG), an exercise tolerance test, and a heart X-ray.
• Weight loss is evaluated under listing 5.08. Meeting this listing requires that—despite treatment— you have a body mass index (BMI) of less than 17.5 during two evaluations, each at least 60 days apart, within a 12-month period.
• Neurological disorders, such as strokes or seizures, are evaluated under Section 11.00. These listings generally require significant difficulties in speech, communication, or motor functions (your ability to walk or use your hands or arms), causing marked limitations in your daily activities.
• Mental impairments, such as mood, anxiety, or cognitive disorders, are evaluated under Section 12.00. In order to meet these listings, you should provide Social Security with evidence of psychological testing and mental status examinations.

Parathyroid Gland Disorders

The main function of the parathyroid gland is to regulate the amount of calcium in blood, bone, muscle, and nerve tissue. An imbalance of calcium can result in the disorders identified below.

• Osteoporosis and bone fractures can be evaluated under the Section 1.00 listings for the musculoskeletal system, specifically listing 1.19, Pathologic fractures due to any cause. You should provide evidence of osteoporosis or pathologic (chronic and recurrent) fractures using an X-ray or MRI, and your doctor's progress notes should document restrictions in your ability to walk effectively or use your arms.
• Elevated calcium in the blood (hypercalcemia) may lead to eye cataracts, which are evaluated under the Section 2.00 listings for visual disorders. In order to meet these listings, you'll need to provide perimetry (tests that measure your visual field) with results showing that your vision is severely reduced or restricted.
• Kidney failure is evaluated under Section 6.00 for genitourinary disorders. You should provide laboratory findings, particularly blood tests, that show deterioration in your kidneys over a period of time as measured by the amount of certain proteins in your blood.
• Tetany (involuntary muscle spasms) are evaluated under the Section 11.00 listings for neurological disorders. Most neurological listings require that you have very significant ("marked") difficulties using your hands, arms, and legs independently.

Adrenal Gland Disorders

Adrenal gland disorders can affect your bone calcium levels, blood pressure, metabolism, and mental status. Glandular dysfunction that causes the following conditions may satisfy the criteria of the listed impairments below.

• Adrenal-related osteoporosis with fractures that restrict your ability to walk or use your upper extremities is evaluated under listing 1.19.
• Adrenal-related hypertension that worsens heart failure or recurrent arrhythmias is evaluated under the Section 4.00 cardiovascular listings.
• Weight loss (with a consistently low BMI) is evaluated under listing 5.08.
• Significant changes in mood or cognition are evaluated under Section 12.00 for mental disorders.

Pancreatic Gland Disorders

Diabetes mellitus is the most common pancreatic gland disorder. Diabetes disrupts the production of insulin, a hormone that the body needs in order to get energy from blood sugar (glucose). High levels of glucose in the blood (hyperglycemia) and low levels of glucose in the blood (hypoglycemia) can cause long-term complications in a variety of body systems.

• Diabetic ketoacidosis is a life-threatening medical emergency that happens when your body starts breaking down fat for fuel instead of sugar, releasing acids known as ketones into your blood. While diabetic ketoacidosis is typically an acute (temporary) condition, it can result in chronic conditions such as cardiac arrhythmias (listing 4.05), intestinal necrosis (damage to the intestine due to a lack of blood supply, evaluated under Section 5.00 for digestive disorders), brain swelling and seizures (neurological disorders under Section 11.00), and eating disorders (listing 12.13).
• Chronic hyperglycemia happens when glucose levels have been elevated for a long period of time, causing disruption in nerve and blood vessel functioning. Many body systems are affected by hyperglycemia, and can result in amputation of an extremity (listing 1.20); diabetic retinopathy (under Section 2.00 for vision loss); coronary artery and vascular disease (under Section 4.00 for heart conditions); gastroparesis (when food stays too long in your stomach due to nerve damage, evaluated under Section 5.00 for digestive disorders); nephropathy (deterioration of kidney function, evaluated under a Section 6.00 renal disease listing); chronic skin infections (listing 8.09); peripheral neuropathy (listing 11.14); and cognitive impairments, depression, or anxiety (evaluated under Section 12.00 for mental disorders).
• Hypoglycemic episodes, or acute periods of low blood sugar, can cause seizures or fainting—evaluated under the Section 11.00 neurological system listings—or altered mental status, evaluated under the Section 12.00 listings for mental disorders.

Assessing Your Residual Functional Capacity

If you have endocrine system disorder but your condition isn't severe enough to meet one of the above disability listings, Social Security can still award you disability benefits if you can't do any jobs because of your residual functional capacity (RFC). Your RFC is a set of limitations on what you can and can't do in a work setting.

What's In Your RFC?

Your RFC will likely contain restrictions on physical and mental activities that correlate to job duties. If symptoms from your endocrine disorder limit the amount of weight you can lift or how long you can walk for, your RFC will limit you to work at a certain exertional level. Exertional levels range from sedentary (sit-down jobs that don't require lifting more than 10 pounds) to very heavy (jobs where you're on your feet most of the workday and have to lift 100 pounds or more).

Your RFC can also contain restrictions on non-exertional activities, such as using your arms and hands to move objects or how long you can remain focused on job tasks. Social Security reviews your medical records, doctors' opinions, and your self-reported daily activities to determine what restrictions should be included in your RFC. The more limitations you have in your RFC, the less likely you'll be able to do any jobs.

How Does Social Security Use Your RFC?

Social Security compares your RFC with the demands of your past work to see if you could do that work today. If you're unable to do your past work given the restrictions in your current RFC, the agency determines whether any other jobs exist that you could do, despite your limitations.

Most disability applicants under the age of 50 will need to show that they can't perform even the easiest, least physically demanding jobs before Social Security will award them benefits. People 50 years of age and older can find it easier to get disability due to a special set of rules called the medical-vocational grid.

Applying for Disability Benefits for Endocrine Disorders

You can start your application for disability benefits in several ways:

• File online at Social Security's secure website.
• Call 888-772-1213 between the hours of 8 a.m. and 7 p.m., Monday through Friday, to speak with a representative who can help you fill out the forms. (People who are deaf or hard of hearing can call the TTY number at 800-325-0778.
• Go to your local Social Security field office to complete the application in person.

If the application process seems intimidating—or you've already received a denial letter and wish to appeal—consider hiring an experienced disability attorney to help you. Your lawyer can gather the medical evidence needed to show that you meet a listed impairment or aren't able to work, and can handle all communications with Social Security, including representing you at a disability hearing.