The diagnosis of fatty liver disease, specifically Non-Alcoholic Fatty Liver Disease (NAFLD) or its more aggressive form, Non-Alcoholic Steatohepatitis (NASH), does not automatically qualify a person for disability benefits. The question of whether it constitutes a disability depends entirely on the disease’s progression and the resulting functional impairment, not the diagnosis alone. For an individual to be considered disabled, the condition must have advanced to a severe stage that prevents them from engaging in work-related activities. This determination is made based on strict legal and medical standards that assess the severity of the illness and its long-term impact on a person’s ability to function.
Understanding the Legal Standard for Disability
The Social Security Administration (SSA) uses a precise and strict definition of disability for its benefit programs, such as Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). This legal definition requires that the medical condition be severe enough to prevent the individual from performing Substantial Gainful Activity (SGA). The SGA threshold is a specific dollar amount of monthly income; if an applicant earns more than this amount, they are generally not considered disabled.
Furthermore, the impairment must be expected to last continuously for a minimum of 12 months, or be expected to result in death. The SSA does not provide benefits for partial or short-term disabilities. Early-stage fatty liver disease, which is often asymptomatic or mild, will not meet the SSA’s durational or severity requirements.
The SSA uses a five-step sequential evaluation process, and the inability to engage in SGA is the first test. If an applicant is currently earning above the SGA limit, their application will be denied immediately without any medical review. This strict financial threshold ensures that the benefits are reserved for those who are completely unable to work.
Specific Medical Criteria for Liver Disease Qualification
Fatty liver disease only becomes medically relevant for disability when it has progressed to Chronic Liver Disease (CLD) with severe complications, typically involving cirrhosis. The SSA evaluates CLD under Listing 5.05 in its official Listing of Impairments. To meet this specific listing, the disease must be characterized by liver cell necrosis, inflammation, or scarring that has persisted for more than six months.
Meeting the listing requires documented evidence of specific, severe complications that demonstrate end-stage organ failure or repeated, life-threatening events. These criteria include:
- Recurrent fluid accumulation (ascites or hydrothorax) present on at least two separate medical evaluations at least 60 days apart, despite prescribed treatment.
- Spontaneous bacterial peritonitis, confirmed by a specific neutrophil count in the ascitic fluid.
- Hepatorenal Syndrome, involving kidney failure evidenced by a serum creatinine level of at least 2 mg/dL.
- Hepatopulmonary Syndrome, confirmed by a low arterial oxygen pressure measurement.
- A history of upper gastrointestinal bleeding from varices that results in hemodynamic instability and requires a blood transfusion.
- End-stage liver disease requiring a transplant, or a severely high SSA CLD score based on serum bilirubin, creatinine, and International Normalized Ratio (INR) lab values.
Required Documentation and Functional Limitations Assessment
For a disability claim based on fatty liver disease, comprehensive medical records are essential to establish the severity and progression of the disease. This documentation must include laboratory test results, such as liver enzyme levels, albumin, and INR, as well as imaging studies like MRIs or ultrasounds. If available, liver biopsy reports that confirm the presence and extent of fibrosis or cirrhosis provide the strongest evidence of advanced disease.
If the medical evidence does not meet the strict criteria of Listing 5.05, the SSA performs a Residual Functional Capacity (RFC) assessment to determine the individual’s remaining capacity for work. The RFC assessment translates the medical limitations into concrete terms regarding the ability to perform work-related tasks, such as sitting, standing, lifting, and carrying.
Limitations frequently seen in advanced liver disease, such as severe, chronic fatigue, cognitive dysfunction from hepatic encephalopathy, and the need for frequent unscheduled breaks due to nausea or pain, are documented in the RFC. The assessment determines if these functional limitations prevent the individual from performing their past work or any other type of work available in the national economy. Even without meeting a specific medical listing, a sufficiently low RFC—indicating the inability to sustain even sedentary work—can still lead to an allowance of disability benefits.