Fatty liver disease, a condition marked by the accumulation of fat in liver cells, is a common health concern. While often asymptomatic in its early stages, it can progress and lead to more serious liver damage. This article explores whether fatty liver disease qualifies as a disability, examining official criteria and its functional impact.
Defining Disability
The Social Security Administration (SSA) defines disability as the inability to engage in any substantial gainful activity due to a medically determinable physical or mental impairment. This impairment must be expected to result in death or last for a continuous period of not less than 12 months.
Substantial gainful activity (SGA) refers to a level of work activity and earnings. For instance, in 2025, earning more than $1,620 per month for non-blind individuals is considered SGA. The SSA evaluates claims through a five-step process, starting with whether an individual is working at or above the SGA level. An impairment is severe if it significantly limits an individual’s physical or mental abilities to perform basic work activities.
How Fatty Liver Impairs Function
Fatty liver disease, particularly as it advances, can cause symptoms and complications that impair daily tasks and work. In its early stages, non-alcoholic fatty liver (NAFL) often presents with few noticeable symptoms, discovered incidentally. However, as fat accumulates and inflammation increases, leading to non-alcoholic steatohepatitis (NASH), individuals may experience significant fatigue and pain in the upper right abdomen due to liver enlargement.
Progression to cirrhosis, involving scarring and impaired liver function, leads to more severe symptoms. These include severe fatigue and weakness, unexplained weight loss, and persistent itching. Complications such as fluid retention (ascites or hydrothorax), internal bleeding from enlarged blood vessels (varices), and muscle wasting can also occur. Cognitive impairment, known as hepatic encephalopathy, can develop, causing confusion and behavioral changes.
Severity and Disability Qualification
Mild or moderate fatty liver disease, often called simple fatty liver or steatosis, generally does not meet disability criteria due to minimal or no symptoms and functional limitations. Most individuals at this early stage do not experience liver damage or progression. However, severe forms, especially those progressed to cirrhosis or decompensated liver disease, can qualify for disability benefits.
Disability agencies, like the SSA, outline specific medical criteria for chronic liver disease in their “Listings of Impairments,” such as Listing 5.05. Meeting this listing requires documented evidence of complications, including:
- Hemorrhaging from varices requiring hospitalization and blood transfusions;
- Persistent fluid accumulation (ascites or hydrothorax) despite treatment;
- Spontaneous bacterial peritonitis;
- Hepatorenal syndrome, characterized by kidney dysfunction;
- Hepatic encephalopathy with documented cognitive and behavioral changes.
End-stage liver disease, with SSA CLD scores of 22 or greater, also indicates severe impairment.
Applying for Disability Benefits
Individuals with severe fatty liver disease applying for disability benefits should gather comprehensive medical documentation. This includes detailed records of diagnosis, treatment history, and hospitalizations. Important diagnostic test results include liver function tests, liver biopsy reports, and imaging studies (ultrasounds, CT scans, or MRIs).
Statements from treating physicians detailing functional limitations are also important. These statements should explain how symptoms like fatigue, pain, or cognitive issues affect the ability to perform work-related activities such as sitting, standing, lifting, or concentrating. Applications can be submitted through programs like Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI); SSDI generally requires a work history, while SSI is a needs-based program.