Post-Sepsis Syndrome (PSS) is a complex health condition that can emerge after a severe infection like sepsis. Many individuals who survive sepsis experience a range of lasting physical, cognitive, and psychological challenges. These persistent effects can significantly alter a person’s life, prompting questions about whether such a condition qualifies as a disability. This article explores the nature of Post-Sepsis Syndrome and how its long-term impacts may align with established disability criteria.
What Post-Sepsis Syndrome Is
Post-Sepsis Syndrome refers to the collection of long-term problems experienced by some individuals after recovering from sepsis. Up to 50% of sepsis survivors may develop PSS, with a higher risk for those admitted to intensive care units or with extended hospital stays.
Physical symptoms often include profound fatigue, muscle weakness, and disabling joint pain. Individuals may also experience shortness of breath, reduced organ function affecting kidneys or liver, and even hair loss. Cognitive difficulties are common, manifesting as memory loss, trouble concentrating, or “brain fog,” which can significantly impair daily functioning. Psychological effects can involve mood swings, anxiety, depression, nightmares, flashbacks, and post-traumatic stress disorder (PTSD). These symptoms can persist for months or even years, fundamentally changing a survivor’s functional abilities and quality of life.
How Disability Is Defined
In the United States, the Social Security Administration (SSA) defines disability for programs such as Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). To meet this definition, an individual must demonstrate an inability to engage in substantial gainful activity (SGA) due to a medically determinable physical or mental impairment. Substantial gainful activity refers to performing significant physical or mental tasks for pay or profit.
The impairment must be expected to result in death or have lasted, or be expected to last, for a continuous period of not less than 12 months. The SSA employs a five-step sequential evaluation process to determine eligibility for disability benefits. This process assesses work activity, the severity of the medical condition, whether the condition meets or equals a listing in the SSA’s official Listing of Impairments (the “Blue Book”), the ability to perform past work, and the capacity to adjust to other types of work.
Connecting Post-Sepsis Syndrome to Disability Criteria
The diverse and persistent symptoms of Post-Sepsis Syndrome can align with the SSA’s definition of disability, even though PSS is not explicitly listed in the Blue Book. Individuals can qualify if their PSS symptoms are severe enough to meet the criteria of other listed impairments, such as neurological disorders, mental health conditions, or chronic fatigue syndrome. For example, chronic fatigue and muscle weakness from PSS might meet criteria for certain musculoskeletal or neurological listings.
Cognitive impairments like memory problems or difficulty concentrating, common in PSS, can be evaluated under mental health listings, including those for anxiety or depressive disorders, especially if they significantly limit daily activities and social functioning. The SSA evaluates the severity of an impairment based on objective medical evidence. This includes detailed doctor’s reports, hospital records, laboratory results, and imaging studies that document the diagnosis, treatment, and functional limitations caused by PSS.
A crucial component in demonstrating disability is the Residual Functional Capacity (RFC) assessment. This evaluation details an individual’s remaining ability to perform work-related activities despite their impairments, such as sitting, standing, lifting, or understanding instructions. If the combined effects of PSS symptoms, as documented by comprehensive medical evidence and RFC, prevent an individual from performing their past work or any other substantial gainful activity that exists in the national economy, they may be found disabled.
The Disability Application Process
Applying for disability benefits due to Post-Sepsis Syndrome involves a structured process that requires thorough documentation. The initial step is to gather all relevant medical records, including hospital stays, physician notes, lab results, and any assessments of physical or cognitive function. These records are foundational for demonstrating the severity and long-term nature of PSS symptoms and their impact on your ability to function.
Applications can be submitted online, by phone, or in person at a Social Security Administration office. It is important to provide a complete picture of how PSS affects daily activities and work capabilities, detailing limitations in areas like concentration, memory, physical endurance, and social interaction. Many initial applications for disability benefits are denied, making the appeals process a common part of the journey.
If an application is denied, individuals typically have 60 days to file a request for reconsideration, the first level of appeal. If reconsideration is also denied, the next step is a hearing before an Administrative Law Judge (ALJ). Further appeals can be made to the Appeals Council and, if necessary, to federal court. Seeking assistance from a disability attorney can be beneficial throughout this process, especially during appeals, as they can help navigate the complexities and present a strong case.