Alagille Syndrome and Social Security Disability

Social Security Disability and Alagille
Syndrome - a Strategy for Winning Benefits

The underlying issue in any Social Security disability case relates to whether a claimant can perform a full day’s work in a normal work environment.  Alagille Syndrome, a complex multisystem disorder involving the heart, liver, kidneys and skeleton can support a claim for disability.

Perhaps the most common argument that I use in my practice to win disability claims looks to my client’s capacity to perform reliably and consistently in even a simple, one or two step entry level job.  This argument is called a “functional capacity” argument.  In the Alagille’s patients I have represented, chronic fatigue brought about by liver or heart complications usually serves to greatly reduce an Alagille claimant’s capacity.

At this point, there is no “listing” for Alagille syndrome:

I have not yet appeared at disability hearing in an Alagille’s case in which a medical expert has been called. It would be interested to learn whether one of these medical experts would evaluate an Alagille’s disability case in terms of a listing.

 

Until that happens, therefore, I will continue to present these cases to a judge by arguing that my client’s capacity to perform reliably 8 hours a day, 5 days a week has been compromised by fatigue, low energy and a need to take frequent unscheduled breaks.

In my experience the factors that judges consider when evaluating an Alagille’s case include:

  • definitive diagnosis - as this condition is a genetic disorder, there should be a firm diagnosis either through genetic test results or conclusive clinical evaluation
     
  • severe symptoms
     
    • most Alagille patients experience narrowing of the peripheral pulmonary artery and its branches leading to high blood pressure, cardiac insufficiency and fatigue
       
    • many Alagille patients suffer with digestive issues because of liver issues such as cholestatic liver disease (often caused by too few bile ducts and decreased flow of bile);  this also results in fatigue, and can be documented with abnormal liver enzyme lab test results
       
    • indications of kidney and/or liver transplant

Because Alagille Syndrome is a genetic disorder that is degenerative and for which there is no cure, most disability judges have been willing to accept a claimant’s testimony as credible regarding fatigue and low energy levels.

Alagille Syndrome Case Study #1: 34 year old female with past work as a cashier, retail sales clerk, bank teller and veterninary technician.

 
 
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