PD, Medicare and Disability

Hi there.

I am at the very beginning of transitioning to PD. I will soon be getting my catheter and starting the treatments. Of course, I have a zillion questions. Right now, I am able to work full time, with a lot of effort. I have health insurance through my job. Do I need to apply for Medicare as well, once dialysis begins? My understanding is that Medicare is pretty much an automatic for people on dialysis. Second question is dealing with disability, I too am a social worker, as we know, it is a high stress, high energy job. I spent half time in the field and half time in the office. Im not sure what to expect being on PD and if I will be able to continue to keep up that pace, even though, I LOVE my job. I know from working with clients that the social security disability process is a process, but does dialysis qualify you for SS disability in itself? I know there are major decisions that I have to make over the next several weeks and I appreciate any advice that you could give.

Jeff

Being on dialysis is considered by Social Security to be potentially disabling because of lab values, treatment demands and symptoms. This s may be because most patients on dialysis do in-center conventional hemodialysis 3-4 hour 3 times a week. This only replaces about 10-15% of natural kidney function so patients don’t feel that great. People who do PD or home hemodialysis can work easier because they don’t have to deal with a dialysis schedule that takes up work hours 3 days a week. Also, when they do dialysis, they don’t have the same “roller coaster” of symptoms that some have referred to as “dialysis hangover.” Patients have told me that the Social Security Disability system can be frustrating and disempowering.

You ask about whether you can work. Yes, you can! Patients who work tell me that it helps them stick with their treatment plan easier because they’re busy and they do what they need to do to stay healthy. I’ve talked with patients who returned to work after being on disability and they say they feel so much better working than they did when they were on disability. You may be interested to know that there are social workers who are working full time in dialysis clinics or transplant programs while being on dialysis. One dialysis soicial worker I know covers several dialysis clinics and does home hemodialysis 5 times a week for 3 hours each time. She has no problem doing her job plus she volunteers with the National Kidney Foundation, serving on the executive committee of the Council of Nephrology Social Workers,. I’ve known patients who do CAPD or CCPD and work too. Ask your clinic to link you with other patients who are on PD and work.