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Genito-Urinary Disorders
Home Full Impairment Discussion The genitourinary system is associated primarily with diseases
of the kidneys and the male and female reproductive organs. In
my years of experience as a senior disability adjudicator, I
have never seen a case involving the reproductive organs
that has resulted in an allowance decision. I'm sure an
allowance can occur from diseases of the reproductive organs
under special circumstances. If an allowance did occur for the
reproductive system, it would probably be based on cancer or
some other serious mechanical dysfunction of this system. In
this report, we'll focus our attention on disorders of the
urinary side of this system. General Evaluation Urinary impairments, as with any disorder that does not meet or equal the medical listings, should be evaluated as to the degree of dysfunction it causes the claimant. Some of the more common signs and symptoms of urinary disease are acute changes in urinary habits, blood in urine, frequent or recurrent bladder infections, incontinence of urine, chronic fever, weight loss, swelling, pain and malaise. These symptoms in and of themselves would not constitute a total disability. However, the claimant with a urinary disorder must be evaluated by keeping in mind how his symptoms affect his ability to perform work. The most obvious symptoms caused by diseases of the urinary system are blood in the urine and urinary incontinence. With urinary incontinence, the claimant cannot control the release of urine from the bladder due to an underlying disorder. Many individuals with urinary incontinence are forced to wear diapers. Granted, wearing diapers is not the worst restriction in the world, but for obvious social reasons it should be argued as a profound restriction to work activity. If the claimant has blood in his urine, this may be a sign of a serious underlying disorder of the urinary tract. The most serious disorders of the urinary system are associated with kidney disease. Since kidney disease is already discussed in detail in our Social Security Guide, section 21/3, I will not duplicate the information here. The progression of a urinary disorder is an important factor to consider when evaluating a claimant's condition for disability. Many claimants with serious kidney disease will be denied benefits because it appears that the condition is improving with treatment. Very often the claimant will experience a relapse and progression of the disease. During the relapse, the claimant's condition could worsen, causing a deterioration of the claimant's overall health. Pain may or may not be present with serious kidney disease. If pain is present, use it as additional ammunition in your effort to lower the claimant's residual functional capacity. The diagnostic tests most often used to supportive the existence and seriousness of kidney disease are kidney biopsy, urinalysis, urine output measurements, serum creatinine and creatinine clearence tests. The urinalysis is the most common test used in the early evaluation of urinary tract disorders. This test is easy to perform and gives a wealth of important information about the condition of the urinary system. A claimant simply gives a specimen of urine to the laboratory tech for evaluation. This test will indicate urine protein concentrations, Ph, microscopic blood, sugar and ketone concentrations. The urine and serum creatinine clearance tests are indicators of kidney function. If the claimant has an elevation in serum or urine creatinine, this can be an indication of a kidney malfunction. If urine output is low, this could indicate poor intake, renal failure or an obstruction in urinary flow.
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