[EN] Type 1 Diabetes & Blood Sugar: Your Guide to Navigating Support & Control

I’ve put together a guide on applying for disability pension with Type 1 Diabetes.
I realized it’s crucial to understand both the timing rule—where you only qualify to apply (the Disability Assessment Date) 1 year and 6 months after your first doctor's visit—and your lab results, like insulin depletion levels (C-peptide values) at the time of diagnosis.
By getting a clear picture of what requirements need to be met and when, I finally feel prepared and have a clear roadmap for the application process ahead.

【Summary】

• As a general rule, you can only apply 1 year and 6 months after your first doctor's visit (known as the Disability Assessment Date).
• Before undergoing the disability assessment, you must have been on continuous insulin therapy for at least 90 days.
• Key medical metrics, such as a serum C-peptide level below 0.3 ng/mL (indicating insulin depletion), are critical evaluation criteria.
• To qualify for Category 3 Employees' Disability Pension, it is an absolute requirement that you were enrolled in Employees' Pension Insurance (Kosei Nenkin) on your first doctor's visit.

[Understanding Disability Pension Criteria and Application Timing for Type 1 Diabetes]

• The fundamental rule for when you can file a claim is on or after the Disability Assessment Date, which is 1 year and 6 months from your very first doctor's visit for this condition.
• On the other hand, the '90-day' rule is a clinical requirement under the assessment criteria; you must have a proven record of at least 90 consecutive days of insulin therapy leading up to your assessment date.
• In short, the '1 year and 6 months' is the waiting period to gain eligibility, while the '90 days' is a clinical/treatment condition proving you are undergoing ongoing insulin therapy.
• Regarding test results, the primary focus isn't a high HbA1c, but rather a serum C-peptide level below 0.3 ng/mL (depleted state), which indicates the pancreas's inability to secrete insulin.
• Even if C-peptide levels differ, you may still qualify if you experience severe hypoglycemic episodes (requiring assistance) at least once a month, or hospitalization due to diabetic ketoacidosis (DKA) or similar crises at least once a year.
• To qualify for Category 3—which is much easier to secure for diabetes alone without severe complications—it is incredibly important that you were enrolled in the Employees' Pension (i.e., working as a company employee or civil servant) on your first doctor's visit.
• If you were on the National Pension (e.g., self-employed, unemployed, or under 20) on your first doctor's visit, you will only be eligible for the Basic Disability Pension (which has no Category 3). This means you would need to meet the stricter criteria for Category 2 or higher (which generally requires severe complications).
• I learned how important it is to keep the 5-year medical record retention period in mind when proving your first doctor's visit, and to gather supporting evidence like old clinic ID cards or prescription logs as early as possible.
• Examples of how diabetes impacts your ability to work include restrictions on driving or working at heights/hazardous environments due to the risk of impaired consciousness from hypoglycemia.
• The assessment also considers whether you require workplace accommodations (falling under General Activity Classifications B or C), such as taking breaks for frequent blood sugar checks, eating fast-acting carbs during hypos, or being exempted from solo work and night shifts.

⚠️ Disclaimer & Important Notice
The blood sugar data, graphs, and opinions shared in this article are based solely on personal records and experiences. They do not constitute, recommend, or guarantee any specific medical treatment, dietary therapy, or diagnosis. Blood sugar fluctuations and bodily responses vary greatly from person to person. If you are currently undergoing medical treatment or dietary restrictions, please consult your primary physician or a registered dietitian before making any changes. This blog assumes no responsibility or liability for any actions taken based on the information provided herein.