Inflammatory bowel disease (IBD) is the chronic inflammation of all or part of your digestive tract, generally the result of ulcerative colitis or Crohn’s disease. The pain associated with IBD can be debilitating, and may sometimes lead to life-threatening complications. Depending on the severity of your IBD and its impact on your ability to work, you may qualify for SSD benefits. Before applying, here’s what you need to know about inflammatory bowel disease and SSD benefits.
Inflammatory Bowel Disease as a Disabling Condition
Inflammatory bowel disease is one of more than 100 medical conditions included in the Social Security Administration’s (SSA) disability blue book. If the evidence in your medical record proves that your IBD meets or exceeds the criteria included in the SSA listing, you may be eligible to receive SSD benefits if the disease negatively impacts your ability to work, and has lasted (or is expected to last) 12 months or longer.
However, it is extremely difficult to obtain SSD benefits due to IBD. Many people who suffer from IBD can control or manage the disease. Symptoms also vary in severity and duration, so those who suffer from it often experience periods of remission and relapse – going for long stretches of time where they have no issues, to suddenly experiencing symptoms. Therefore, the fact that you have been diagnosed with IBD is insufficient, without more, to meet the SSA’s level of disability. In addition, most doctors do not document how frequently the disease causes patients to use the restroom per day, so the record gives an incomplete account of how the disease impacts their patient’s ability to work.
How the Disability Examiner Reviews Inflammatory Bowel Disease
As with any SSD benefits application, a letter from your physician stating that you have been diagnosed with IBD is not enough to qualify for benefits. Your medical record must include specific documentation verifying the diagnosis, including test results and any imaging (such as X-ray, imaging, sonography, CAT scan or MRI), labs or medical notes to support the diagnosis.
The SSA requires that IBD be documented by either endoscopy, biopsy, operative findings or other medically acceptable imaging. Any obstructions should be noted, as should the date(s) and length of any hospitalizations required for the obstructions, and the course of treatment.
In addition, the record must show that you experienced any one of the following conditions two or more times, at least 60 days apart, during a continuous six-month period, despite receiving treatment:
- Anemia with hemoglobin of less than 10.0g/dL;
- Serum albumin of 3.0 g/dL or less;
- Clinically documented tender abdominal mass palpable on physical examination with abdominal pain or cramping that is not completely controlled by prescribed narcotic medication;
- Perineal disease with a draining abscess or fistula, with pain that is not completely controlled by prescribed narcotic medication;
- Involuntary weight loss of at least 10 percent from baseline, as computed in pounds, kilograms, or BMI, or;
- Need for supplemental daily enteral nutrition via a gastrostomy, or daily parenteral nutrition via a central venous catheter.
In addition to the above, there are numerous signs and symptoms of IBD which must be documented by medical records and laboratory findings. These symptoms and signs may include, but are not limited to:
- Fecal incontinence;
- Rectal bleeding;
- Abdominal pain or tenderness;
- Nausea and vomiting;
- Abdominal mass felt via palpitations, or;
IBD may also impact other body systems. The impact on these systems should also be included in the medical record. If the symptoms of IBS are insufficient to meet the disability listing, any impairment caused by the impact of IBS on the other systems may be sufficient to prove disability.
Inflammatory Bowel Disease and SSD Benefits Success Story
Our office recently helped a client obtain SSD benefits due to a number of medical conditions, which included irritable bowel disease. The IBD caused disturbances in the client’s appetite, which caused fluctuations in her weight. Our office stepped in to represent this client at the administrative law hearing, and were able to show that her physical disabilities and mental impairments made her unable to continue to work in any capacity; in addition, they interfered with her ability to perform basic activities of daily living, like cooking, cleaning and shopping. The judge approved her application and she is now receiving benefits.
Resources for Those Suffering from Irritable Bowel Disease
Irritable bowel disease isn’t often taken seriously by the public, by those diagnosed with IBD know it’s no laughing matter. There are resources available to help you learn more about the disease and how to manage it.
The Crohn’s & Colitis Foundation of America is the leading source of information on Crohn’s disease, ulcerative colitis, and all other inflammatory bowel diseases. Search the site for a variety of topics on living with and managing IBD, treatment options, and connect with others on-line (or search for local support groups) who can relate to your experience.
You and IBD is an animated, interactive site that uses videos and graphics to help patients understand IBD, it’s effects and treatment options.
Are you applying for Social Security Disability benefits due to IBD? Consider the Law Office of Neil H. Good for your legal representation. Call us at #(847) 577-4476 or complete this form online.