Receiving Social Security Disability for Inflammatory Bowel Disease

An estimated 3 million Americans had Inflammatory Bowel Disease in 2015, according to a Centers for Disease Control (CDC) report. Those with IBD suffer great discomfort to the point it can often interfere with their daily functions. Many find it difficult to maintain their ability to work and suffer financial loss.

If you have an Inflammatory Bowel Disease and it interferes with your ability to work, you could be eligible to receive Social Security Disability (SSDI) benefits.

What is Inflammatory Bowel Disease?

Inflammatory Bowel Disease (IBD) is a general term describing a group of conditions that affect the gastrointestinal (GI) tract. The conditions cause chronic inflammation and swelling in the GI tract, namely the intestines and colon, that can cause permanent damage.

The two most common IBD conditions are Crohn’s disease and ulcerative colitis. They differ in the type of inflammation the cause and where it occurs in the GI tract.

Crohn’s disease may affect any part of the GI tract. But, most cases occur in the part of the small intestine that meets the large intestine. Inflammation from Crohn’s disease may affect the entire wall of the GI tract and damage appears in patches. Ulcerative colitis occurs in the colon and rectum with inflammation only affecting the innermost layer of the bowel lining. Damage from ulcerative colitis can be seen in a continuous area starting from the rectum and spreading into the colon.

Although the exact cause of IBD is unknown, it is believed to result from a defective immune system. 

Some common symptoms of IBD are:

  • Chronic diarrhea
  • Abdominal pain and cramping
  • Vomiting
  • Rectal bleeding/bloody stools
  • Weight loss
  • Fatigue
  • Fever

Treatment for IBD conditions typically includes medications to prevent or manage inflammation flare-ups in the GI tract. But, in serious cases, surgery to remove damaged portions of the intestines or colon may be required.

SSDI and Inflammatory Bowel Disease

The Social Security Administration (SSA) has a 5 step process they use to determine a claimant’s eligibility for SSDI benefits. Those filing a SSDI claim for an Inflammatory Bowel Disease must go through the following process:

  1. Determine if the claimant is working at or above the Substantial Gainful Activity (SGA) level as defined by the SSA in the year they file. The SGA level for 2017 is a monthly income of $1170.
  2. Determine if the claimant’s complications from Inflammatory Bowel Disease significantly limits their ability to perform basic work activities such as:
  • sitting
  • standing
  • reaching
  • pulling or pushing
  • lifting or carrying
  • simple cognitive reasoning
  1. Determine if complications from claimant’s Inflammatory Bowel Disease meet the criteria outlined in the SSA’s impairments list.

The impairment listing for Inflammatory Bowel Disease requires a clinical diagnosis of an IBD condition with the following:

A scar tissue obstruction in the colon or small intestine requiring hospitalization for intestinal decompression or surgery on at least two occasions, 60 days apart, and within a consecutive six-month period

OR

At least 2 of the following symptoms occurring within a consecutive six month period despite treatment:

  • Anemia with hemoglobin levels of less than 10.0 g/dL, present on at least two evaluations at least 60 days apart
  • Serum albumin levels of 3.0 g/dL or less, present on at least two evaluations at least 60 days apart
  • Clinically documented mass in the abdomen with pain or cramping not fully controlled by prescribed medication, present on at least two evaluations at least 60 days apart
  • Perineal disease with a draining abscess or fistula, with pain not fully controlled by prescribed medication, present on at least two evaluations at least 60 days apart
  • Involuntary weight loss of at least 10 percent from baseline (original weight), present on at least two evaluations at least 60 days apart
  • Need for feeding tube to provide daily supplemental nutrition
  1. Determine if the claimant can still do any work they may have done in the past despite the complications of Inflammatory Bowel Disease.
  2. Determine if the claimant can do any other type of work based upon their:
  • age
  • education
  • prior work experience
  • mental and physical capabilities

Getting Help with Your Claim

Have you been diagnosed with Inflammatory Bowel Disease? Do complications from your IBD interfere with your ability to work? You could be eligible to receive SSDI benefits.

Getting approval for benefits because of IBD can be complicated. You must have detailed medical records showing how your IBD affects your daily life and ability to work. Your information must be complete and stand up to evaluation by the SSA.

You should not face this process alone. Contact us today for a free evaluation of your situation and let one of our experienced SSDI lawyers help you get the benefits you need.