Social Security doesn't include endometriosis in its listing of impairments, but if you have complications, you might still qualify for disability benefits.
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Endometriosis is a chronic inflammatory condition where tissue cells that are similar to the uterine lining (“endometrial cells”) grow outside the uterus, causing severe discomfort. Over 80 million people worldwide, most between 20 and 40 years old, have endometriosis. Pain from endometriosis, particularly during menstruation, can make it difficult to accomplish your daily activities and can disrupt your work routine.
Treatments like surgery and medication can ease some of the symptoms, but there’s currently no cure for the disorder. Even so, getting disability benefits for endometriosis is a challenge. But if your endometriosis symptoms are severe enough to keep you from working full-time for at least a year, you might qualify for SSDI or SSI. (Milder forms of the condition may entitle you to reasonable accommodations under the Americans With Disabilities Act.) Rather than powering through the pain to the detriment of your work, it helps to learn more about these benefits.
Is Endometriosis a Disability?
The Social Security Administration (SSA) awards disability benefits to people who have a medically determinable impairment that keeps them from earning at or above the level of substantial gainful activity for twelve months or longer. That means you’ll first need to have doctor’s notes or tests establishing that you have endometriosis as well as symptoms that keep you out of work for a year or more.
Endometriosis isn’t included among Social Security’s Blue Book list of conditions that can automatically qualify as disabilities, so you’ll also have to show that you have functional limitations that rule out both your past work and all other jobs. Because many people with endometriosis are in their prime working years, that typically means being unable to perform even the simplest sedentary (sit-down) jobs on a regular basis, which can be difficult.
If you can still do a basic desk job despite your symptoms, you won’t be eligible for SSDI or SSI benefits. However, you might be entitled to reasonable accommodations under the Americans with Disabilities Act (ADA) if your endometriosis substantially limits a major life activity. (42 U.S.C. § 12102 (2026).) Examples of ADA accommodations could include a flexible schedule or extra time off work to manage your symptoms.
How to Get Social Security Disability Benefits for Endometriosis
Social Security will need to see medical records showing that your endometriosis symptoms limit you so much that you can no longer work. The agency will review these records—including doctors’ progress notes, hospital admission and discharge summaries, and medication lists—in order to decide which limitations should be included in your residual functional capacity (RFC).
Your RFC is a set of restrictions that describe what you can and can’t do in a work environment. These restrictions can be physical, mental, or both, depending on what the medical evidence shows. For example, your records might show Social Security that chronic pain and fatigue from your endometriosis limit your ability to perform the following activities:
- standing, walking, or sitting
- lifting or carrying objects
- concentrating on job tasks
- understanding instructions from your supervisor, or
- dealing with coworkers and the general public.
It’s helpful to have your doctor or gynecologist complete a physical RFC form or a mental RFC form that discusses what your specific limitations are. Social Security values the opinions of medical providers who’ve seen you regularly and can provide helpful insight into how your endometriosis affects your ability to work full-time.
Once Social Security has assessed your RFC, the agency will then look at your past work history to determine whether you could still do those jobs given your current limitations. If you can’t, then Social Security will see whether any other work exists that you could do with your RFC. Here’s an example:
Age can work against you here because Social Security assumes that younger claimants (under 50) will have an easier time adjusting to other jobs, and most people with endometriosis fall within this age category. But keep in mind that the agency must consider the combined effect of all your medical conditions when assessing your RFC, so make sure to discuss all medical impairments, physical and mental, that you’re receiving treatment for when you apply for benefits.
Medical Records You’ll Need to Get Disability for Endometriosis
Medical evidence is the foundation of your disability claim. You’ll want to submit all the progress notes from your physician or gynecologist that show what symptoms you’re receiving treatment for and when. The primary symptom of endometriosis is pelvic pain, particularly during menstruation, sexual intercourse, bowel movements, and urination. Abdominal bloating and nausea are also widely reported symptoms.
Endometriosis can cause internal bleeding, inflammation, and the formation of scar tissue. If you have medical imaging (such as an X-ray, MRI, or CT scan) that shows symptoms, don’t forget to mention them in your disability application. And although endometriosis mainly affects the uterus, ovaries, and fallopian tubes, endometrial cells can grow on or in other organs like your bladder, bowels, and small intestine. If that’s the case for you, imaging of those organs should also be included in your medical record.
How Do You Apply for SSDI or SSI?
You can apply for Social Security disability benefits in a few different ways. The fastest way to get started is to use the SSA’s online application. Another advantage to applying online is that you can do so at your convenience, pausing the process as often as needed.
You can also apply by phone by calling Social Security’s national office at 800-722-1213 (TTY 800-325-0778). Or apply in person at your local Social Security field office. Both of these methods can involve long waits, but they offer you a chance to speak to an agency representative and ask questions during the process.
What If Social Security Says I Don’t Qualify?
Winning a disability claim for endometriosis is an uphill battle. Few people are awarded disability benefits on their first try, but you can appeal the denial, preferably with help from an experienced disability attorney or advocate.
A lawyer can help you gather medical evidence, handle communications with Social Security, and represent you at a disability hearing. Disability attorneys work on contingency (meaning they get paid only if you win) and many offer free consultations, so it doesn’t hurt to ask around to find a lawyer you like.
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