Getting Social Security Disability Benefits for Severe Gastroparesis

When gastroparesis is so disruptive to your digestion that you can no longer work, you may be able to get Social Security disability benefits.

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Gastroparesis is a condition that prevents a person’s food from moving normally through the digestive tract due to abnormally weak muscles in the stomach wall. Sometimes the condition is so severe that the muscles can’t function at all. The result is that the stomach doesn’t empty or digest properly. This can lead to nausea, vomiting, blood sugar problems, and nutritional deficiencies. Severe cases of gastroparesis can result in malnutrition, the development of potentially fatal bezoars (hardened food material in the stomach), and dehydration.

Diet changes can sometimes help a little with the symptoms of gastroparesis, as can medications, though their side effects can be serious.

Doctors don’t know the exact cause of gastroparesis, but it is often related to damage to the vagus nerve (this nerve helps regulate digestion). Conditions like diabetes or surgical procedures can both result in damage to the vagus nerve.

Can I Get Disability Benefits for Gastroparesis?

You may be eligible for disability based on gastroparesis if your symptoms are so severe that you are not able to work at the substantial gainful activity (SGA) level for at least 12 months. For 2014, SGA was defined as earning $1,070 a month from working.

If you satisfy this basic requirement, the Social Security Administration (SSA) will look to see whether your gastroparesis meets one of the medical conditions it has named in its Listing of Impairments (referred to as “the listings.”) The conditions named in the listings are those that the SSA has decided are so severe that they usually warrant an automatic approval of benefits.

Even though gastroparesis doesn’t have its own listing, you can still get approved under one of the digestive system listings. Here is an example:

Listing 5.08 Weight loss due to any digestive disorder

If you are getting treatment for your gastroparesis and are following the prescribed treatment, you can get approved under the listing for weight loss if:

  • your body mass index (BMI) falls below 17.50
  • the BMI is documented on two separate occasions, and
  • the documentation occurs at least 60 days apart during a 6-month consecutive period.

It is important to note that if you are not following your prescribed treatment, you will not be eligible for approval under this listing.

Related Listings

If an underlying cause has been identified for your gastroparesis, you may be able to qualify for disability benefits base don that listing. For example, gastroparesis can occur in people who have severe Type I or Type II diabetes.

Can I Still Get Disability if I Don’t Meet a Listing?

You may still be eligible for disability even if your gastroparesis doesn’t meet the listing, depending on any physical or non-physical limitations it causes.

Your RFC

If you don’t meet a listing, the SSA will determine your residual functional capacity (RFC). Your RFC describes which of the physical aspects of a job you can do on a regular and sustained basis (full-time). To make this determination, the SSA will prepare an RFC report based on the medical records you have provided, assessing how your symptoms impact you ability to do certain exertional activities like your ability to stand, walk, lift, and carry. But because the symptoms of gastroparesis don’t necessarily cause weakness, you may be more likely to get approved because of your non-exertional impairments.

Your Non-Exertional Impairments

A non-exertional impairment is one that affects your ability to do work-related activities that are not related to strength. Non-exertional impairments can result from the illness itself or from medications you take to treat your the illness. Medications for gastroparesis can cause fatigue, sleepiness, and depression.

The SSA must consider any non-exertional impairments when deciding whether you can work. Here are some examples of non-exertional impairments:

  • impaired functioning because of nervousness, anxiety, or depression
  • reduced ability to pay attention or concentration
  • reduced ability to understand or remember simple instructions
  • impaired vision or hearing, and
  • difficulty with the physical aspects of a work environment such as noise and dust.

Here is an example of how non-exertional impairments can affect someone with someone with gastroparesis.

Example

Lyndsey applied for disability based on severe gastroparesis. Although she didn’t meet the listing requirements, she still had multiple symptoms that impacted her ability to work. For example, Lyndsey experienced stomach pain and intense nausea after each meal despite following a prescribed diet and taking medication. These symptoms occurred with each meal and she would frequently experience intense fatigue once the nausea and stomach pain had passed. The fatigue severely impacted her ability to focus and concentrate on her job. Additionally, the medication Lyndsey took for the gastroparesis caused intense drowsiness. Lyndsey was required to take the medication with each meal and would frequently need to rest for at least an hour following each dose. Also, the medication itself caused stomach upset, including vomiting and diarrhea. These symptoms severely limited her productivity at work and she often had to leave early or call in sick to work. Based on these symptoms and the medical evidence in her file that supported her claim, Lyndsey’s attorney was able to prove that the combined effect of these non-exertional impairments made it impossible for her to work, and she was approved for benefits.

The SSA is required to consider the combined effect of any exertional or non-exertional impairments you experience. For more information, read our article How Combining Exertional and Non-Exertional Limitations Can Help You Get Disability.

by: , Contributing Author

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