Can You Get Disability Benefits for Celiac Disease?

It's difficult to get ongoing Social Security or SSI disability benefits for celiac disease since avoiding gluten usually removes impairments.

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Celiac disease is a type of digestive disorder that prevents you from eating foods containing gluten, a protein that can be found in barley, rye, and wheat products. When you have celiac disease, your body responds to gluten by destroying villi located in the small intestine. If these villi are damaged, then you are unable to absorb nutrients from food into your bloodstream. Celiac disease may be related to leaky gut syndrome.

Common symptoms of celiac disease include abdominal pain and bloating, diarrhea, poor smelling stools, weight loss, delayed growth in children due to malnutrition, fatigue, bone loss, numbness in the hands and feet, canker sores, and depression.

Celiac disease is usually treated by eating a gluten-free diet. You can ask your doctor for a blood test or laboratory test to see whether you have this disease. 

Qualifying for Disability Benefits with Celiac Disease

The Social Security Administration (SSA) requires that you are unable to work for at least a year (or longer) as a result of your celiac disease. This is a difficult requirement to meet for celiac disease, because once you've been diagnosed with it and give up gluten-containing foods, you should no longer suffer any disability. However, there are cases where it takes years to be diagnosed with celiac disease. In those cases, if your disability lasted at least one year before you were diagnosed with celiac disease, you can ask for benefits for that length of time as a "closed period" of benefits.

When considering whether you are disabled, the SSA will also consider whether you have any other disorders, such as depression

Meeting a Disability Listing in the Listing of Impairments

The Listing of Impairments (known as the "Blue Book") describes various types of diseases and what medical evidence is needed to prove disability for each disorder. Unfortunately, celiac disease is not included as a separate listing, so if you are diagnosed with celiac disease, you will not be automatically granted benefits.

Instead, the SSA will review your medical information to determine if your condition is severe enough to "equal" (be equivalent in severity to) another disability listing, such as the listing for inflammatory bowel disease. This would require your doctor to submit a medical statement to the SSA stating that the impairments and limitations caused by your celiac disease are equivalent in severity to the requirements of another disability listing. The SSA will look to see if your medical history and clinical testing supports your doctor's statement. 

Two disorders that are similar to celiac disease and which are included in the Listing of Impairments are: (1) weight loss due to any digestive disorder; and (2) inflammatory bowel disease (IBD).

To meet or equal Listing 5.08, weight loss due to any digestive disorder, you must show evidence of the following factors.

  • You have a body mass index (BMI) of less than 17.50, and this BMI was present during at least two evaluations at least 60 days apart within a six-month period, and
  • You have been continuing your medical treatment as ordered by your doctor.

To meet or equal Listing 5.06, inflammatory bowel disease, you must show evidence of two of the following factors in the same six-month period despite treatment.

  • The presence of anemia along with a reading of hemoglobin (a protein in your red blood cells) that is less than 10.0 g/dL, and occurring during two evaluations at least 60 days apart.
  • A tender abdominal mass documented by physical examination along with cramping or abdominal pain that is not under control by medication, and occurring for two evaluations at least 60 days apart.
  • Having weight loss that is 10% less than normal, that was documented during two evaluations at least 60 days apart.
  • Needing supplemental daily nutrition through either a gastrostomy (a tube located in your stomach) or a central venous catheter.

Evaluating Your Residual Functional Capacity

If your symptoms of celiac disease are not severe enough to equal one of the disability listings above, then the next step is for the SSA to determine your residual functional capacity (RFC). Your RFC describes the most amount of work that you can perform, and is labeled as sedentary, light, medium, or heavy work. To determine your RFC, the SSA will evaluate your ability to perform work tasks such as sitting, standing, walking, interacting with coworkers and supervisors, and following simple instructions.

If you can't perform at least sedentary work (for instance, an inability to sit for six hours per day and stand/walk for two hours per day), you should be found disabled.

If you are over age 50, you could be found disabled even if you can perform sedentary or light work, if your education and prior job skills didn't prepare you to do sedentary or light work. 

It would be helpful for your doctor to write out an opinion stating any limitations that you have as a result of your celiac disease. If you need to take frequent rest room breaks throughout the day, your RFC should include that limitation. In addition, if you suffer from any type of abdominal pain that could affect your ability to concentrate on tasks, this should be in your RFC. If you are unable to work on a regular basis, or you would miss several days of work per month as a result of your disorder, then this should be in your RFC, and the SSA could find you disabled.

Learn more about your RFC and how it can help you get approved for disability.

by: Suzanne Gaffke

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