Ulcerative colitis is an intestinal disease that causes ulcers in the large intestine and can lead to serious health problems. Severe symptoms of colitis can significantly interfere with your activities of daily living and ability to work full-time.
Ulcerative colitis causes ulcers in the large intestine (also called the colon). These ulcers cause thickening and scarring of the colon, which makes it difficult for the body to properly absorb water and electrolytes from the food passing through the organ as stool.
People with ulcerative colitis can experience serious complications including colon rupture, colon cancer, fistulas, and abscesses around the anus. A related but different intestinal disorder is Crohn's disease.
Doctors aren't yet sure what causes ulcerative colitis. Many people with ulcerative colitis have other immune system abnormalities, but the reasons why some people's immune systems target the large intestines while others don't remain unclear. Genetics and exposure to bacteria or viruses may also play a role.
Diet and stress were previously suspected to cause ulcerative colitis, but doctors now know these factors don't cause the disorder (although they may aggravate certain symptoms.)
The most common symptoms of ulcerative colitis include:
Ulcerative colitis is diagnosed with an endoscopic colonoscopy, a procedure where a thin, flexible tube is inserted into the colon through the anus. Doctors use the tube to take pictures of your intestine and rule out other types of colitis. Your doctor might also take a blood test or stool sample to confirm the diagnosis.
Most doctors prefer medication as the initial step in treatment for ulcerative colitis. Along with medication, symptoms can sometimes improve by avoiding foods that irritate the intestine, such as highly seasoned foods, raw fruits and vegetables, or milk sugar (lactose). In severe cases, surgery may be necessary to remove the diseased colon.
Social Security's Listing of Impairments—also known as the Blue Book—contains medical criteria the agency uses to evaluate disabling conditions in adults. If you meet the criteria of a listing, you'll automatically qualify for benefits as long as you satisfy the non-medical requirements for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI).
Ulcerative colitis is evaluated under the Blue Book section for digestive disorders. Depending on what evidence your medical record contains, you might be approved for SSDI or SSI under one of the following listed impairments.
You may qualify for disability automatically under listing 5.06 if your medical record contains evidence of at least two of the following criteria in the same six-month period, despite treatment:
If you haven't had at least two of the above complications, you can still meet the listing criteria if you have a condition called intestinal stenosis—a blockage or narrowing of the intestine to the point where it's difficult for nutrients to move through. You'll need to show that you've been hospitalized for the condition two times in six months, and each hospitalization must be at least 60 days apart.
Severe cases of ulcerative colitis may require surgery to correct. If you've had surgical resection of more than one-half of your small intestine, and you rely on a device called a central venous catheter to meet your daily nutrition requirements, you'll likely meet listing 5.07. (Read our article on getting disability for short bowel syndrome.)
If ulcerative colitis has caused you to lose a significant amount of weight, you may qualify under listing 5.08 for digestive disorder weight loss. Your medical records will need to show that you have a body mass index (BMI) of less than 17.5 on two occasions at least 60 days apart within a consecutive 6-month period.
You can still qualify for disability benefits even if you don't meet (or "equal") one of the digestive system listings—if you can show that your ulcerative colitis symptoms keep you from full-time work. If you don't meet a listing, Social Security will decide whether you can work despite your health conditions by doing a residual functional capacity (RFC) assessment.
Your RFC lists the tasks you can do at work and any restrictions on tasks you'll need to avoid. The agency examines your medical records and daily routine to assess your RFC. For example, if you have diarrhea from ulcerative colitis that requires frequent and unplanned trips to the restroom, your RFC might state that you'll need to be allowed to take unscheduled breaks during your workday. Or, if you have chronic rectal pain, your RFC may state that you must be able to change positions frequently in a job setting.
Many jobs can't accommodate the number of unscheduled breaks a person with ulcerative colitis may need to take in a workday. And needing to change positions too frequently at work in order to manage pain can also eliminate even simple, sit-down jobs. You can read more about which limitations can rule out all jobs in our article on getting disability when you're unable to do sedentary work.
There are four ways you can file your application for Social Security benefits:
For more tips, check out our article on how to apply for Social Security disability benefits.
Updated September 12, 2023
Need a lawyer? Start here.