How to Get Disability Benefits for Ulcerative Colitis

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.

Understanding and Managing Ulcerative Colitis

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.

What Causes Ulcerative Colitis?

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.)

Symptoms of Ulcerative Colitis

The most common symptoms of ulcerative colitis include:

• stomach pain and cramping
• weight loss
• constipation
• diarrhea
• rectal pain and bleeding
• fatigue, and
• fever.

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.

Treatment for Ulcerative Colitis

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.

Getting Disability for Ulcerative Colitis by Meeting a Listed Impairment

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.

Listing 5.06, Inflammatory Bowel Disease

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 twelve-month period, despite treatment:

• anemia, as demonstrated by tests showing a level of hemoglobin—a protein in your red blood cells—that is less than 10 grams per deciliter (g/DL), and occurring during two evaluations at least 60 days apart
• levels of serum albumin, a blood protein, at or below 3.0 g/DL on two evaluations at least 60 days apart
• a tender abdominal mass that your doctor can feel on physical examination, along with cramping or abdominal pain, that occurs for two evaluations at least 60 days apart
• a draining abscess or fistula in the perineum, accompanied by pain, documented at least two times 60 days apart, or
• needing supplemental daily nutrition through either a gastrostomy, duodenostomy, or jejunostomy (medical procedures that place a tube in your stomach or intestines) or a central venous catheter.

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 twelve months, and each hospitalization must be at least 60 days apart.

Finally, you may also meet the listing if you have repeated complications of ulcerative colitis (such as joint pain or dehydration) that are frequent and severe. You'll need to show that your flare-ups meet the following requirements over a twelve-month period:

• they occur on average three times a year or once every four months
• each complication lasts two weeks or more, and
• they cause "marked" (intense) limitations in your daily activities, social functioning, or ability to concentrate.

Listing 5.07, Intestinal Failure

Severe cases of ulcerative colitis may result in gut function below the minimum needed for your body to absorb nutrients on its own. When that happens, it's referred to as intestinal failure.

Causes of intestinal failure can include short bowel syndrome (commonly due to surgical removal or resection of the small intestine), chronic motility disorders (a condition where food moves along the digestive tract in an abnormal way), or extensive small bowel mucosal disease (where the surface of the small bowel loses nutrients). If you have one of the above conditions, and you rely on a central venous catheter to meet your daily nutrition requirements for at least a year, you'll likely meet listing 5.07. (Read our article on getting disability for intestinal failure or "short bowel syndrome".)

Listing 5.08, Weight Loss Due to Any Digestive Disorder

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 twelve-month period.

Ulcerative Colitis and Your Residual Functional Capacity

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.

Filing for Disability Due to Ulcerative Colitis

There are four ways you can file your application for Social Security benefits:

• File for disability online through Social Security's website.
• Complete the application over the phone at 888-772-1213, between 8 a.m. and 7 p.m., Monday through Friday. (People who are deaf or hard of hearing can call the TTY number at 800-325-0778.)
• Apply in person at your local Social Security office.
• Hire an attorney or representative to file your application for you.

For more tips, check out our article on how to apply for Social Security disability benefits.