Getting Social Security Disability Benefits for Severe Gastroparesis

Gastroparesis is a chronic 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, which can lead to nausea, vomiting, abdominal pain, blood sugar problems, and nutritional deficiencies.

Complications, Causes, and Treatment of Gastroparesis

Severe cases of gastroparesis can result in the development of potentially fatal bezoars (hardened food material in the stomach), severe dehydration, and malnutrition, and can lead to disability.

Doctors don't know the exact cause of gastroparesis, but it's often related to damage to the vagus nerve (this nerve helps regulate digestion). Conditions like diabetes, eating disorders, and surgical procedures can all result in damage to the vagus nerve. Scleroderma, Parkinson's disease, and hypothyroidism have also been linked to gastroparesis.

Diet changes can sometimes help a little with the symptoms of gastroparesis, such as eating smaller meals, avoiding fibrous vegetables, raw foods, and alcohol, and eating softer foods. Medications can sometimes help as well (such as metoclopramide or erythromycin), though their side effects can be quite serious.

Can I Get Disability Benefits for Gastroparesis?

You might be eligible for disability benefits based on gastroparesis if your symptoms are so severe that you aren't able to do a substantial amount of work for at least 12 months. Social Security considers anything above approximately $19,200 per year to be a substantial amount of work.

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 included 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 medical listing, your digestive symptoms might be able to get you approved under one of the digestive system listings. Here's an example:

Listing 5.08, Weight loss due to any digestive disorder

If you're getting treatment for your gastroparesis and are following the prescribed treatment, you can get approved under listing 5.08 for weight loss if:

• your body mass index (BMI) falls below 17.50
• the BMI is documented on two separate occasions in one year, and
• the two occasions are at least 60 days apart.

It's important to note that if you are not following your prescribed treatment, you won't 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 based on the listing for that medical condition. For example:

• If you have scleroderma, you could qualify under listing 14.04 for systemic sclerosis.
• If you have Parkinson's disease, you could qualify under listing 11.06 for Parkinsonian syndrome

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

You might still be eligible for disability even if your gastroparesis doesn't meet (or "equal") the weight loss listing or another listing, depending on the physical or non-physical limitations it causes you to have. You'd have to show that your limitations prevent you from doing full-time work. If you don't meet a listing, Social Security will determine your residual functional capacity (RFC).

Your Physical Limitations and Your RFC

Your RFC describes which of the physical aspects of a job you can do on a regular and sustained basis (full-time). Social Security will prepare an RFC report based on the medical records you've provided, including your doctor's notes about how your symptoms impact your 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 aren't related to strength. Non-exertional impairments can result from the illness itself or from medications you take to treat your illness. Medications for gastroparesis can cause fatigue, abdominal cramps, diarrhea, and depression.

The SSA will add non-exertional impairments to your RFC and must consider them when deciding whether you can work. Here are some examples of non-exertional impairments:

• reduced ability to pay attention or concentration
• impaired functioning because of depression, and
• needing to take unscheduled trips to the bathroom.

Social Security recognizes that limitations that affect your ability to attend work regularly and to be productive at work can affect your ability to keep any type of job. And the SSA is required to consider the combined effect of all exertional or non-exertional impairments you experience. (For more information, read our article on how having multiple types of limitations can help you get disability.)

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

How to Apply for Disability for Gastroparesis

You can apply for Social Security disability online or by phone at 800-772-1213 (TTY 800-325-0778). You can also contact your local SSA office to get help completing your application in person, or ask a disability law firm to help you with the application.

When you apply, the SSA will need your employment history and records of your medical evidence, including:

• results of clinical exams and blood tests
• medications and treatments you've tried (and whether they cause any serious side effects), and
• your doctor's treatment notes (including how gastroparesis limits your ability to work).

In addition, you must meet certain non-medical requirements to be eligible for disability. For SSI, which is for low-income applicants who haven't worked recently, the non-medical requirements are based on income and asset limits. For SSDI, you must have worked enough to have earned the required amount of work credits. When you apply, Social Security can help you decide whether to apply for SSDI or SSI.