Crohn's disease is a type of inflammatory bowel disease (IBD), a chronic inflammatory condition of the intestines. Crohn's disease primarily causes breaks (ulcerations) in the lining of the small and large intestines, but it can affect the digestive system at any point in the gastrointestinal (GI) tract, as well as the kidneys, skin, and eyes. In severe cases, bowel obstructions and perforations can occur.
Crohn's disease usually causes inflammation in the lower part of the small intestine and the beginning of the large intestine. The inflammation extends deep into the intestinal lining and can cause pain and make the intestines empty frequently. Disabling symptoms of Crohn's include:
These symptoms tend to fluctuate between periods of inactivity (remission) and activity (relapse). It can be difficult to diagnose because its symptoms are similar to other intestinal disorders, such as irritable bowel syndrome (IBS), and to another type of IBD known as ulcerative colitis.
Iloecolotis is the most common form of Crohn's disease, but there are five main types of the disease, defined by the location of the inflammation in your GI tract:
Diverticulitis is a sometimes-related form of inflammation in your large intestine, usually at the end of your colon (the sigmoid colon). Like Crohn's, diverticulitis symptoms aren't usually constant but can flare up and then recede.
Yes, the Social Security Administration (SSA) considers severe Crohn's disease to be a significant impairment that can prevent an individual from performing substantial work.
The limitations caused by the symptoms listed above can be disabling, and the ongoing treatment for Crohn's can also make it difficult to work. Doctors treat acute flare-ups of Crohn's disease aggressively to achieve remission. Once remission is achieved, treatment usually continues, including antibiotics for infections and anti-inflammatory drugs to control inflammation. Severe Crohn's cases may require multiple surgeries to control or maintain remission of the disease.
Even after surgery, Crohn's can continue to be a lifelong problem that makes it impossible to hold down a full-time job.
Yes, you can get disability benefits if your Crohn's disease causes severe symptoms that make it extremely difficult for you to do physical activities and focus on work. Social Security will approve you for benefits if you either show that there are no jobs you can do with your limitations or you show that your medical evidence meets the criteria in a medical listing.
In the listing of impairments published by the SSA, Social Security evaluates Crohn's disease under the medical listing for inflammatory bowel disease (IBD).
Social Security includes inflammatory bowel disease in its list of impairments called the Blue Book. To qualify under the IBD listing (listing 5.06), your Crohn's disease must be documented by endoscopy, biopsy, surgery, or appropriate imaging (like a CT scan or x-ray).
First, you need to have a diagnosis of IBD or Crohn's, and second, you need to have one of the two following complications:
1) A bowel obstruction. You must have had an obstruction in the small intestine or colon, with dilation and swelling, requiring two instances of hospitalization or surgery within a six-month period.
2) Two of the complications listed below. You must have any two of the following symptoms within a six-month period:
If you don't have one of the above complications that are required for meeting the medical listing, you can qualify for benefits "vocationally." You'll need to show that your symptoms make it impossible to work your prior job, and that with your job skills and education, there are no other types of jobs you could learn to do that you would be capable of doing.
First, Social Security will look at your documented symptoms to determine your residual functional capacity (RFC): what activities you can still do despite your medical condition. To help the SSA assess your RFC, it's helpful for your doctor to know enough about your limitations to be able to describe them fully:
Your doctor should also document how often you have flare-ups and should detail whether you need to frequently reposition yourself or take frequent and unscheduled breaks or trips to the restroom. These last limitations, often caused by chronic diarrhea, can affect your ability to keep any type of job, and are often the reason that Social Security judges will grant benefits for Crohn's disease. Other patients with Crohn's have symptoms so severe that they need to take off several days a month from work, which also rules out most jobs.
For more information, see how the SSA judges your ability to work despite your symptoms.
Crohn's can also cause mental and cognitive impairments. Cognitive and emotional symptoms can include:
If you experience any of these mental symptoms, Social Security will consider how they affect your ability to work. The SSA has to consider your combined impairments when determining whether you can work, so let your doctor know about these health concerns so that they're included in your doctor's treatment notes when they get sent to the agency.
If you've been unable to work for a year—or you're not working now and think you won't be able to work for at least a year—and you think you can qualify under the above criteria, here are your next steps.
What types of medical evidence do you need to meet the listing for Crohn's disease? Your doctors' treatment notes should be extensive and include a record, over time, of the frequency and severity of all of your physical and mental symptoms.
To get approved for disability under the listing for IBD specifically, your medical records should also include the following:
If your medical records are thin, Social Security might also send you for an independent exam by one of their doctors or ask your doctor to complete a questionnaire about your limitations.
To learn more, read about how to gather the medical evidence you'll need to prove you qualify for Social Security disability because of your inflammatory bowel disorder.
Even if your Crohn's or IBD qualifies as a disability under Social Security's medical rules, you must meet certain non-medical requirements to be eligible for disability. The specific requirements depend on which benefit(s) you're applying for—SSDI, SSI, or both.
For SSDI eligibility, you must have worked and paid Social Security taxes—FICA or self-employment tax. And you must have worked long enough to have earned the required amount of work credits.
Since SSI disability is for low-income applicants who haven't worked much or haven't worked recently, the non-medical requirements are based on your income and assets. (Although your citizenship or immigration status is also a factor.) Learn more about the specific income and asset limits you must meet to qualify for SSI.
When you apply, Social Security can help you decide whether to apply for SSDI or SSI, or the agency can decide for you.
In addition to your name, Social Security number, and work history, the SSA will need records of your medical evidence, including:
After you submit your application, your state's disability determination services (DDS) agency will assign your claim to a disability examiner for review. The process can take several months, but the more evidence and medical documentation you're able to provide, the better your chances of being able to get your claim approved.
Unfortunately, getting disability benefits for IBD or Crohn's disease isn't easy. According to the most recent statistics available from Social Security, only 26% of disability applicants whose primary complaint was Crohn's disease were approved at the initial application stage. But at the hearing stage, Social Security judges granted benefits to 76% of those who appealed the denial, so it makes sense to appeal.
If you receive a denial letter and feel your case is strong enough to win an appeal, consider contacting a disability lawyer to help you file the appeal paperwork before the deadline (60 days after the denial). Here's what to do if you get denied.
Updated September 19, 2023