Getting Social Security Disability for Crohn's Disease

Sufferers of Crohn's disease have a good chance of getting approved for Social Security disability benefits at an appeal hearing.

According to the most recent statistics available from Social Security, disability applicants whose primary complaint was Crohn's disease were likely to get denied at the initial application stage (only 26% approved), but approved at the hearing stage (Social Security judges granted benefits to 76% of those who appealed the denial).

Crohn's disease is a type of inflammatory bowel disease (IBD), a chronic inflammatory condition of the intestines. Crohn's disease primarily causes breaks in the lining of the small and large intestines (ulcerations), but it can affect the digestive system at any point in the gastrointestinal track as well as the kidneys, skin, and eyes. In severe cases, bowel obstructions and perforations may occur.

Symptoms of Crohn's Disease

Crohn's disease usually causes inflammation in the lower part of the small intestine, called the ileum. The inflammation extends deep into the intestinal lining and can cause pain and make the intestines empty frequently. Disabling symptoms of Crohn's include abdominal pain, diarrhea, rectal bleeding, fever, loss of appetite, fatigue, and weight loss. 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.

Treatment of Crohn's Disease

Acute flare-ups of Crohn's disease are treated aggressively to achieve a remission. Once remission is achieved, treatment usually includes 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 be a lifelong problem to that makes it impossible to hold down a full-time job.

Getting Disability for Crohn's Disease

Is Crohn's disease considered a disability? Yes, Social Security considers severe Crohn's disease to be a significant impairment that may prevent an individual from performing substantial work. In the listing of impairments published by the Social Security Administration (SSA), Social Security evaluates Crohn's disease under inflammatory bowel disease (IBD).

Listing for Inflammatory Bowel Disease

To qualify under the IBD listing (listing 5.06), you need to have a diagnosis of IBD or Crohn's plus one of the following complications.

Bowel obstruction. An obstruction in the small intestine or colon, with dilation and swelling, requiring two instances of hospitalization or surgery within a six-month period.

OR

Two of the complications listed below. Any two of the following symptoms within a six-month period.

  • severe anemia (hemoglobin less than 10 g/dL) in two blood tests at least 60 days apart
  • low levels of serum albumin (3.0 g/dL or less) on two occasions 60 days apart
  • tender abdominal with abdominal cramping or pain uncontrolled with prescription pain medication, documented twice at least 60 days apart
  • perineal disease with an abscess or fistula, with pain uncontrolled with prescription pain medication, twice at least 60 days apart
  • involuntary weight loss of 10% or more from your starting weight, documented twice at least 60 days apart, or
  • need for feeding tube in the stomach, nose, or small intestine, or feeding by central venous catheter.

If you don't have the requisite complications, you can also qualify if you can 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.

Getting Disability for Crohn's Without Meeting Listing 5.06

The SSA will look at your documented symptoms to determine your residual functional capacity (RFC): what activities you can do despite your medical condition. To help the SSA assess your RFC, it's helpful for your doctor to describe your limitations: how long you are able to sit, stand, walk, and lift, how much weight you can carry and how often, and whether you can operate heavy equipment or drive. 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. For more information, see how the SSA judges your ability to work despite your symptoms.

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