Can You Get Disability Benefits for Celiac Disease?

Celiac disease is a type of autoimmune digestive disorder that prevents you from eating foods containing gluten, a protein that can be found in barley, rye, and wheat products. When you have celiac disease, your body responds to gluten by destroying villi—tiny protrusions in your small intestine that help absorb nutrients from food into your bloodstream.

Common symptoms of celiac disease include abdominal pain and bloating, diarrhea, poor smelling stools, weight loss, fatigue, bone loss, numbness in the hands and feet, canker sores, and depression (and, in children, delayed growth due to malnutrition ). Celiac disease may be related to leaky gut syndrome.

Celiac disease is usually treated by eating a gluten-free diet. You can ask your doctor for a blood test or laboratory test to see whether you have this disease.

Qualifying for Disability Benefits With Celiac Disease

The Social Security Administration (SSA) requires that you are unable to work full-time for at least a year as a result of a medical impairment in order to qualify for disability benefits. This is a difficult requirement to meet for celiac disease, because once you've been diagnosed with it and give up gluten-containing foods, you should no longer experience disabling symptoms.

However, there are cases where it takes years to be diagnosed with celiac disease. In those cases, if your disability lasted at least one year before you were diagnosed with celiac disease, you can apply for disability for that length of time as a "closed period" of benefits (more on this below).

Getting Disability by Equaling a Listed Impairment

The Listing of Impairments (known as the "Blue Book") describes various types of diseases and what medical evidence is needed to prove disability automatically for each disorder. Celiac disease isn't included as a separate listing, so if you are diagnosed with celiac disease, you won't automatically be granted benefits on the basis of the disorder.

Instead, the SSA will review your medical information to determine if your condition is severe enough to "meet" or "equal" (be equivalent in severity to) another disability listing. The agency evaluates disorders of the digestive system under Blue Book category 5.00. Celiac disease is similar to two disorders included in this category: listing 5.06 for inflammatory bowel disease and listing 5.08 for weight loss due to any digestive disorder.

Meeting Listing 5.06 for Inflammatory Bowel Disease

To meet listing 5.06, your medical record must contain evidence of at least two of the following criteria in the same six-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 isn't controlled by medication, that occurs for two evaluations at least 60 days apart
• a draining abscess or fistula in the perineum, accompanied by pain not completely controlled by narcotic medication, documented at least two times 60 days apart
• involuntary weight loss of at least 10% from baseline, that was documented during two evaluations at least 60 days apart, or
• needing supplemental daily nutrition through either a gastrostomy (a tube located in your stomach) or a central venous catheter.

If you think you may meet the criteria of the above listing, make sure that your medical record contains the tests "spread out" over the required period of time. Social Security needs to see that your abnormal test results are chronic (not a one-time outlier) and unresponsive to treatment in order to find you disabled under listing 5.06.

Meeting Listing 5.08 for Weight Loss Due to Any Digestive Disorder

Celiac disease can sometimes cause dramatic weight loss and even malnutrition. While this usually improves with a gluten-free diet, some people may continue to experience unwanted weight loss. You may be able to meet listing 5.08 with evidence of both the following factors:

• You have a body mass index (BMI) of less than 17.50, and this BMI was present during at least two evaluations at least 60 days apart within a six-month period.

• You've been continuing your medical treatment as ordered by your doctor.

You may be able to meet these listings exactly with the correct medical tests and results, or you can equal them if your doctor submits a medical source statement to the SSA stating that the symptoms of your celiac disease are equivalent in severity to the requirements of one of these disability listings. The SSA will review your medical history and clinical testing to see if they support your doctor's opinion.

Evaluating Your Residual Functional Capacity

If your symptoms of celiac disease aren't severe enough to equal one of the disability listings above, then the next step is for the SSA to determine your residual functional capacity (RFC). Your RFC is a set of limitations that describes the most you can do in a work environment.

What's In Your RFC?

To determine your RFC, the SSA will evaluate your ability to perform work tasks such as sitting, standing, walking, interacting with coworkers and supervisors, and following simple instructions. Somebody with celiac disease may have environmental limitations that prevent them from working at jobs where they'd be exposed to gluten or have to handle wheat pr products with wheat in them.

If you have a doctor (such as a gastroenterologist) who you see regularly to treat your celiac disease, consider asking your doctor to write an opinion stating any limitations that you have as a result of your celiac disease. Social Security values treating doctors' opinions and will typically incorporate their limitations into your RFC. For example, if you need to take frequent restroom breaks throughout the day, or you struggle with abdominal pain that distracts you from concentrating on tasks, these limitations should be included in your RFC.

How Does Social Security Use Your RFC?

The SSA will limit the types of jobs you're able to do based on the limitations in your RFC. Somebody with celiac disease is unlikely to be able to work in a general bakery, for example, so if your work history includes working in a bakery, restaurant, or similar environment, the SSA is likely going to find that you can't perform those past jobs.

If you can't perform your past jobs, then Social Security will need to see if any other jobs exist that you can do despite the restrictions in your RFC. If the agency finds that no jobs exist that somebody with your RFC can perform, you'll be awarded disability benefits.

For most people under the age of 50, this means that you'll need to show that you can't perform even the easiest sit-down jobs. Applicants 50 years of age or older may be able to qualify for disability even if other jobs exist that they could perform, if their education and prior job skills didn't prepare them for other work.

Closed Period of Benefits for Celiac Disease

Because celiac disease is usually treated effectively by switching to a gluten-free diet, it can be difficult to qualify for ongoing disability benefits solely on the basis of the celiac disease. But it can take a while for somebody to recognize the symptoms of celiac disease, get a diagnosis, and have the dietary changes take effect. You may still qualify for disability benefits if you met or equaled a listing—or if your RFC prevented you from working any job—for at least one year, even if you later felt better enough to return to work. Social Security calls this a "closed period" of benefits.

The process for getting disability benefits for a closed period is the same as getting ongoing benefits. The only difference is that your benefits will have an "end date" where you're no longer considered disabled according to Social Security. If you win disability benefits for a closed period, you'll receive a lump sum payment for the time that you were disabled. You won't receive monthly benefits past the end date of your disability.

You can learn more in our article on closed periods for disability benefits.