A hiatal hernia occurs when the stomach pushes up from the abdomen into the chest cavity through an opening in the diaphragm.
Many people with a hiatal hernia have no symptoms, but for people who do have symptoms, those symptoms often include chest pain, stomach pain, heartburn and difficulty swallowing. Many of the symptoms associated with a hiatal hernia may actually be caused by acid reflux, including gastroesophageal reflux disease (GERD).
In some cases, a hiatal hernia can lead to the stomach being squeezed so much no blood can get to it. Surgery is often recommended for para-esophageal hernias (where the stomach stays in the chest) since the stomach can become strangled, leading to tissue death.
There are two different avenues the Social Security Administration (SSA) will explore when deciding if your impairment qualifies you for disability payments. The SSA will see if your medical condition in its "blue book" of qualifying impairments or if your condition limits you to the point where there is no work you are able to do.
A hiatal hernia is not one of the SSA’s impairments listed in its blue book. There are, however, listed impairments that are sometimes associated with hiatal hernias. Some people with hiatal hernias also experience gastrointestinal (GI) bleeding. If you experience GI bleeding that caused you to have at least three blood transfusions of at least two units of blood per transfusion in a six-month period, you may qualify for disability under the SSA’s listing for GI hemorrhaging.
The SSA also has a listing for “severe weight loss due to a digestive disorder.” If your hiatal hernia or associated symptoms has caused your body mass index (BMI) to drop below 17.50, you may qualify for disability under that listing.
If your hiatal hernia and the symptoms associated with it do not meet a listing, you may still qualify for disability if your symptoms are too limiting for you to work. However, the SSA requires that your limitations prevent you from working at the SGA level for at least one year. For patients with hiatal hernias, this can be a difficult threshold to pass, since those with severe symptoms will usually undergo surgery to cure the hernia. (And the SSA is likely to assume it will take much less than a year to recover from hiatal hernia surgery.)
But if you haven't been able to work for a year due to your hernia and the SSA believes your impairment is severe, the agency will decide whether you have the residual functional capacity (RFC) to engage in any "substantial gainful activity" (SGA). The SSA will assess your RFC by looking at whether or not you are capable of working despite your hiatal hernia and any complications and symptoms associated with it. For instance, someone who becomes short of breath walking a short distance or who can't walk without a great deal of pain may receive an RFC for sedentary work only.
The SSA would then look at your job skills and education to see if you are qualified to do any sedentary jobs. (This may be difficult if you've worked heavy or medium jobs that required a lot of lifting or walking.) Your age also factors into the equation because the SSA will require younger workers to retrain themselves for new types of work.
In the end, the SSA uses a grid of "medical-vocational" rules to determine whether someone with your RFC, age, education, and job skills is disabled. For more information, see our section on the medical-vocational analysis.