Part of life is that as we grow older, our body does not necessarily work as well as it once did, and certain things that we once did with ease may become increasingly difficult or even impossible. Most times, this loss of functionality is through no individual fault and can even be due to their self-sacrificing and hard-working nature. Whether it be due to a catastrophic injury or the development of a severe impairment, the realization that one can no longer work due to a medical condition can result in severe anxiety and worry.
You may wonder how you will pay your mortgage, feed your children, or pay your bills. While anxiety can be expected, it can also be reduced by understanding that certain severe conditions, like Inflammatory Bowel Disease (IBD), can qualify you to receive Social Security Disability Insurance (SSDI, SSD, or DI) benefits. However, you must present your medical evidence and impacts on your daily life in a form to which the Social Security Administration (SSA) will be receptive. Read more from Fayetteville, AR disability lawyer Ken Kieklak about how to file for social security disability benefits if you or your child has Crohn’s disease in Arkansas.
How Will the SSA Evaluate a Medical Condition Like Crohn’s?
Irritable Bowel Disorder is a condition that can cause inflammation, ulcers, and damage to the bowels. In short, there is actual damage and physical changes to the bowel. The two primary forms of IBD are Crohn’s disease and ulcerative colitis. While the cause of IBD conditions is not known, researchers believe that it may be genetic. Other research shows that environmental factors or inappropriate immune responses may exacerbate the condition. It is important to note that IDB is not the same condition as Irritable Bowel Syndrome (IBS). In contrast to IBD, IBS is a functional disorder. This means that while sufferers of the condition may experience bloating, gas, discomfort, and pain, there are no physical changes or damage as seen with IBD.
If you can show that your IDB condition is so severe that it meets or equals the SSA’s Listing, then you may qualify for benefits at Step 3 of the 5-Step Sequential Evaluation Process utilized by the SSA. IBD is addressed in Listing 5.06. Your condition must be documented by endoscopy, biopsy, or surgical findings. The medical imaging or finding must show that there is an obstruction in the small intestine that required hospitalization to undergo decompression or corrective surgery. This must have occurred at least two times in 6 months, with each incident at least 60 days removed from the other. In the alternative, you can prove that your condition is a condition that qualifies for disability benefits in Arkansas and meets the listing by showing that two of the following have occurred within a 6-month period:
- Anemia with hemoglobin of less than 10.0 g/dL, present on at least two evaluations at least 60 days apart.
- Serum albumin of 3.0 g/dL or less. The Listing requires two findings of this sign a minimum of 60 days apart.
- Presence of a “tender abdominal mass” that is medically documented. Abdominal pain and cramping must be present that cannot be controlled with narcotic medication. The Listing requires two findings of these signs and symptoms a minimum of 60 days apart.
- Detection of pineal disease with draining abscess or fistula. The pain must be present that cannot be controlled by narcotic medication. The Listing requires two findings of these signs and symptoms a minimum of 60 days apart.
- An involuntary weight loss of 10% or more from your baseline weight. This may be measured in pounds or kilograms or by BMI. The Listing requires two findings of these signs and symptoms a minimum of 60 days apart.
- Supplemental daily enteral (oral, rectal, or sublingual administration) nutrition via a gastrostomy or daily parenteral (Intravenous or other administration that does not involve the digestive tract) nutrition via a central venous catheter is necessary.
In short, proving your IBD condition in Step 3 can be difficult because of the number of medical findings required. Presenting these findings in a form that is easy to understand by SSA claims administrators and administrative law judges can make the difference between receive benefits or engage in a lengthy appeals process.
Qualifying for Disability Benefits in Arkansas for Crohn’s
The Social Security Administration (SSA) can provide special assistance to people who are disabled or develop a condition preventing them from returning to work. Under the SSA, a disabled worker can request monthly benefits known as SSDI (Social Security Disability Insurance). This program allows people to receive assistance through a challenging period of their lives when they cannot work and support themselves due to their disability or condition.
However, the fact you may have a condition such as Crohn’s doesn’t automatically make you eligible to receive your benefits. There are several things to consider before getting your SSDI benefits in Arkansas. The first thing the SSA will look at is whether you have enough working credits allowing you access to SSDI benefits. In other words, you must have accrued a number of working credits and paid your FICA taxes for a specific number of years. Once you have met this threshold, the SSA will make a full evaluation using the following criteria:
Proof of Your Medical Condition
To qualify for your SSDI benefits, you can’t argue you suffer from a condition, and you need assistance from the SSA through SSDI monthly payments. It is critical to show the SSA that your condition justifies the concession of a benefit. Gathering and compiling all of the required information from the SSA is something you can achieve by hiring an experienced, skilled Arkansas children’s disability attorney.
Your Condition Must Meet the SSA’s Definition of Disability
In addition to the mentioned working credits, your condition must meet SSA’s definition of disability. The SSA has a clear definition of what a disability should be to qualify for disability benefits. According to the SSA, your condition must be severe. A severe disability or condition is one that is expected to last for at least a year or is likely to cause your death. Additionally, your condition prevents you from going to work and generate a certain amount of income.
You Can’t Engage in Substantial Gainful Activity (SGA)
Substantial gainful activity or “SGA” is one of the criteria used by the SSA to determine whether you are eligible for your benefits. Any person earning more than a certain monthly income may not have access to their SSDI benefits. As the new year approaches, the SSA has already rolled out the projected SGA an individual can engage in if they want to get their benefits. As of 2021, the SGA limits will be $2,190 for statutorily blind people and $1,310 for non-blind individuals per month.
If you meet all of these requirements, you may proceed with your SSDI claim in Arkansas. However, it is always in your best interest to hire an experienced Fayetteville, AR workers’ comp lawyer for assistance with all of these matters.
How Much Can I Get in Disability Benefits for My Crohn’s Disease in Arkansas?
If you are eligible for your SSDI benefits in Arkansas, your compensation will depend largely on your lifetime earnings before your disability, or occupational disease took place. It is essential to understand that the SSA does not gauge your benefits based on your condition’s severity or income. Every case is different, and the SSA will analyze every claim separately. On average, many SSDI recipients can receive up to $1,250 every month. However, there have been cases where a recipient can get up to $1,800.
This monthly benefit can help you get back on your feet and have financial support while your injury prevents you from working. However, it is also essential to understand that your benefits may be reduced if you receive disability payments from other sources. While the SSA will likely get all of the supporting documents to analyze your situation, it is always a great idea to have an Arkansas SSDI attorney by your side.
Calculating Your SSDI Benefits for Crohn’s in Arkansas
The SSA uses a complex formula to determine each claimant’s unique circumstances. As we mentioned, the SSA will consider your FICA taxes paid over your years of work. The amount of Social Security taxes you have paid are known as your “covered earnings.” These covered earnings are spread over a number of years. The accumulation of your covered earnings and your years of service is known as your average indexed monthly earnings (AIME). Once the SSA has your AIME, they will apply a complex formula to determine your PIA or primary insurance amount.
As you can see, there are many moving parts that come together to determine your SSDI benefits. In calculating your SSDI benefits, the SSA may overlook an important detail of your claim or produce a wrong calculation on your benefits. Our Greenland, AR disability benefits lawyers can help you make an accurate report. To help the SSA calculate the maximum benefits on your case.
What Happens if My SSDI Claim for Crohn’s is Denied in Arkansas?
It is not unusual for the SSA to deny an SSDI claim in Arkansas. Approximately 65 to 70% of all SSDI claims are denied. You may wonder what can lead to so many denials by the SSA. There are many reasons why the SSA may deny your claim. For instance, it is possible your condition does not satisfy the SSA’s definition of severe disability. Additionally, your application may not be accurate or incomplete, which is reason enough to deny your claim from the get-go. No matter the reason for your claim’s denial, there is always an opportunity to appeal your case.
Your Arkansas disability benefits attorney can help you file an appeal as soon as your claim is denied. Going through this process can be challenging and complex. However, it may be a unique opportunity to increase your chances of approval moving forward drastically. There are no guarantees the SSA will definitively approve your claim. However, this is your best and most important opportunity, and you should never give up on your first denial. Our attorneys for disability denials in Arkansas can assist you.
Let Our Arkansas Disability (SSDI) Lawyer Work for You
For more than 20 years, Fayetteville, AR disability lawyer Ken Kieklak has fought for and assisted hard-working Arkansans in and around the Arkansas area. We recognize the difficulties that come with the development of a serious condition like IBD and will work with you each and every step of the way. To schedule your free and confidential Social Security Disability consultation, contact The Law Practice of Ken Kieklak by calling (479) 316-0438 or contact us online.
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