Part of life is that 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 fault of the individual 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.
What is IBD and SBS?
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 main 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 the condition may be exacerbated by environmental factors or inappropriate immune responses. 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 not the physical changes or damage as seen with IBD.
How will the SSA evaluate an IBD condition like Crohn’s?
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 an 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 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 2 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 a narcotic medication. The Listing requires 2 findings of these signs and symptoms a minimum of 60 days apart.
- Detection of pineal disease with draining abscess or fistula. Pain must be present that cannot be controlled by narcotic medication. The Listing requires 2 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 2 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 at Step 3 can be difficult because of the amount of medical findings required. Presentation of these findings in an form that is easy to understand by SSA claims administrators and administrative law judges can make the difference between receive benefits or engaging in a lengthy appeals process.
Put our SSD experience to work for you in Rogers
For more than 20 years Fayetteville AR disability lawyer Ken Kieklak has fought for and assisted hard-working Arkansans in and around the Rogers 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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