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Filing for Social Security Disability or SSI with Crohn's Disease



 
Crohnís disease affects about 600,000 men and women in the United States and Canada alone. Currently, there is no pharmaceutical or surgical cure for Crohnís disease. All treatment is geared toward controlling symptoms, maintaining remission and preventing relapses.

Considered an autoimmune inflammatory gastrointestinal disease, Crohnís disease generally manifests itself in the gastrointestinal tract from mouth to anus, causing abdominal pain, vomiting, and weight loss.

However, the disease can exhibit significant extraintestinal (other than intestinal) manifestations in other body systems. These extraintestinal manifestations of Crohnís might include non-destructive inflammatory arthritis, inflammations of the eye, skin rashes and ulcers, and for a small percentage of people, neurological complications.

Social Security defines disability as any medically determinable mental or physical condition that A) has prevented the performance of substantial and gainful work activity for twelve months, or B) is expected to prevent the performance of substantial and gainful work activity for twelve months, or C) is expected to result in death.

Social Security evaluates Crohnís disease using the disability guidebook impairment listing 5.06 Inflammatory bowel disease (IBD).

The following sections of listing 5.06 detail what is needed to meet or equal the listing requirements for Crohnís disease:

A. Blockage of stenotic areas in the colon or small intestine with dilation of nearby areas. Medically acceptable imagining techniques or surgery must substantiate the obstructions and the obstructions require a hospitalization for intestinal decompression or surgery. The listing requires that an individual must require hospitalization on two occasions with the above procedures at least sixty days apart in a six-month period.

OR

B. Two of the following in spite of ongoing treatment as prescribed, and happening within the same consecutive six month period.
  1. Anemia with hemoglobin levels of less than 10.0b/dL (on two tests at least 60 days apart).

  2. Serum albumin levels of 3.0g/dL or less (on two tests at least 60 days apart).

  3. A palpable abdominal mass that is clinically documented with abdominal pain and cramping that is not completely controlled by narcotic pain medication. This must be present on two examinations at least sixty days apart.

  4. Perineal disease (usually starts as inflammation of the perineal area that progresses to fistula or abscess) with fistula or draining abscess for which narcotic pain mediation does not completely control the pain on two examinations at least 60 days apart.

  5. Weight loss (involuntary) of at least ten percent from baseline, as calculated in kilograms, pounds or body mass index (BMI) on at least two evaluations at least 60 days apart.

  6. Supplemental nutrition is required daily via enteral nutrition through a gastrostomy or parenteral nutrition though a central venous catheter.
If a personís impairment does not meet any of the criteria of listing 5.06, Social Security will consider the effects of other Crohnís disease manifestations outside the intestinal system in order to determine if their impairment meets or medically equals the criteria of another impairment listing.

It is important to remember that the Social Security Disability program is two-fold in that it considers medical information along with the limitations imposed by an individualís impairment.

Social Security Disability is based upon an inability to perform substantial work activity (See SGA monthly earnings amount) due to the limitations imposed by a medically determinable mental or physical impairment for a period of twelve months or more. Since Crohnís disease is a condition that exacerbates and remits, it can be difficult to be difficult to meet the twelve month durational requirement of Social Security Disability.

If a person cannot meet or equal any impairment listings associated with their Crohnís disease symptoms, they still may be approved on the basis of a medical vocational allowance. Disability examiners consider an individualís age, education, residual functional capacity, past work and ability to do other work when limitations are considered.

While some may be able to be approved for disability benefits through medical vocational allowances, many will not. For those who are not approved for disability benefits, it is important to appeal disability denials all the way through to the level of an administrative law judge hearing. The national average for administrative law judge hearing approvals is sixty percent percent making it the most winning level of the Social Security Disability process.








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These pages answer some of the most basic questions for individuals who are considering filing a claim.

Can you get temporary Social Security Disability or SSI benefits?

Permanent Social Security Disability

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Who is eligible for SSI disability?

Can I Be Eligible For SSI And Social Security Disability At The Same Time?

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For the sake of clarity, SSDRC.com is not the Social Security Administration, nor is it associated or affiliated with SSA. This site is a personal, private website that is published, edited, and maintained by former caseworker and former disability claims examiner, Tim Moore, who was interviewed by the New York Times on the topic of Social Security Disability and SSI benefits in an article entitled "The Disability Mess" and also by the Los Angeles Times on the subject of political attempts to weaken the Social Security Disability system.

The goal of the site is to provide information about how Social Security Disability and SSI work, the idea being that qualified information may help claimants pursue their claims and appeals, potentially avoiding time-consuming mistakes. If you find the information on this site helpful and believe it would be helpful to others, feel free to share links to its homepage or other pages on website resource pages, blogs, or social media. Copying of this material, however, is prohibited.

To learn more about the author, please visit the SSDRC.com homepage and view the "about this site" link near the bottom of the page.