Facts about Celiac Disease and Filing for Disability
These selected pages answer some of the most basic, but also some of the most important, questions for individuals who are considering filing a claim for disability benefits.
Facts about the condition
1. Celiac disease is an inherited small intestine immune reaction to eating protein gluten. Intestinal damage and nutrient malabsorption can occur due to the autoimmune disease.
2. The most common signs of celiac disease are bloating, abdominal pain, abdominal distention, mouth ulcers, fatigue and diarrhea, although symptoms can range from person to person, and are dependent upon the amount of intestinal damage and whether or not the sufferer is experiencing nutrient malabsorption.
3. There is no cure for celiac disease. The only treatment known is a strict gluten-free diet. Thankfully for those with celiac disease, many restaurants and grocery stores now offer gluten-free options.
4. Gluten is found in barley, rye, wheat ' and many grass related grains. Bagels, pizza dough, breads, and many fake vegetarian meats are made from gluten. Many other foods and drinks, such as oats, wine and anything with glucose syrup, also contain gluten.
5. Those with celiac disease must be extra careful not to ingest gluten, or use any products with gluten. This means they must also check ingredients and processing details for over-the-counter medications, prescription medicines, cosmetics and other products that are ingested or go on their skin.
6. Many with celiac disease experience dramatic weight loss and anemia, due to the malabsorption of minerals and nutrients. The most common vitamins that are unable to be absorbed due to celiac disease are vitamins D, E, K, and A.
7. Although celiac disease is thought to be genetic, the cause is unknown. The disease can occur at any time in one's life. Infants may develop the disease, but some may not experience celiac disease, or know that they are experiencing celiac disease, until late adulthood.
8. Antibody tests can help determine whether one has celiac disease. These tests may be followed by genetic testing, endoscopy, blood work or a biopsy.
9. Although celiac can be treated by abstaining from gluten products, it is not a disease to be taken lightly. If sufferers continue to eat gluten products they are at risk for osteoporosis, autoimmune disorders, miscarriage, intestinal cancers and infertility, to name a few. Untreated it can be life-threatening.
Qualifying for disability benefits with this condition
Whether or not you qualify for disability and, as a result, are approved for disability benefits will depend entirely on the information obtained from your medical records.
This includes whatever statements and treatment notes that may have been obtained from your treating physician (a doctor who has a history of treating your condition and is, therefore, qualified to comment as to your condition and prognosis). It also includes discharge summaries from hospital stays, reports of imaging studies (such as xrays, MRIs, and CT scans) and lab panels (i.e. bloodwork) as well as reports from physical therapy.
In many disability claims, it may also include the results of a report issued by an independent physician who examines you at the request of the Social Security Administration.
Qualifying for SSD or SSI benefits will also depend on the information obtained from your vocational, or work, history if you are an adult, or academic records if you are a minor-age child. In the case of adults, your work history information will allow a disability examiner (examiners make decisions at the initial claim and reconsideration appeal levels, but not at the hearing level where a judges decides the outcome of the case) to A) classify your past work, B) determine the physical and mental demands of your past work, C) decide if you can go back to a past job, and D) whether or not you have the ability to switch to some type of other work.
The important thing to keep in mind is that the social security administration does not award benefits based on simply having a condition, but, instead, will base an approval or denial on the extent to which a condition causes functional limitations. Functional limitations can be great enough to make work activity not possible (or, for a child, make it impossible to engage in age-appropriate activities).
Why are so many disability cases lost at the disability application and reconsideration appeal levels?
There are several reasons but here are just two:
1) Social Security makes no attempt to obtain a statement from a claimant's treating physician. By contrast, at the hearing level, a claimant's disability attorney or disability representative will generally obtain and present this type of statement to a judge.
Note: it is not enough for a doctor to simply state that their patient is disabled. To satisy Social Security's requirements, the physician must list in what ways and to what extent the individual is functionally limited. For this reason, many representatives and attorneys request that the physician fill out and sign a specialized medical source statement that captures the correct information. Solid Supporting statements from physicians easily make the difference between winning or losing a disability case at the hearing level.
2) Prior to the hearing level, a claimant will not have the opportunity to explain how their condition limits them, nor will their attorney or representative have the opportunity to make a presentation based on the evidence of the case. This is because at the initial levels of the disability system, a disability examiner decides the case without meeting the claimant. The examiner may contact the claimant to gather information on activities of daily living and with regard to medical treatment or past jobs, but usually nothing more. At the hearing level, however, presenting an argument for approval based on medical evidence that has been obtained and submitted is exactly what happens.
About the Author: Tim Moore is a former Social Security Disability Examiner in North Carolina, has been interviewed by the NY Times and the LA Times on the disability system, and is an Accredited Disability Representative (ADR) in North Carolina. For assistance on a disability application or Appeal in NC, click here.
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