Facts about Inflammatory bowel 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. Inflammatory bowel diseases, primarily Crohn's disease and ulcerative colitis, are called such because the conditions cause long-term inflammation of the digestive tract.
2. Inflammatory bowel disease is frequently debilitating, causes a lower quality of life, and may lead to serious complications. Symptoms may include pain, vomiting and diarrhea, bright red stool and weight loss.
3. While inflammatory bowel disease may cause serious complications, the condition and it's symptoms are rarely a cause of death.
4. Serious complications of Crohn's disease may be bowel obstruction, ulcers, fistulas (an ulcer that extends through the wall of the intestine and can cause infection), anal fissure (tear) and malnutrition.
5. Serious complications of ulcerative colitis include severe bleeding and dehydration, colon problems, liver disease, inflammation in other parts of the body and osteoporosis.
6. Crohn's disease is usually diagnosed in young people between the ages of 20 and 30. Ulcerative colitis usually develops in the 30s. Both conditions are more common among whites, and most common among those of Jewish descent. The conditions also seem to run in families.
7. While inflammatory bowel disease increases the risk of colon cancer, most patients never develop cancer. Those that do are more likely like the public as a whole to live from cancer, due to regular screenings required to manage their condition.
8. Inflammatory bowel disease is treated with the aim of remission, where the affected individual may experience short flare ups of symptoms but otherwise has minor or no symptoms.
9. Treatment includes immunosuppressive and anti-inflammatory drugs as well as steroids. After remission is achieved, treatment usually involves a light drug with few side effects.
10. Researchers have noted that the number of diagnoses are going up as the number of parasitic infections go down, showing that the condition may be caused by the immune system attacking the digestive tract rather than other infections. This is furthered by the lack of inflammatory bowel disease in parts of the world where other digestive infections are still common.
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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