Disability Claims for Inflammatory Bowel Disease

Digestive disorders can cause a wide range of symptoms including abdominal pain, fatigue, diarrhea, vomiting, nausea, and weight loss. Inflammatory bowel disease (“IBD”, not to be confused with Irritable Bowel Syndrome, IBS) may be responsible for such symptoms. IBD includes, but is not limited to, Crohn’s disease and ulcerative colitis. When these conditions are not controlled, symptoms may become so frequent and severe that work is not possible.

Testing and Treatment

To assess IBD, the patient should seek treatment with a gastroenterologist. A gastroenterologist (GI) is the appropriate specialist to determine which testing is needed, and which treatment options are available. Available tests include endoscopy/colonoscopy, biopsy, blood tests, stool tests, and small intestine imaging. These tests may need to be repeated on occasion to determine how the disease is progressing.

Treatment options for Crohn’s disease and ulcerative colitis vary patient to patient. Some GI specialists may present surgery as an option, although conservative treatment will be attempted first. Typically, adjustments to diet and medications will be offered first. Types of medication options are aminosalicylates, corticosteroids, immunomodulators, antibiotics, and biologic therapies. A high percentage of Crohn’s disease patients will have surgery, although surgery does not cure Crohn’s – it can only conserve portions of the gastrointestinal tract.

Maintaining Treatment and Recording Gastrointestinal Symptoms

Disabled patients should make sure they maintain treatment with GI specialists, follow their prescribed diet, and follow their doctors’ treatment plans as best as possible. Often, patients will only see their GI specialist on a quarterly basis. Due to the chronic nature of IBD and the possibility that symptoms may wax and wane, it is not possible for patients to see their doctor every time there is a slight change in their condition. Therefore, it is advisable for disabled IBD patients to keep a log of their gastrointestinal symptoms. The log should indicate which days the patient is experiencing gastrointestinal symptoms, how long the symptoms last, and which symptoms are occurring. The patient may also want to note any other important data, such as abdominal pain level (rated on a scale of 1-10), what may have caused the symptoms (such as a stressful situation or a change in diet), and medication taken. For computer and smart phone users, there are options to easily record gastrointestinal symptoms such as GI Buddy App (available for iPhone and Android users). IBD patients should provide copies of their GI logs to treating doctors.

Social Security Disability Claims

IBD patients who have applied for Social Security disability benefits may be able to meet or equal a medical listing. If IBD patients meet or equal listing 5.06 or 5.07, they will automatically be determined disabled by the Social Security Administration. The listing requirements for 5.06 are as follows:

5.06 Inflammatory bowel disease (IBD)documented by endoscopy, biopsy, appropriate medically acceptable imaging, or operative findings with:

A. Obstruction of stenotic areas (not adhesions) in the small intestine or colon with proximal dilatation, confirmed by appropriate medically acceptable imaging or in surgery, requiring hospitalization for intestinal decompression or for surgery, and occurring on at least two occasions at least 60 days apart within a consecutive 6-month period.

OR
B. Two of the following despite continuing treatment as prescribed and occurring within the same consecutive 6-month period:

1. Anemia with hemoglobin of less than 10.0 g/dL, present on at least two evaluations at least 60 days apart; or
2. Serum albumin of 3.0 g/dL or less, present on at least two evaluations at least 60 days apart; or
3. Clinically documented tender abdominal mass palpable on physical examination with abdominal pain or cramping that is not completely controlled by prescribed narcotic medication, present on at least two evaluations at least 60 days apart; or
4. Perineal disease with a draining abscess or fistula, with pain that is not completely controlled by prescribed narcotic medication, present on at least two evaluations at least 60 days apart; or
5. Involuntary weight loss of at least 10 percent from baseline, as computed in pounds, kilograms, or BMI, present on at least two evaluations at least 60 days apart; or
6. Need for supplemental daily enteral nutrition via a gastrostomy or daily parenteral nutrition via a central venous catheter.

Contact O’Ryan Law Firm

If your claim for disability benefits has been denied, please contact O’Ryan Law Firm immediately. There are time limits to appealing denials of disability benefits. O’Ryan Law Firm helps individuals whose short term disability, long term disability, or Social Security disability benefits have been denied. You can call us toll-free at 1-855-778-5055 or contact us online.