Medical doctor holding blue ribbon.

Inflammatory Bowel Disease

What is Inflammatory Bowel Disease?

For Social Security Administration (SSA) disability purposes, Inflammatory Bowel Disease (“IBD”) includes Crohn’s disease and ulcerative colitis along with other disorders which are similar in their objective medical findings and treatment regimens.

 

What are the symptoms of IBD?

IBD symptoms can include fecal incontinence, rectal bleeding, diarrhea, abdominal pain, tenderness and masses, nausea, vomiting, fever, fatigue, and perineal disease. Crohn’s disease can affect any or all portions of the alimentary tract from the mouth to the anus whereas ulcerative colitis only affects the colon. Crohn’s is rarely curable whereas ulcerative colitis can be cured by total colectomy.

 

How does SSA determine eligibility for IBD?

SSA has disability “Listings” for the vast majority of disabling impairments which list specific criteria that you can “meet” to automatically be found disabled. IBD appears in Listing 5.06 and requires the following:

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

  1. 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
  2. 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.
      Additionally, if you are unable to maintain adequate nutrition due to your IBD, SSA can also evaluate your impairment under Listing 5.08 according to your Body Mass Index (“BMI”). Listing 5.08 requires evidence of a BMI of less than 17.50 calculated on at least two evaluations at least 60 days apart within a consecutive 6-month period and can be due to any digestive disorder as long as you are following prescribed medical treatment.
      IBD may be associated with disorders involving your eyes, hepatobiliary disease, urological disease, skin involvement, and inflammatory arthritis and SSA can also evaluate your medical evidence to see if you meet the requirements of any applicable Listings concerning those additional body systems.
      If your IBD is not severe enough to meet or equal the Listings, SSA will determine your residual functional capacity (“RFC”) – what kind of activities you still retain the ability to do – and whether or not you still retain the ability to perform any full-time jobs in the national economy. Many times a claimant’s need for frequent restroom visits can preclude any type of work as most employers only allow a lunch period and two additional scheduled breaks throughout a typical workday.

 

Why and when to hire a law firm?

At Balin Law, the only type of law we practice is SSD/SSI claims (along with an occasional LTD or VA claim). We work very hard to be fluent in all facets of a disability claim, especially as one as complicated as IBD. We know what the law requires and what needs to be presented in order to maximize your chances at winning your disability claim. Thus, it is very important that you consider hiring legal counsel as soon as you file or even coming to us to file the initial application on your behalf.