If you can no longer work due to severe symptoms and complications of Crohn’s Disease, you may qualify for certain disability benefits.
The disability claims process for inflammatory bowel disorders such as Crohn’s can be an uphill battle. You may have problems proving to Social Security how severely the disease affects your daily activities. You may be fighting an insurance company that has dug in its heels and won’t approve your claim. Or, as a disabled veteran you may be struggling to obtain service connection or a higher rating from the VA.
In any case, you need to know how each disability program or insurance company evaluates disability claims for Crohn’s disease. Filing a successful disability claim based on Crohn’s requires specific medical and vocational evidence. This holds true, even when you have been diagnosed and your doctor says you can no longer work.
Signs and Symptoms of Chronic Crohn’s Disease
A long-term condition, Crohn’s is one of a group of disorders known as inflammatory bowel disease (IBD). Crohn’s disease can be extremely debilitating and painful. It is generally a lifelong problem for which there is no definitive cure.
With Crohn’s, the intestines are irritated and inflamed, often with complications of sores and bowel obstructions. Symptoms include severe diarrhea, as well as abdominal pain and cramping. Flare-ups may come on suddenly and last weeks or months, turning your world into chaos and suffering.
Other symptoms include rectal bleeding, loss of appetite, weight loss, and fever. There may also be complications caused by malnutrition. Many people encounter impairments in areas beyond the intestinal tract, including arthritis, kidney disease, vitamin D deficiencies, migraines, and eye and skin disorders.
Crohn’s can be confused with other digestive disorders that share like symptoms, such as ulcerative colitis. Crohn’s typically affects the large and small intestines, and most commonly Crone’s attacks the ileum, the lower part of the small intestine. However, the disease can affect the entire digestive tract—it can affect the mouth, esophagus, stomach, intestines, appendix, and the anus while skipping areas of healthy tissue along its path.
There is no single test that can diagnose Crohn’s disease.
Diagnosis is based on medical history, an assessment of your symptoms, and results of various tests. Your doctor will rule out similar disorders, and work to establish the existence of Crohn’s by performing tests which may include:
- blood tests
- stool tests
- imaging tests (barium x-ray, MRI, CT scans)
- glucose breath test
- barium enema
- upper endoscopy (upper GI tract)
- colonoscopy (lower GI tract)
- capsule endoscopy
Treatment for Crohn’s disease is about controlling the symptoms.
Treatments generally work to alleviate and manage symptoms during flairs. Treatments vary widely, from medicines and nutritional supplements to special diets and lifestyle changes.
When other treatments are ineffective, people who suffer chronic severe symptoms may undergo surgeries for Crohn’s disease, including
- small intestine resection
- colectomy (segmental resection or total removal of the large intestine)
- surgery to widen the small intestine
- total proctocolectomy with ileostomy (surgery to remove the entire colon and rectum).
Social Security Disability Insurance (SSDI) Benefits
SSDI benefits provide crucial relief for working people who meet the SSA’s requirements. Unfortunately, many applications for benefits based on Crohn’s disease are initially denied and must be pursued through appeals.
SSA grants benefits in one of two ways:
1) Meet the medical criteria for Crohn’s listed in SSA’s Listing of Impairments.
SSA lists “Crohn’s Disease” as a qualifying condition of the Digestive System, under listing 5.06, Inflammatory Bowel Disease.
If the SSA finds objective medical evidence in your record that shows your Crohn’s meets the criteria of the listing, the SSA will proceed to approve your claim for disability.
To be eligible in this way, you must provide the SSA with the right medical information. First, you need a diagnosis of Crohn’s documented by endoscopy, biopsy, or medically acceptable imaging.
You will also need to show one of the following complications have occurred at least twice, 60 days apart and both within 6 months:
A. Bowel obstruction, confirmed by imaging or by surgery
– or –
B. Two other related symptoms have occurred, regardless of treatment. These can include intestinal blockage, anemia, perineal disease, severe weight loss, and/or abdominal mass with pain and cramping.
2) Medical-Vocational Allowance / RFC Assessment
If your condition does not medically meet the criteria above, the SSA has other very effective steps you can take to prove disability. You may still qualify for disability benefits for Crohn’s disease under a “medical-vocational allowance.”
You will need to show that you no longer have the capacity to do the work you did previously or any other type of work based on your age, education, and work experience.To do this, SSA will evaluate your residual functional capacity (RFC). Your RFC is the work you can still do, despite your illness, to determine whether you qualify for benefits at Step 4 and Step 5 of the Sequential Evaluation Process.
Remember: Social Security’s main concern is whether you’re able to work in a full-time capacity in any kind of employment. Our attorneys can provide invaluable assistance overcoming the challenges of proving that your Crohn’s disease has disabled you from working.
By understanding what evidence the disability examiner is looking for, we can demonstrate how your Crohn’s has reduced your productivity and your ability to perform even sedentary tasks. If your claim has been denied, we can handle your appeal and will assist throughout your case in all possible ways.Here is an in-depth look at what we do to win your Social Security Disability Case.
Long Term Disability (LTD) Insurance when You Cannot Work Due to Crohn’s Disease
Disability insurance companies will often dismiss inflammatory bowel diseases such as Crohn’s as nothing more than an occasional, unpleasant annoyance. Many LTD carriers are skeptical of Crohn’s-related disability claims. They are unaccepting of the devastating complications you face. Most take the stance that Crohn’s is not a true long term disability and that medicines, diet, and treatment will resolve the problem over time.
Another tactic to avoid paying benefits is to characterize your Crohn’s disease as a mental or nervous disorder, because most LTD policies limit the benefits for mental to 24 months, and then benefits stop.
To counter these and other strategies to deny your rightful benefits, you must prove all of the ways your condition limits your ability to do your job. Our disability attorneys can help you develop the necessary evidence including documentation of your diagnosis, complete medical records, functional capacity evaluations, and ongoing treatment history.Your doctor’s support is essential. We work with treating doctors to help them strengthen your claim. Eligibility for disability will hinge on several things, beginning with your policy’s definition of disability. From there you develop your claim to establish the severity of your Crohn’s disease and its effects upon your daily activities and your ability to work.
- What are the terms and conditions, including restrictions and limitations, of your insurance policy?
- How severe is your Crohn’s? What is your prognosis?
- Do you suffer depression, general anxiety, or chronic pain associated with Crohn’s?
- Does your disorder cause you to be fatigued or unable to concentrate?
- Must you take frequent restroom breaks?
- How frequent are your flares?
- How has your Crohn’s disease affected your Activities of Daily Living?
- Have you followed your treatment plan?
- Has your treatment plan, including medication and surgeries, been effective?
Getting long term disability benefits for Crohn’s disease and other digestive disorders can be a struggle. We have assisted many clients where the insurer has told them that if they’re close to a restroom then they should be able to work. This is unacceptable and an attempt to pressure you into giving up. We know what insurance companies are up to and are prepared to put an end to these and other tactics.
If you have questions about Crohn’s disease and long-term disability, contact Marc Whitehead & Associates. There are critical time limits involved, so don’t delay.
VA Compensation – Veteran’s Disability Benefits for Crohn’s Disease
If you are a military veteran anywhere in the United States with a denial of service connection, you have been rated too low, or you’re unsure about a potential claim based on Crohn’s disease, please contact us for an immediate, free legal consultation with an accredited Veterans claims attorney.
The VA rating schedule, while extensive, does not provide a unique Diagnostic Code for certain conditions and diseases. One of these conditions is Crohn’s disease.
For veterans with Crohn’s, the VA will choose the diagnostic code that is most applicable to the veteran’s gastrointestinal disorder and should result in the most favorable disability rating. VA refers to this as an “analogous rating” (i.e., a comparable rating).
As a rule, the VA will rate your service-connected Crohn’s disease “by analogy” under 38 C.F.R. § 4.114, Diagnostic Code 7323 for ulcerative colitis.
Crohn’s disease is currently rated as 30%.
- A 30% rating requires moderately severe symptoms with frequent exacerbations.
- The next highest 60% rating requires severe symptoms with numerous attacks a year, and malnutrition and the veteran’s health is only fair during remissions.
- A 100% rating is warranted for pronounced symptoms, resulting in marked malnutrition, anemia, and general debility, or with serious complication as liver abscess.
Analogous ratings can be very confusing with seemingly grey areas. There are times when the VA gets it wrong and assigns ratings that do not properly represent your symptoms or the severity of your conditions. We are often able to argue that a more appropriate diagnostic code be applied.
Give yourself a better chance of obtaining disability benefits for Crohn’s Disease.
Don’t let a delay or denial turn into months or even years before getting the benefits you deserve. We provide significant help, and your initial consultation is always free. If your disability claim was denied by the SSA, an insurance company, or the VA, please contact us.