5.02: Gastrointestinal Hemorrhaging From Any Cause

Overview and objective

Listing 5.02 is about severity and recurrence: uncontrolled GI bleeding proven by transfusion requirements or hemodynamic instability despite transfusion. It’s document-driven—labs, transfusion records, and admission notes win these cases.

Exact text

5.02 Gastrointestinal hemorrhaging from any cause, with one of the following:

5. Requiring at least 2 blood transfusions (see 5.00G2) within a 6-month period on at least 2 occasions at least 60 days apart; or
6. Hemodynamic instability, due to hemorrhaging, despite at least 1 blood transfusion, as evidenced by one of the following:
7. Systolic blood pressure persistently less than 90 mm Hg; or
8. Mean arterial pressure persistently less than 60 mm Hg; or
9. Evidence of hypoperfusion, as shown by lactic acidosis or ischemic changes on ECG; or
10. The need for vasopressors to maintain blood pressure; or
11. The need for invasive monitoring (such as arterial line or central venous pressure monitoring). Social Security

Checklist of elements

• Cause immaterial (ulcer, varices, AVM, IBD flare, etc.).
• Route A: ≥ 2 transfusions in a 6-month span on at least two separate dates ≥ 60 days apart; document units and dates.
• Route B: Hemodynamic instability despite ≥ 1 transfusion, shown by persistent hypotension, MAP < 60, hypoperfusion evidence, vasopressors, or invasive monitoring.

Tips & recommended evidence

• Hospital records: H&P, ICU notes, operative reports, endoscopy reports (EGD/colonoscopy), transfusion logs (units, dates), vital sign trends, vasopressor orders.
• Labs: serial hemoglobin/hematocrit, lactate, troponin (if ischemia), type-and-cross, coagulation studies.
• Imaging/procedures: EGD with variceal banding, colonoscopy, tagged RBC scan, CT angiography, capsule endoscopy when relevant.
• Practical point: Build a simple timeline of bleeding episodes with dates, number of units transfused, and discharge diagnoses.

Under Listing 5.02, a Social Security Disability Lawyer can help compile transfusion records, hospitalization notes, endoscopy findings, laboratory data, and ICU documentation to establish recurrent gastrointestinal bleeding or hemodynamic instability despite treatment. Clear evidence of qualifying transfusions, persistent hypotension, hypoperfusion, vasopressor use, or invasive monitoring is critical to satisfying SSA’s strict criteria. A well-documented timeline of bleeding episodes, transfusion dates, and supporting clinical findings can be essential to securing a Step 3 disability determination without vocational analysis.