Crohn’s Disease is an Inflammatory Bowel Disease (IBD), but can affect the entire digestive tract. It causes inflammation in all or parts of the intestines and can affect all the layers of the bowel walls. Doctors believe it is an auto-immune disease, meaning the inflammation results from the body’s immune system mistakenly attacking tissue in the digestive system.
Common symptoms include abdominal pain, cramping, diarrhea, and a sense of fecal urgency. Sufferers may experience intermittent fevers and fatigue which can range from mild to extreme. Rectal bleeding can occur, as well. Over time, Crohn’s can result in unintended and unhealthy weight loss. Other symptoms of autoimmune disorders (dry eyes, rashes, joint pain) can accompany the extreme digestive problems that characterize Crohn’s Disease.
How Does Crohn's Disease Qualify You for Social Security Benefits?
Crohn’s can affect people of any age, but it is most likely to initially arise in individuals aged 15 to 35. At a very basic level, this creates challenges for someone in this age group attempting to get disability for Crohn’s, because the disability system is designed to be more conducive to older people (over 50 years old) obtaining disability benefits. However, Social Security rules make it very clear that someone should be medically eligible for disability if an impairment makes them unable to work on a “regular and continuing basis” (more or less a full-time schedule). Therefore, a strong showing about how Crohn’s prevents full-time work should result in a finding of medical eligibility, even when faced with a judge who is reluctant to approve a younger person for disability.
Anyone who has Crohn’s Disease which meets or equals Social Security’s listing for IBD (Listing 5.06, which includes Crohn’s and Ulcerative Colitis) should be found medically eligible for disability. If bowel obstructions have required someone to be hospitalized on at least two occasions (at least 60 days apart) within a 6-month period, this person should be found to meet or equal this listing.
Social Security will also evaluate blood test results and look for low levels of proteins such as hemoglobin and serum albumin. Medical documentation showing things like an abdominal mass, an abscess, or a fistula would support a conclusion that someone’s Crohn’s Disease meets or equals this listing. Involuntary weight loss of more than 10% would likewise be consistent with such a conclusion.
Is the Standard for Disability for Crohn's Disease too Strict?
Nonetheless, this listing seems unfairly strict. In fact, it does not even provide someone who requires a feeding tube would necessarily satisfy its requirements – this person would still need to satisfy one of five other criteria. It seems that listings like this are intended to be strict so that the disability decision maker (like the judge who presides over a disability hearing) has a great deal of discretion in making the disability determination. While this kind of policy design may contribute to the problem of uneven decision making in disability cases (with some judges approving less than 10% of claims and others approving more than 80%), it still provides the Social Security claimant with the opportunity to be approved for disability if they can convince a judge that their Crohn’s Disease makes them unable to sustain full-time work.
Is Your Crohn's Disease Making It Impossible to Work?
Several times, I have consulted with a client or potential client with an age of around 30 who is struggling to maintain employment due to the disruptions caused by Crohn’s Disease. My first advice to this person would be to consider all options for seeking and sustaining work. There are numerous reasons for this. First, someone is ineligible for disability - no matter what the extent of their medical problems - if the person is working above the level of “Substantial Gainful Activity” or SGA. For wage workers, the 2022 SGA amount is $1,350 per month. In the long term, it’s not an option to get a monthly disability benefit while at the same time working and earning more than this SGA amount. Therefore, someone in their 30s who is seeking disability may be limiting their financial potential. (The average monthly disability benefit is even less than this SGA amount.)
I would advise this person that employers are required to make reasonable accommodations for people with medical problems under the Americans with Disabilities Act (ADA). For example, if placing an employee’s workspace near a restroom wouldn’t interrupt business activity, this would be considered a reasonable accommodation. However, even something like elective bathroom access (allowing an employee to go to the bathroom whenever they need to) wouldn’t be possible with many jobs, like assembly line or call center work. While employers are required to provide reasonable accommodations, they still have every right to demand that employees maintain regular attendance and stay on task throughout the workday. If an employee has an impairment that prevents this, the Family and Medical Leave Act (FMLA) may enable an employee to keep their job for a period of time, but certainly does not mandate that an employee be paid while not working. In short, the ADA and FMLA can be helpful, but still leave problems for workers who struggle with chronic diseases.
Our Social Security Disability Attorneys Are Here to Help
The length of time associated with the disability application process and its uneven decision making are also factors to consider. Someone applying for disability may be approved right away but, if not, can expect to wait 1-2 years before getting to go in front of a judge for a hearing. (It used to be longer.) This person could then end up a judge who only approves around 10% of their cases. These factors indicate that someone should explore all options for working before applying for disability.
Perhaps most importantly, however, a claim for Social Security Disability benefits is going to be stronger if the decision maker can see that the person seeking disability has done everything they could to work before applying. If we can show that someone has explored various work-related options and complied with the reasonable recommendations of doctors to treat the disease, but is still unable to sustain employment, a reasonable judge is likely to approve the claim.
If you reach this point, the Social Security attorneys of Keller & Keller are available to help you pursue the disability benefits you need. While there are certainly challenges associated with the disability application process, we can help you navigate those and present your case as strongly and persuasively as possible. You are welcome to contact us for a free consultation.