You might be eligible for Social Security disability benefits based on Crohn’s disease depending on the severity of your disease.
The Social Security Administration (SSA) has a multi-step evaluation process to decide whether you're disabled.
First, Social Security will determine whether you're working at or over the substantial gainful activity (SGA) level. If you're earning $1,550 or more per month (in 2024), the SSA will deny your claim, because the agency sees that as evidence that you're not disabled.
The SSA must also determine whether your Crohn’s disease is expected to last at least a year; because Crohn’s is a life-long disease, this requirement is easily satisfied, as long as you can't work for that long.
At the next step, Social Security will look to see if your Crohn’s disease meets or equals one of the conditions set forth in its Listing of Impairments. Crohn’s disease is included as a qualifying condition under listing 5.06, for inflammatory bowel disease. If Social Security finds evidence in your medical records that demonstrates you meet the criteria of listing 5.06, you'll automatically be approved for disability benefits.
You might meet listing 5.06 if you have had at least two of the following complications in the same year (at least 60 days apart), despite treatment:
If you haven't had two or more of the above complications, you can still meet the listing criteria if you've had a bowel obstruction or narrowing of your intestines, accompanied by inflammation and confirmed by imaging, that required decompression or surgery (two times in the last year, at least 60 days apart).
Finally, you can also meet the listing if you have repeated, severe complications of Crohn's disease such as perforations, abscesses, or infections. Your complications must:
If your Crohn’s disease doesn't meet listing 5.06 because you haven't had severe complications or hospitalizations, but you have had significant weight loss, you might be found disabled under listing 5.08, weight loss due to digestive disorder.
If you've lost an excessive amount of weight because of your Crohn’s disease, you can be found disabled under listing 5.08. To qualify under listing 5.08 you must show all of the following.
Sometimes people with Crohn’s are too sick to work but don’t meet the specific listing criteria for IBD or weight loss. In this case, you can still be approved for disability, but it may be more difficult.
Social Security will look at your documented symptoms to determine what type of work you can do: heavy work, medium work, light work, or sedentary work. The agency will create a residual functional capacity (RFC) assessment for you, describing what you can and can't do, and will then compare your RFC to your past work. If Social Security believes you can do your past work, your claim will be denied.
If the SSA agrees that you can't do your past work, the agency will next consider whether you can learn to do another job, given your RFC and your age, education, and work background. Older, less educated people are more likely to be approved at this stage.
To help the SSA assess your RFC correctly, it's helpful to provide the agency with an analysis from your treating doctor(s) about how Crohn’s affects your ability to work (but remember, your doctor’s opinion must be supported by objective medical evidence like a CT scan).
Your doctor can fill out an RFC form to describe your limitations:
The more restrictions your RFC reflects, the more likely you are to be approved. In particular, if you have limitations that require you to have unlimited access to a restroom at all times, this can prevent you from keeping any type of job.
Chronic illnesses like Crohn’s can also cause anxiety and depression. It's important to let the SSA know if you're under a doctor’s care for any emotional problems or mental illnesses.
If you're seeing a psychiatrist or psychologist, the SSA should create a mental RFC assessment for you as well. Your mental RFC will reflect your cognitive and emotional limitations, such as your ability to focus, follow directions, get along with others, and complete tasks in an acceptable amount of time. If your mental RFC limits you to unskilled work with simple instructions, that will greatly limit the types of jobs you can be expected to do.
The more objective medical evidence you provide, the more likely the SSA is to find you disabled. You should provide copies of all tests performed that relate to your Crohn’s disease, such as:
You should also provide copies of the notes your doctor takes during your appointments, called treatment notes or progress notes, and any reports from surgeries or hospitalizations.
Social Security will only consider medical evidence from acceptable medical sources. This includes licensed physicians (including osteopaths), nurse practitioners, and psychologists, among others, but Social Security will likely give more weight to opinions and diagnoses that come from doctors who specialize in Crohn’s, such as gastroenterologists.
If you don't provide enough medical evidence for the SSA to make a decision, the agency may send you for a consultative examination (CE). Sometimes the CE is performed by the doctor who ordinarily treats you, but a CE can also be performed by another qualified physician.
The SSA has several ways you can start your application for disability benefits.
If you need help with your application, you can try contacting a disability advocate or attorney for a consultation. If they think you have a reasonable chance of getting approved for benefits, they should be able to help with filling out your application, gathering your medical records, and filing an appeal if you get denied.
Updated December 20, 2023
]]>Alcoholic cirrhosis is a liver disease caused by the chronic consumption of excess alcohol. Alcohol abuse causes the liver to become inflamed, and the chronic inflammation eventually leads to scarring of the liver, and then cirrhosis. Cirrhosis is poor liver function caused by the scarring.
Symptoms caused by alcoholic cirrhosis often appear gradually. Symptoms can include swelling of the hands and abdomen, impotence, difficulty thinking, pale stools, abdominal pain, weight loss, and yellowing of the skin and eyes. A liver biopsy is usually required to diagnose cirrhosis.
Treatment depends on the severity of your cirrhosis and can include medication, dietary changes, and shunts. If your alcoholic cirrhosis progresses to end-stage liver disease, you will likely require a liver transplant. (A liver transplant will automatically qualify for one year of disability benefits.)
The Social Security Administration (SSA) goes through some preliminary steps with each application before evaluating whether your specific medical condition is disabling. You may be eligible for disability benefits because of your alcoholic cirrhosis if you aren't working, or aren't working above the substantial gainful activity (SGA) level (for 2024 the monthly amount is $1,550). That means if you are earning at least $1,550 or more a month, the SSA will automatically deny your claim for disability. Your alcoholic cirrhosis must be expected to last at least 12 months (or result in death). This requirement should be simple to satisfy because of the chronic nature of cirrhosis. Your alcoholic cirrhosis must also be a “severe” impairment, meaning that it has more than a minimal impact on your ability to do work-related activities.
The SSA will then see if your alcoholic cirrhosis meets or equals the criteria of one of the conditions described in its official Listing of Impairments. If your alcoholic cirrhosis satisfies the criteria of an illness outlined in the listing, you will be automatically approved for disability.
If you have been diagnosed with alcoholic cirrhosis, you might be approved automatically for disability under Listing 5.05, Chronic Liver Disease. Listing 5.05 addresses chronic liver diseases, hepatitis, primiary biliary cirrhosis, and alcoholic cirrhosis. In order to meet the listing requirements for this illness, your cirrhosis must be severe. You must have experienced one of the following problems, with complications as specified in the impairment listings:
The severity criteria for Listing 5.05 are complex. For example, to meet the listing under peritonitis, your peritoneal fluid must contain a neutrophil count of 250 cells/mm3 or higher. It will be helpful to consult your treating physician to determine whether you have suffered any of the above complications to the level required to meet the SSA's impairment listing. The complete criteria for Listing 5.05 can be found at http://www.ssa.gov/disability/professionals/bluebook/5.00-Digestive-Adult.htm#5_05.
If your alcoholic cirrhosis does not meet or equal the listing requirements of Listing 5.05, you will not be automatically approved for disability. However, you still have a good chance at being approved for disability if you can show that your alcoholic cirrhosis limits you so much that it prevents you from working. At this stage, the SSA will assess your "residual functional capacity" (RFC) level based on your ability to perform basic work tasks. To give you an RFC, the SSA will look through your medical records for your doctor's opinion on:
The SSA will give you an RFC level, such as medium work, light work, or sedentary work. For example, if your doctor says can lift no more than 10 pounds at a time and can walk or sit only four hours per day, you would get a sedentary RFC. The SSA will then evaluate whether you are able to perform your past work with your RFC. If you had a position that involved heavy physical labor or very skilled work, it will be easier for you to prove that you can no longer perform this type of work.
The SSA will then look at its medical-vocational guidelines to see if at your age, with your education, you can be expected to learn a new job that fits your RFC level. Learn more about how the SSA uses your RFC and medical-vocational guidelines to decide if you can work.
It is important at this stage to provide the SSA with a statement from your treating physician regarding his or her opinion of your physical RFC. The RFC should state whether you require unscheduled breaks during the day or if you need to lie down. It is important that your doctor provides the SSA with objective medical evidence to support the RFC.
If you are receiving treatment for mental health issues such as depression and anxiety, you should also request a mental RFC from your treating doctor or psychologist. A mental RFC should include specific limitations on your ability to concentrate, follow directions, get along with others, perform tasks in a normal amount of time and whether or not you are currently using drugs or alcohol, and how long you have abstained from drugs and alcohol.
And because medications for alcoholic cirrhosis can have serious side effects, it is important to document all the medications you take and how they affect you. The can affect what RFC the SSA give you, and thus their decision whether you are disabled or not.
If you are still drinking, the SSA adds an additional step to its evaluation process, called a drug addiction/alcoholism (DAA) determination. The idea is that if you are still drinking and it's contributing to your impairments, you won't get SSDI or SSI benefits even if you're disabled. To evaluate whether your alcohol abuse contributes to your disability, the SSA asks if you would be able to work if you stopped drinking. For more information, read Nolo's article on DAA determinations.
]]>Severe abdominal pain, changes in bowel habits, bloody stools, and unintended weight loss can all signal a digestive disease. There are myriad disorders that can affect the digestive tract, so it is important to seek a doctor’s opinion if you experience these symptoms.
You may be eligible for Social Security benefits based on your digestive disease. First, the Social Security Administration (SSA) will look to see if you are working. You have to be making under a certain amount of money ($1,550 per month in 2024) to be eligible for disability benefits. Second, you must show that your digestive disease is expected to last at least one year (or result in death).
If the SSA agrees that your digestive problems are “severe” (affecting your ability to perform basic work activities), the agency will look to see if your digestive disease meets or equals one of the illnesses established in the SSA’s Listing of Impairments. The SSA addresses digestive diseases in Listing 5.0, Digestive System. If you can prove that your condition meets one of the qualifying disorders under Listing 5.0, you will be automatically approved for benefits.
The digestive diseases that qualify for disability under Listing 5.0 are:
Merely being diagnosed with one of these digestive diseases will not result in an automatic approval for disability (with the exception of a liver transplant). Each of these disease listings has complex medical requirements that must be proven by acceptable medical evidence. These listings are described in more detail under the links above.
Even if your digestive disease does not meet the criteria of Listing 5.0, you may still be too sick to work. The SSA will evaluate your disease and give you a residual functional capacity rating (RFC) of medium work, light work, or sedentary work. An RFC also describes your physical limitations in light of your digestive disease; for example, how long you are able to sit, stand, and walk and how much you can push, pull, lift, and carry. If the SSA decides that despite your illness and your RFC, you can do your past work, your claim will be denied. (Learn more about the RFC evaluation here). Digestive diseases that aren't covered in the listings include diverticulitis, IBS, and celiac disease.
If the SSA believes you are unable to do your past work, the SSA will then take into consideration vocational factors such as your age, education, work history, and medical factors such as your RFC and your symptoms, to determine whether there is other work you can do in the U.S. The SSA uses a medical-vocational factor grid to determine whether you should get disability benefits with a medical-vocational allowance. Learn more about how the medical-vocational factor grid works.
To help the SSA develop an RFC in your favor, you should provide a statement from your treating physician(s) that discusses your residual functional capacity (RFC). It is important for your doctor to note if you need to rest throughout the day or if you need frequent and unscheduled breaks. Also, it is helpful for your doctor to state whether side effects from medication limit your ability to work. The more limitations your doctor reports in your RFC, the more likely the SSA will find you disabled. Make sure that you or your doctor can provide medical evidence to support your doctor’s opinion.
Although the SSA must consider evidence from all acceptable medical sources (most licensed doctors), the SSA places the heaviest weight on specialists’ opinions. That means you should seek treatment from a doctor who specializes in your particular digestive disease.
Many applicants are denied because they simply do not provide enough medical evidence to the SSA to prove their claim. When you file your initial application, be sure to list all doctors, laboratories, hospitals, and clinics you have seen for treatment of your digestive disease. It is also important to include any results from tests such as MRIs, endoscopies, x-rays, blood tests, and ultrasounds. The SSA will consider only those tests that are medically appropriate, meaning those tests that are ordinarily used to diagnose or treat your digestive disease.
Chronic illnesses can cause anxiety and depression. If you are seeing a psychiatrist or psychologist for these illnesses, it is important to let the SSA know. The doctor who treats your depression can prepare a mental RFC that explains any mental limitations such as your ability to focus, get along with others, and demonstrate reliability, as a result of your depression or anxiety. A limited mental RFC combined with a limited physical RFC can really reduce the number of jobs that the SSA can expect you to do.
]]>If you have celiac disease, eating foods with gluten causes an autoimmune reaction in the small intestines and damages the inner lining of your intestines. Symptoms of celiac disease include:
Your doctor may use a blood test or collect a sample of your small intestine to determine whether you have celiac disease. Treatment of this disease generally involves eating a gluten-free diet. If someone in your family has celiac disease, you’re at a higher risk of having this condition.
Once you’ve been diagnosed with celiac disease, it's unlikely your inability to work will last a year, since going on a strict gluten-free diet usually eliminates celiac symptoms. And because Social Security doesn’t provide “temporary” or “short-term” benefits, you won’t be able to qualify for Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI) if your symptoms have improved within twelve months of your diagnosis.
But if it took you and your doctor over a year to figure out that celiac disease was the cause of your symptoms and put you on a gluten-free diet that treated those symptoms, you still may be able to receive some benefits even if you’re now able to work. As long as you were unable to work for a year, you could still ask for a closed period of disability benefits for the time that you couldn’t work.
Social Security has created a category of medical conditions (the “Listing of Impairments”, also known as the "Blue Book") that describes certain disorders along with the evidence needed to prove that the disorder is automatically disabling. While celiac disease isn’t a listed impairment on its own, you may still be able to qualify for benefits if your symptoms are severe enough to meet or equal a related digestive system listing.
Examples of related disorders include gastrointestinal hemorrhaging, inflammatory bowel disease, and severe weight loss. You should review the listings below and discuss them with your doctor.
If your doctor agrees that your celiac disease symptoms are severe enough to be functionally equal to the above listing requirements, have them write a medical source statement to that effect and submit it to Social Security.
If your symptoms and your medical evidence aren’t severe enough to meet or equal a disability listing, then Social Security will assess your residual functional capacity (RFC). Your RFC is a set of limitations on the type of work activities you can do.
Most RFCs contain restrictions to a certain exertional level, a way of classifying jobs according to the physical demands needed to perform the job. For example, sedentary work is performed mainly while sitting down and without needing to lift more than ten pounds, while light work requires you to be on your feet for six hours a day and lift up to 20 pounds. Medium, heavy, and very heavy work describe jobs where you need to be able to lift 50 pounds or more.
If your celiac disease symptoms are so intense that you can’t do any sit-down jobs (in Social Security lingo, you have a “less than sedentary” RFC), your disability application will be approved. That’s because sedentary work is the least physically demanding exertional level, so being unable to lift ten pounds or sit for six hours a day will rule out all jobs. Similarly, needing to take unscheduled breaks, failing to complete basic tasks, or missing too many work days means that you’re not able to do a job at any exertional level full-time.
Depending on your age and education, you may also be found disabled if your RFC limits you to light or sedentary work, but your past jobs were performed at a medium (or higher) exertional level and you don’t have any transferable skills. For more information on why it becomes easier to get disability at age 50, see our article on the medical-vocational grid rules.
Getting Social Security benefits for celiac disease by yourself can be challenging. Consider hiring an experienced disability attorney to help you with your claim. Your lawyer can tell you what the strengths of your case are and help address any weaknesses. Having an attorney can make it easier for you by gathering and submitting medical information to Social Security, and applicants who are represented at a disability hearing have a higher chance of success.
Updated October 9, 2023
]]>Even with treatment, diverticulitis can cause symptoms like intense, recurring abdominal pain, constipation, and bloating. If your diverticulitis symptoms are severe enough to interfere significantly with your life, you might qualify for Social Security disability benefits.
Common signs and symptoms of diverticulitis include:
If you’re experiencing these symptoms, let your doctor know as soon as possible so that you can get the proper diagnosis and start treatment (if you haven’t already). If you’re only being treated by your family physician or general practitioner, consider seeing a gastroenterologist. Gastroenterology is the branch of medicine that treats your intestines.
When you show up to your doctor’s office or the emergency room with symptoms of diverticulitis, your doctor will want to conduct a physical examination in order to rule out other disorders with similar symptoms. The examination will include checking your abdomen for tenderness, which can indicate that your intestines are inflamed. For women, a pelvic exam is sometimes included as well.
Other common diagnostic tools for diverticulitis include:
Once you’ve been diagnosed with diverticulitis, your doctor will start you on a treatment regimen (or adjust your current plan). The type of treatment depends on how severe your symptoms are. People with mild symptoms can sometimes avoid future bouts of diverticulitis effectively by making adjustments to their diet such as eating more fiber-rich foods. But if your symptoms are more severe, you might need to be hospitalized to receive intravenous antibiotics or undergo surgery (to repair perforations or remove blockages or unhealthy parts of your intestine).
In order to be eligible for Social Security disability benefits, you need to show that you have a medical impairment that has significantly interfered with your life and prevented you from working for at least 12 months. Because diverticulitis—along with most other digestive problems—usually improves quickly with treatment, Social Security doesn’t often award disability benefits based on diverticulitis alone.
But if your diverticulitis causes complications like fistulas, abscesses, intestinal bleeding, or dangerous weight loss, or you have recurrent diverticulitis, you’re more likely to qualify for disability. Alternatively, if your medical records show a long history of related digestive problems, you could get disability benefits if your digestive problems are severe and long-lasting enough.
The Social Security Administration (SSA) maintains a listing of impairments that can automatically qualify for disability, and people with diverticulitis might also suffer from some of these impairments. If your medical record shows that your digestive conditions match the requirements of any of the following listings, you could qualify for disability.
If you have diverticulitis but don’t meet any of the impairment listings mentioned above (or any other Social Security listing), the SSA will assess your residual functional capacity (RFC). Your RFC is what you are capable of doing despite the limitations caused by your medical conditions.
Social Security will use your RFC to translate your medical limitations into terms an employer (or vocational expert) would understand, in order to determine if there are any jobs you can still do.
For instance, if you have recurrent bouts of diverticulitis and gastrointestinal bleeding, you might be calling in sick so frequently that you couldn’t perform any job full-time. Or, if you have chronic abdominal pain and cramping, you might be too distracted by the discomfort to focus enough on your work tasks. If you have persistent diarrhea and need immediate and frequent access to a bathroom, an employer might not hire you because you need extra breaks.
If the SSA determines there are no jobs you can do due to your symptoms and limitations, you will be awarded benefits under what's called a “medical-vocational allowance.” But if the SSA finds that you’re capable of performing any kind of work, the SSA can deny your claim.
Social Security will be looking at your medical records for evidence that you’re getting treatment for your diverticulitis symptoms (as well as any other medical conditions that are contributing to your disability claim). Make sure that you give the SSA permission to obtain records of your medical treatment, and let them know the dates and locations of any doctor’s visits or hospitalizations.
Your complete medical records should contain most, if not all, of the following:
One way you can help your disability claim is to have a doctor (preferably a gastroenterologist) who you’ve seen consistently for a long time write a medical source statement about your diverticulitis. The SSA values the opinions of treating doctors who are familiar with your medical history and who specialize in the area of your condition.
Another way you can help your claim is to be very thorough in filling out the function report. The SSA will ask you to submit this important questionnaire about your activities of daily living to get a clear picture of how your diverticulitis interrupts your life. The more specific you can be, the harder it will be for the SSA to conclude that your diverticulitis isn’t disabling.
Updated May 25, 2022
]]>The exact cause is of IBS is unknown. Some research suggests that people who suffer from IBS have abnormal levels of serotonin in the brain. IBS may also be caused by abnormalities in the brain and nervous system that cause a person to feel more pain as stool and gas pass through the intestinal track.
Although difficult, it may be possible to win a claim based on IBS alone. If you are making less than about $1,500 per month, your condition is severe, and your IBS has lasted, or is expected to last, at least a year, the SSA will review your case to see if you qualify for disability. But proving your condition will last or has lasted a year can be difficult for IBS sufferers to prove as the symptoms of IBS often come and go. The SSA defines a “severe” impairment as one that significantly impacts your ability to perform basic work activities like walking, sitting, standing, following directions, getting along with co-workers, and so on.
Unfortunately, IBS is not currently a qualified condition included in the SSA’s Listing of Impairments; however, this does not mean you can't be found disabled. It does mean that it will be harder to prove your case, and it will take longer.
The SSA will decide whether your IBS prevents you from performing your past work. To make this determination, the SSA looks at the objective medical evidence you have provided from your treating doctors, information provided by any exams performed by the SSA’s doctors, and your own testimony. The SSA will give you an RFC (residual functional capacity) rating based on this information, which states whether you can do sedentary work, light work, or medium work. If the SSA concludes that you can do your past work with your RFC rating, your claim will be denied.
If the SSA finds that because of your IBS, you cannot perform your past work, the SSA will next decide whether there is any other work you are able to perform.
For example, if your IBS causes you frequent and uncontrollable urges to have a bowel movement, you would need a job where you are allowed frequent and unscheduled bathroom breaks. This limitation would severely limit the number of jobs available to you. The SSA must also consider how IBS symptoms such as abdominal pain, cramps, and bowel incontinence affect your ability to perform your work at a commonly acceptable rate and whether your IBS will cause you to miss a large amount of work. If the SSA finds that your productivity is reduced by at least 20% because of your IBS, you will most likely win your claim because you would be unlikely to be able to keep a job.
In this last step, Social Security also takes into account your age, education, past work experience and RFC level. It is often easier for older, less educated applicants to win approval at this stage because of the "grid rules."
The SSA will consider medical evidence only from licensed physicians (including osteopaths) and psychologists. The medical evidence you provide to the SSA should come from the doctor who regularly treats you for your IBS. And though the SSA will consider evidence from a licensed general practitioner or your family doctor, it gives more weight to opinions and diagnosis that come from doctors who specialize in IBS, such as gastroenterologists.
Medical evidence from your treating physician should include lab results, x-ray or other imaging results, and consultation notes. It is important that your records include your physician’s opinion about your work restrictions, specifically, how long you can sit, stand, or walk; how much you can push, pull, and lift; and whether you require rest periods throughout the day.
If the SSA needs more information about your illness, it may send you to a doctor hired by the SSA for what's called a “consultative examination” (CE). Sometimes the CE is performed by the doctor who ordinarily treats you, but it may also be performed by another qualified physician.
The SSA must also consider the side effects of medication on your ability to work, so it is important to document and report negative side effects to your doctor and to the SSA.
In addition, people with IBS often suffer from other illnesses like depression and anxiety. It is important to let the SSA know about all the illnesses you receive treatment for because the SSA must consider the combined effect of all impairments, even those it determines are not severe.
]]>Most people who have been recently infected by the Hepatitis C virus have no symptoms. However, a chronic infection may lead to abdominal pain and swelling, internal bleeding, fatigue, itching, jaundice (yellowing of the skin), and nausea. More severe cases of Hepatitis C can result in cirrhosis of the liver or liver cancer, either of which may ultimately require a liver transplant.
Hepatitis C can be treated with a combination of medicines, but the side effects of these medications are often quite severe. It is important that a doctor closely monitor a patient’s medications and side effects when treating someone for Hepatitis C.
If you have been diagnosed with Hepatitis C and your symptoms are severe, you may qualify for Social Security disability benefits (either SSI or SSDI) if your illness meets the criteria established by Social Security's Listing of Impairments (Listing 5.05 Chronic Liver Disease), or if Social Security finds that because of the disabling effects of your illness there are no jobs you can be expected to do. Also, your impairment must have lasted at least a year, or be expected to last at least a year (unless you are terminally ill).
To meet the requirements of Listing 5.05 and be automatically approved for disability benefits, you must be diagnosed with chronic liver disease (as defined by Social Security) and have experienced one of the following complications:
The full Listing requirements for Hepatitis C are complicated; it may be helpful to ask your physician whether your illness meets the criteria of listing 5.05, Chronic Liver Disease.
If you don't meet the requirements of listing 5.05, Social Security will not automatically approve you based on your Hepatitis C infection. However, if you are able to show that, because of the symptoms of the infection or the side effects from medication, your level of functioning (your "residual functional capacity" (RFC), discussed below) is so low that you can't do any work, you may still qualify.
The more medical evidence you have when you apply for disability, such as lab work, x-rays, ultrasounds, biopsies, and doctor’s records, the more likely it is you will be approved. When you apply, be sure to provide Social Security with the names of all the doctors you have seen for treatment for your Hepatitis C, and all the hospitals or labs that have performed blood work, scans, or other tests to treat or diagnose your Hepatitis C, and a complete list of the medications you are taking.
Side effects from medications are important information that applicants often overlook when applying for disability. In particular, the mental side effects of the medications for Hepatitis C can be especially debilitating. Many people on interferon, a drug commonly used to treat Hepatitis C, experience difficulty thinking or with memory, severe depression, mood swings, and suicidal thoughts.
Some people also have significant physical side effects from some drug treatments for Hepatitis C; they include chest pain, heart attacks, inflammation of the bowels, and autoimmune disorders (where the immune system attacks one or more parts of your body). If you suffer from any of these side effects, it is important that you keep you doctor informed so that she may document them in your medical records and treat you accordingly.
If you aren't able to qualify for disability for your Hepatitis C based on the listing 5.05 requirements, you may be able to qualify for disability if you can show that the combined effect of your illness and side effects from medications make it impossible for you to perform any jobs. This route is easier for individuals over the age of 50 and for those who don't have much education.
The term residual functional capacity (RFC) means what you are able to do, both mentally and physically, despite the symptoms of your impairment and medication side effects. Your doctor is the most important source of information in determining your RFC. Be sure that your doctor notes in your records any specific physical limitations you have as a result of your impairment or from the side effects from medications. The side effects of Hepatitis C treatment are often the most debilitating part of the disease, so it is important that you report all of your symptoms to your doctor (and to Social Security). The Social Security Administration (SSA) prefers medical evidence from doctors who are specialized in treating your illness.
When determining your physical RFC, Social Security will look at such factors as how long you can walk, sit or stand; how much you can lift, push and pull; and whether you have any significant problems hearing, seeing, or communicating.
For example, if Social Security determines that you are only able to sit or stand for 10 minutes at a time and lift no more than 10 pounds, then your physical RFC should be “less than sedentary.” This RFC would prevent you from doing any jobs and the SSA would find you disabled. However, if the SSA determines you are able to sit or stand for 6 hours or more and lift at least 20 pounds on a regular basis, your RFC would probably be for light work, which would be high enough to allow you to do most jobs. However, if you are over 50 or have little formal education, you might qualify for a medical-vocational allowance.
To determine your mental RFC, Social Security will consider such things as how your impairment or side effects from medication impact your ability to get along with others, make decisions, maintain focus, follow directions, remember job instructions, and be reliable. For example, if your medication makes it extremely difficult to focus on, remember instructions for, and follow through on even simple job tasks (like placing a box on a conveyor belt), then Social Security will consider you to have a reduced mental RFC. A low mental RFC makes it less likely you can perform even the most basic jobs, and more likely that you will qualify for disability. If your Hepatitis C or side effects from medication cause significant mental impairments, it is important to seek medical care from a psychiatrist or other doctor specializing in mental health.
If you are applying for SSDI only, you can apply for benefits online at www.ssa.gov/pgm/disability.htm. You can also call 800-325-0778 or go directly to your local Social Security field office to apply for SSI or SSDI. Office locations can be found at www.ssa.gov/regions/.
Remember that people are often denied simply because they fail to provide adequate medical information to Social Security; therefore it is important to give as much medical information as possible when you first apply. Social Security will also ask for financial information and for your work history.
If you do not meet the listing requirement for Hepatitis C, and need to qualify for disability benefits under an RFC or medical-vocational allowance (which is how most people qualify), the process can take well over a year before a final decision is made in your case. Don’t forget that most applications are denied initially and that you have a right to appeal that denial. Pay attention to all deadlines for appealing Social Security decisions, or you may have to start the process all over again.
]]>People with strong immune systems who have been infected with hepatitis B are usually able to wipe out the virus and have no lasting side effects. However, some people infected with HBV have a chronic infection for life, which causes inflammation and scarring in the liver. Severe scarring of the liver, or cirrhosis, can damage the liver's ability to function and can lead to liver failure. Chronic carriers of the Hepatitis B virus are also at risk for liver cancer.
If you have a chronic infection of hepatitis B and it limits your functioning, then you might be eligible for either Social Security Disability (SSD) benefits or Supplemental Security Income (SSI) benefits under the Social Security Act. (SSD is also called Social Security disability insurance, or SSDI.)
When the Social Security Administration (SSA) receives your claim for SSD or SSI benefits, your claims examiner will order copies of medical reports from your doctor. The SSA will first want to determine whether you meet listing 5.05, Chronic Liver Disease. This listing, like many other SSA disability listings, has strict requirements that must be demonstrated through the use of medical laboratory findings. For example, you will need to show that your HBV infection has caused a serious ailment such as gastrointestinal hemorrhage or related kidney or lung problems.
You might be required to produce a liver biopsy to show the degree of liver infection, imaging studies such as an MRI, CAT scan, or ultrasound to indicate whether the liver has increased in size or whether there has been any scarring of the liver, and other lab tests that reveal the level of liver enzymes and serum albumin (protein in the liver).
The SSA will also review your medical charts to see if you have undergone any treatments for hepatitis B. Common treatments are oral antiviral drugs and injections of interferon. If there has been no decrease in the level of the HBV virus despite ongoing treatment, then the SSA might consider whether your hepatitis B medically equals a disability listing (is equivalent to a listing, though it doesn't match it exactly).
The SSA will also look to see if you are suffering any side effects as a result of medications. Common side effects of treatment may include fever, fatigue, joint pain, nausea, insomnia, or other flu-like symptoms. These side effects can impact your ability to work on a regular basis. If the side effects you are experiencing are especially severe, then you might need to stop treatment or reduce your dosing level.
Even if you do not meet or equal an official SSA disability listing, you can still be found disabled if your residual functional capacity (RFC) shows that you are unable to perform your past job or that you are unable to perform any other jobs due to your HBV infection or the side effects of your medication. The SSA will assess your RFC level based on your ability to perform basic work tasks during a 40-hour workweek.
The agency will consider the following factors in developing your RFC:
It is important that the medical records from your doctor contain sufficient evidence of your symptoms from hepatitis B and evidence of limitations in your ability to do above tasks. Based on this evidence, the SSA will give you an RFC level, such as medium work, light work, or sedentary work. For example, an RFC level for a severe chronic HBV infection might be stated in these terms: limited to a sedentary level of work; can lift no more than 10 pounds at a time; walking, sitting, and standing required less than 6 hours out of an 8-hour day; limited to simple and routine tasks.
Statements you make to your doctor indicating the level of fatigue or pain that you feel during various activities can be used to support a lower RFC level. You should discuss with your doctor such topics as whether you need to rest during the day, whether you can handle everyday household chores, whether your level of activity has changed since before you were diagnosed with hepatitis B, whether you have a good appetite, and whether you are getting enough sleep during the night.
Once the SSA has determined your RFC level, the SSA will evaluate whether you are able to perform your past work with your RFC. The SSA is limited to reviewing jobs that you have performed in the last 15 years. Generally, if you had a position that involved heavy physical labor or which involved very skilled work, it will be easier for you to prove that you can no longer perform this type of work.
The SSA will then look at its Medical-Vocational Guidelines to determine if you can be expected to learn and do other work based on your age, education, previous work experience, and RFC level. If you are over the age of 50, you are more likely to fall within the disabled section of the medical-vocational grid, which means you could qualify for a medical-vocational allowance.
If you feeling any depression or other mental symptoms as a result of your hepatitis B, tell your doctor. If are experiencing depressive symptoms, then you might qualify for SSD or SSI benefits based on a combination of your depression and hepatitis B. You might also have mental symptoms such as an inability to stay focused or remember instructions. If you have severe mental limitations due to your medications, the SSA could give you a mental RFC, which, combined with a low physical RFC, could limit the number of jobs you could be expected to do.
If you would like to file for SSD or SSI benefits, you can call the SSA at 1-800-772-1213. Or, you can go online at www.ssa.gov if you are filing only for SSDI benefits.
If you do not currently have medical insurance or are unable to afford a doctor, the SSA might send you to a consultative medical examination. During this exam you should explain your symptoms and follow any instructions given by the doctor. Failure to attend a scheduled exam can result in a denial of your disability benefits.
Even if you are found non-disabled after your initial application or at an early stage of review (such as a request for reconsideration), you can still request a hearing before an Administrative Law Judge, where you have the opportunity to provide additional evidence of your disability. With a disease such as hepatitis B, it is common that your symptoms will continue to worsen over time. Therefore, it is always advisable that you appeal any unfavorable decision so that you can present new evidence because the SSA might not have had your most current medical information at the time.
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