The digestive system can be the source of many medical conditions. The digestive tract breaks down the food we eat, extending from the mouth to the anus, and involves a series of long tube-like structures that connect various hollow organs. The gallbladder, pancreas, and liver provide juices that aid in the digestive process, and are considered part of the digestive system.
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 ($1,470 per month in 2023) 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.
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