Getting Disability Benefits for Celiac Disease

Celiac disease, or gluten sensitive enteropathy (GSE), is a disorder in which you are unable to eat foods containing gluten. Gluten can be found in wheat products, spelt, rye, and barley.

Symptoms and Treatment of Celiac Disease

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 abdominal pain, vitamin deficiencies because you are unable to absorb nutrients (such as anemia resulting from a lack of iron and osteoporosis resulting from a lack of calcium), weight loss, diarrhea, joint pain, depression, numbness in the hands or feet, headaches, and fatigue.

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 are at a higher risk of having this condition.

Obtaining Disability Benefits for Celiac Disease

If your symptoms of celiac disease have lasted for a year or more and they have resulted in you being unable to work, then you might be eligible for Social Security disability (SSDI/SSD) benefits or Supplemental Security Income (SSI) benefits. Once you have 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 removes celiac symptoms.

But if you were't able to work for a period of over a year, though your doctor has now figured out that celiac disease was the cause of your symptoms and put on a gluten-free diet that treated those symptoms, you still may be able to receive some benefits even if you are 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 that length of time.

Meeting a Disability Listing to Get Benefits

The Social Security Administration (SSA) has created a Listing of Impairments (the "Blue Book") that contains categories of diseases and the requirements needed to prove disability for each condition. Although celiac disease is not included as a separate listing, you may still be able to qualify for benefits if your condition is severe enough to "equal" a listing. For example, there are listings on inflammatory bowel disease, gastrointestinal hemorrhaging, and severe weight loss. Your doctor would need to write a medical opinion stating that the symptoms and signs of your celiac disease equaled in severity the requirements of one of the disability listings.

Depending on your symptoms, your doctor might be able to write an opinion that your condition equals Listing 5.06, for inflammatory bowel disease (IBD). The IBD listing requires that you have two of the following factors in a six-month period, despite being on medication.

• Anemia with hemoglobin of less than 10.0 g/dL
• A tender abdominal mass with abdominal pain or cramping
• Weight loss of at least 10% from normal
• The need for supplemental daily nutrition through a gastrostomy (tube in the stomach) or intravenous solution (IV).

A second possibility for meeting a disability listing is for your doctor to document that you meet, Listing 5.08, for weight loss due to any digestive disorder. Your doctor would need to provide evidence you have a BMI (body mass index) of less than 17.50, recorded on at least two evaluations 60 days apart or more, despite being on medication.

Determining Your Residual Functional Capacity

If your symptoms and your medical evidence are not severe enough to meet or equal a disability listing, then the SSA will assess your residual functional capacity (RFC). Your RFC is a determination of what level of work you can do, such as sedentary, light, or medium work. If the most that you can perform is less than sedentary work (that is, you are unable to sit for six hours a day and stand/walk for two hours a day), then you will be found disabled. Depending on your age and education, you may also be found disabled if you are limited to light work (that is, you are unable to stand/walk for six hours a day and sit for two hours a day). If you are over age 50, it is easier to be found disabled.

Since the most obvious symptom of celiac disease is digestive problems, your RFC could look like the following: limited to light work and simple tasks, but needing breaks from work as necessary to deal with abdominal pain. If your doctor can provide medical documentation showing that you would need to miss work often during the month, or that you would need to take frequent breaks, the SSA could take this as evidence that you are unable to perform work on a consistent basis. Thus, the SSA could find you disabled. Likewise, if you have severe pain or headaches that make you unable to focus on work tasks, your RFC could limit you to less than simple work, thus making you disabled.

To determine your RFC, the SSA will review your medical history, including any treatment you have received, whether the treatment was successful, the frequency and degree of your pain and fatigue, and any other medical findings showing the severity of your celiac disease.

Learn more about RFCs and qualifying for disability benefits.