Getting SSDI Benefits for Diverticulitis

It is difficult to get disability for diverticulitis unless you suffer from long-term complications.

Diverticulitis occurs when pouches form in the wall of the intestines and get infected. Usually these pouches occur in the colon, which is in the large intestine, but they can occur anywhere in your digestive system, including your stomach, esophagus, and small intestine.

About Diverticulitis

It is unknown what exactly causes the pouches to form, but many medical experts believe that a lack of fiber in the diet is a main cause of the pouch formation. Although it is very common to have these pouches, it is less common for the pouches to become infected or inflamed and develop into diverticulitis. Diverticulitis is usually discovered during a colonoscopy.

Symptoms of diverticulitis usually appear suddenly and include gas, bloating, diarrhea or constipation, a tender abdomen, loss of appetite, nausea and vomiting, and fever and chills.

Disability for Diverticulitis

In order to be eligible for disability benefits, your impairment must be expected to last at least 12 months. Diverticulitis, along with most other digestive problems, can be expected to improve drastically with treatment in much less than 12 months, so getting disability based on diverticulitis alone would be difficult.

If your diverticulitis causes complications like fistulas, abscesses, intestinal bleeding, or dangerous weight loss, you are 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 any of your digestive problems are severe and long-lasting enough.

The Social Security Administration (SSA) publishes a listing of impairments that automatically qualify for disability, and people with diverticulitis may also suffer from some of these impairments. If your digestive condition matches the requirements of any of the following listings, you could ualify for disability.

Severe Weight Loss

You can meet this listing if, despite continuing medications or treatment as prescribed, you have a body mass index (BMI) of less than 17.50 (shown over a period of six months).

Gastrointestinal Hemorrhaging

If you have severe and recurring bleeding from your gastrointestinal tract (that is, from your esophagus, stomach, small intestine, or large intestine) that has required blood transfusions, you may meet this listing.

Inflammatory Bowel Disease (IBD)

It has been suggested by some medical experts that some types of inflammatory bowel diseases may be a secondary reaction to diverticulitis. IBD is an umbrella term that covers any chronic inflammatory intestinal disorder, including Crohn’s disease and ulcerative colitis. If you have a diagnosis of IBD and meet other specific criteria, you may meet this listing.

Short Bowel Syndrome

In some cases, diverticulitis can lead to bowel diversion surgery. Short bowel syndrome occurs when a person has had a substantial amount of small intestine removed. If you have had bowel diversion surgery, you may qualify for disability under this listing.

Disability Based on Medical Limitations

If you have diverticulitis but do not meet any of the impairment listings mentioned above (or any other Social Security impairment 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 condition. For instance, if you have severe gastrointestinal bleeding, you will likely be found unable to perform heavy work. If you have severe abdominal pain and cramping, this might limit your ability to pay attention at work. If you have persistent diarrhea, this can also cause limitations in your ability to work. (There may not be a job you could hold if you need immediate access to a bathroom and need to be able to take breaks to go to the bathroom frequently, immediately, and whenever you need to.)

Your RFC assessment is used by the SSA to determine what types of jobs you are still capable of doing. If the SSA finds that you are capable of performing any kind of work, the SSA can deny your claim. But if the SSA determines there are no jobs you can do due to your symptoms and limitations, you will be awarded benefits under what is called a “medical-vocational allowance.”

Learn more about how to get a medical-vocational allowance.

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