Do I Qualify For Social Security Disability Benefits If I Have Crohn’s Disease?
The Social Security Administration (SSA) doesn’t always make it easy for those with Crohn’s disease (Crohn’s) to get the Social Security Disability Insurance (SSDI) or Supplemental Security Income benefits they deserve. Many claims are denied because SSA says:
- (1) Your Crohn’s hasn’t lasted a year,
- (2) Your Crohn’s isn’t severe,
- (3) Your Crohn’s doesn’t meet the requirements of or is the equivalent of a Medical Listing,
- (4) You can return to the lightest job you held in the 15 years before you became disabled, or
- (5) There is other work you can do in the mythical national economy based on your age, education, transferable skills and your residual functional capacity.
Not all cases of Crohn’s are severe enough to make you eligible for Social Security Disability benefits. But Nancy Cavey has successfully represented many SSA applicants with Crohn’s. She works to overcome the claims denial by working closely with you and your physician to show that you:
- Meet the requirements for a disability listing, or
- Your limitations are too great for you to work at your old job or any other job in the national economy in view of your age, education and transferable work skills.
She offers a free initial consultation and welcomes the opportunity to speak with you about your Social Security disability claim.
What Is Crohn’s Disease?
Crohn’s disease is an inflammatory bowel disease that can involve different areas of the digestive tract.
The inflammation of the lining of your digestive tract can spread to the layers of your bowel tissue, which can lead to life-threatening complications.
The disability carrier will accept certain studies as objective basis of the diagnosis, but these studies do not document the severity of your restrictions and limitations. It is key that your symptoms be developed in your medical records and your physician comment on how those symptoms cause restrictions and limitations on your ability to work.
What Are The Symptoms of Crohn’s Disease?
Crohn’s can involve the last part of your small intestine, called the ileum, or the colon, which is part of your large intestine.
The range of symptoms can be mild to severe, and you may have periods of time that you have no symptoms.
Common symptoms can include:
- A change in bowel habits with diarrhea,
- Cramping and loose stools,
- Fever and fatigue,
- Rectal bleeding or blood in your stool,
- Abdominal cramping with severe pain,
- Nausea and vomiting,
- Weakness or fatigue,
- Reduced appetite and weight loss,
- Mouth sores, and
- Pain or drainage near the annus.
It can be difficult to work with these symptoms or the side effects of treatment.
When Your Crohn’s Meets A Listing
Crohn’s is evaluated under the inflammatory bowel disease listing found in the SSA’s “Listing of Impairments.” If your Crohn’s meets or equals a Listing, your Social Security disability benefits will be awarded at Step 3 of the Five-Step Sequential Evaluation process.
Your medical records must establish that you meet every element of the Listing for your Crohn’s to be considered disabling. SSA will review your medical records and look for the following:
- A specific Crohn’s diagnosis,
- A listed complication such as untreatable anemia, bowel obstruction, an abscess or fistula, significant, unintentional weight loss of more than 10% of your body weight or a tender abdominal mass with pain and cramping.
If your Crohn’s doesn’t meet or equal a listing, SSA then will determine your entitlement to benefits based on medical and vocational criteria at Steps 4 and 5.
When Your Crohn’s Makes It Impossible to Work
If your Crohn’s doesn’t meet or equal a listing, you will have to prove that you:
- Can’t return to the lightest job you held in the 15 years before you became disabled (PRW), and
- There isn’t any other work you can do in the mythical national economy based on your age, education, transferable skills and your residual functional capacity (RFC).
SSA or, ultimately an Administrative Law Judge, will answer those questions by determining your residual functional capacity. Your RFC is what you can do despite your Crohn’s.
Residual Functional Capacity For Crohn’s
The SSA will review your medical records at the Initial Application and Reconsideration stage of the claims process and determine your functional capacity to perform sedentary, light, medium and heavy work.
SSA medical consultants often opine that a Social Security Disability applicant can do light and sedentary work, and that will result in a claims denial. The lower your RFC the more likely that you can’t return to the lightest job you held in the last 15 years or perform other work. SSA doesn’t tell applicants or physicians about the existence and importance of properly completed RFC forms that will explain:
- How your abdominal cramps and pain interfere with your ability to focus and work at an acceptable pace,
- How often must take unscheduled restroom breaks and how long are you in the restroom at a time,
- How your symptoms reduce your productivity by 20%,
- How your fatigue impacts your ability to function,
- What side effects of medication you have,
- Whether you have good days and bad days and how many days per month you would miss from work, and
- Whether you have psychological problems like depression or anxiety that would interfere with your ability to work.
This is not an exhaustive list of all of the questions on a Crohn’s RFC form. But you can see that having an explanation of what you can do physically, cognitively and emotionally is key to winning your case.
Many SSA cases are lost because the applicant did not obtain an RFC or the right RFC form, or because their treating physician didn’t properly complete the RFC form. That is one of the many reasons you should have an experienced Social Security attorney like Nancy L. Cavey represent you in your claim.
How Your Residual Functional Capacity Is Used At A Social Security Hearing
Many claims are denied both at the Initial Application and Request For Reconsideration stages of the claims process.
At the hearing stage, the Administrative Law Judge will determine your RFC and give hypotheticals to the vocational evaluator (VE) who will testify at your hearing. The judge will ask the VE to take into consideration your RFC, as determined by the judge, your age, education and prior work experience in determining:
- Whether you can return to the lightest job you held in the last 15 years,
- Whether there is other work you can do or could learn to do.
It is crucial that you are represented at a hearing to make sure the right questions are asked of the VE.
How Do I Get The Social Security Disability Benefits I Deserve?
Crohn’s interferes not only with your daily activities but with your ability to work. If you no longer can work or your doctor has told you to apply for Social Security disability, you should hire Nancy Cavey to help you:
- File your initial Social Security Disability application. The application process is confusing and designed so you make mistakes that can result in a delay or even a denial of your benefits.
- Appeal a wrongful denial of your Social Security disability application or Request for Reconsideration.
- File an Application for Hearing and represent you at the hearing with the Administrative Law Judge who will decide if you get benefits. She will have your physician, if possible, complete the right RFC(s), prepare you for the hearing, prepare a hearing brief, and be prepared to cross-examine the VE.
The SSA is in the business of denying claims and will use any reason to deny your benefits. The odds of getting your Social Security benefits are greater when you are represented by an experienced Social Security Disability attorney like Ms. Cavey.
Contact Social Security Disability Attorney Nancy L. Cavey, Who Can Help You Regardless of Where You Live in Florida
You owe it to yourself and your family to get help today for your Crohn’s Social Security Disability claim. Ms. Cavey can explain the Five-Step Sequential Evaluation process used in every claim, the claims process and how to get your disability benefits. Call today for a free consultation at 727-894-3188.