Crohn’s disease is one of the most common types of inflammatory bowel disease (IBD) that people develop. There are currently an estimated 1.6 million people living with IBD in America, and 70,000 people are diagnosed with some form of the condition each year, according to the Crohn’s & Colitis Foundation of America (CCFA).
If you or your child’s Crohn’s disease meets certain criteria, you may be able to qualify for Social Security disability benefits. Below, we share some of the facts you should know about applying for disability benefits for Crohn’s disease. For case-specific questions or for legal help getting Social Security disability for Crohn’s disease, call Lunn & Forro, PLLC at 888-966-6566 to schedule a free consultation.
How can Crohn’s disease lead to long-term disability?
Crohn’s disease is not just a simple irritable bowel disease. It is a chronic condition with possible, serious complications such as:
- Anal fissures
- Colon cancer
- Inflammation of the liver or bile ducts
- Lymphoma and skin cancers
- Increased risk of infection
What are the criteria to qualify for disability benefits for Crohn’s disease?
IBD is one of the conditions in Social Security’s listing of impairments. If your Crohn’s disease meets certain criteria, the Social Security Administration (SSA) will consider your condition disabling.
To qualify for benefits you must either have:
- “Obstruction of stenotic areas (not adhesions) in the small intestine or colon with proximal dilatation that requires hospitalization for intestinal decompression or for surgery, and occurring on at least two occasions at least 60 days apart within a consecutive six-month period;” or
- Two of the following factors, despite continuing treatment as prescribed and occurring within the same consecutive six-month period: A) anemia, B) serum albumin, C) a tangible “tender abdominal mass palpable with abdominal pain or cramping, D) painful perineal disease with a draining abscess or fistula E) involuntary weight loss of at least 10 percent from baseline,” or F) “a need for supplemental daily enteral nutrition via a gastrostomy or daily parenteral nutrition via a central venous catheter.”
What other criteria must I meet to qualify for disability benefits?
To qualify for disability benefits, you will need to meet specific guidelines. In a nutshell, you must meet the following criteria:
- Your disease must be so severe that it prevents you from working, either at your last job or at any job, or from engaging in any type of substantial gainful activity.
- A doctor must expect your disease to last at least a year or to result in death.
- Your must not be able to earn SGA due to your health. In 2021 SGA is $1310/month
Depending on the type of disability benefits you are pursuing, you must meet additional criteria as well. There are two types of disability benefits available through the SSA: Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI).
To qualify for SSDI, you must have sufficient work credits. The number of work credits you need to qualify depend upon your age. Since Crohn’s disease primarily effects youth and young adults, many claimants might not have the required work credits. To qualify for SSI, you must have limited income and resources.
How do I prove that I meet the disability criteria?
You will need to substantiate your claim with medical evidence that includes an endoscopy, biopsy, appropriate medically acceptable imaging, or other operative findings.
The more exhaustive your records, the better. Also, you can avoid hurting your chances of winning your benefits by sticking to your treatment plan to a T. The SSA may deny the claim if you are not getting the treatments your doctor prescribed.
What do I do if the SSA has denied my disability claim?
If the SSA denied your claim, you have the right to appeal your claim. If you believe the SSA has wrongfully denied your application or prematurely terminated your benefits, secure an attorney to help.
The first step is to request a reconsideration (i.e., a review by someone who did not deal with your claim the first time). During the reconsideration, the SSA will review your file again as well as any new evidence you submit. You have only 60 days from the time you received your decision letter in the mail to request a reconsideration. Even if the SSA denies your claim again, there are other levels of appeals you can pursue.
Your attorney can help you prepare for and navigate the process. Consult a lawyer before you meet with the Social Security representative or before sending in additional evidence.
Speak to a Disability Lawyer in Raleigh for FREE
If you or your child has been diagnosed with a severe case of Crohn’s disease, contact Lunn & Forro, PLLC for a no-cost, no-obligation case evaluation.
We help people with disabilities in Raleigh get the benefits they need. After getting background information from you, we can explain your rights and help you take the next step in the claims process. Feel free to bring any questions you have about us or about disability benefits to the meeting.
Contact a Social Security disability lawyer in Raleigh at Lunn & Forro, PLLC today to get started: 888-966-6566.
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