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A Guide to Disability Benefits and Crohn’s Disease

Given the long-term nature of Crohn’s disease, it may be worth looking into disability benefits. This can help offset the costs of management and help pay for unexpected expenses surrounding potential complications of the disease.

Complications associated with progressed forms of the disease can interfere with your daily life and even make it difficult to work. These issues might make you eligible for disability benefits. You may qualify to receive social security disability insurance (SSDI) benefits if:

How to Qualify for Social Security Disability Benefits with Crohn’s Disease

Crohn’s disease can be a strange, confusing, and debilitating disorder. Unlike most disorders, the effects that Crohn’s disease can have on a person truly vary from case to case. While some people can manage to continue their normal life with minor dietary and medication adjustments, others see symptoms throughout their whole digestive tract and have difficulty working or living independently.

If your Crohn’s is severe enough to cause you daily pain and struggle, then you may qualify for Social Security disability benefits. Disability benefits can provide monthly financial assistance and insurance benefits to those in need due to a severe disorder.

Medical Requirements for Crohn’s

To qualify for Social Security benefits, you must prove on your disability application that your disorder leaves you “totally and permanently disabled”. This means that your disorder must be:

a) expected to last longer than 12 months or result in death, and

b) severe enough to limit your ability to live and work normally.

Because Crohn’s is chronic, these time requirements are usually not an issue. However, the severity of Crohn’s depends greatly on the individual’s unique symptoms. To gauge your condition, the Social Security Administration (SSA) will compare your symptoms to those listed in the “Blue Book”, which contains listings for all severe disorders.

According to Section 5.06 for “Inflammatory bowel disease (IBD)”, your Crohn’s can qualify in one of two ways:

A) Your Crohn’s causes obstruction of stenotic areas (thinned blood vessels) in the small intestine or colon, confirmed by medical imaging or during surgery, requiring hospitalization on at least two occasions at least 60 days apart during a consecutive 6-month period,

OR

B) You meet two of the following conditions, despite continued treatment, occurring within the same consecutive 6-month period:

  • ¥ anemia with hemoglobin less than 10.0g/dL, present on at least two occasions at least 60 days apart
  • ¥ serum albumin of 3.0g/dL or less, present on at least two occasions at least 60 days apart
  • ¥ tender abdominal mass palpable on medical examination, with abdominal pain or cramping that is not completely controlled by narcotic medication, present on at least two occasions at least 60 days apart
  • ¥ perianal disease with a draining abscess or fistula, with pain that is not completely controlled by narcotic medication, present on at least two occasions at least 60 days apart
  • ¥ involuntary weight loss of at least 10 percent, measured with either pounds, kilograms, or BMI, present on at least two occasions at least 60 days apart
  • ¥ need for supplemental nutrition via a gastronomy or parenteral nutrition through a catheter

This listing for Crohn’s disease can be overwhelming, especially when the majority of qualifications rely on specific medical terms or test findings. To see if your Crohn’s meets these requirements, it is best to consult with your doctor and get additional/updated testing to understand your specific diagnosis. Be sure to save copies of all test results, medical history, medication lists, and hospitalization records to include on your application.

Understanding SGA

On top of medical history, disability applicants must also present their financial history to qualify. Depending on your financial situation, you may qualify for Social Security disability insurance (SSDI), Supplemental Security Income (SSI), or both. SSDI is typically for people with a history of working and paying taxes into the Social Security system, while SSI is typically for those who are younger, unemployed, or don’t have a history of working.

However, regardless of the program, it is important to understand Substantial Gainful Activity (SGA). When a person makes enough money to support themselves each month, they are considered to be “engaging in SGA” and do not qualify for governmental support. However, if you do not engage in SGA, then you are still considered eligible for disability benefits.

Because Crohn’s disease affects everyone differently, it is possible for a person with severe symptoms to still work on occasion. If this is the case for you, make sure to compare your monthly earnings to the SGA limit. For 2017, applicants cannot make more than $1,170/month through work before they are deemed ineligible for disability benefits.

Starting the Application

Once you have both your medical and financial paperwork prepared, you can begin filling out your application. Applications for SSDI can be found online on the SSA’s website, while both SSDI and SSI applications can be filled out in person at your local Social Security office. If you need assistance on the application, you can always call your local office to ask questions or have them guide you through the process.

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