Last Updated on June 29, 2023 by Steven Root
Introduction
Crohn’s disease is a type of chronic inflammatory bowel disorder that may be classified as a disability under certain conditions.
This article will help you to understand:
- Is Crohn’s disease a disability?
- The prerequisites for securing benefits
- The procedure to apply for disability benefits
- The role of legal support
- An estimate of the disability payments for Crohn’s disease
Understanding Crohn’s Disease
Crohn’s disease is an inflammatory bowel condition that has a substantial impact on an individual’s general health and quality of life.
Unlike ulcerative colitis, it can affect any part of the gastrointestinal tract, from the mouth to the anus, and may involve multiple layers of the bowel walls, causing a range of symptoms.
These can include:
- Diarrhea, often with blood or mucus
- Abdominal pain and cramping
- Fatigue and weight loss
- Fever
- Mouth ulcers
The condition can also lead to complications beyond the digestive system, including skin rashes, arthritis, eye inflammation, and more.
Alongside medications, an integrated approach involving dietary adjustments and lifestyle changes is progressively gaining traction in managing the symptoms of Crohn’s disease.
Contact us here for assistance in developing a diet and lifestyle plan to mitigate the symptoms of Crohn’s disease.
Is Crohn’s Disease a Disability?
Crohn’s disease can significantly impair an individual’s capacity to conduct normal daily activities, including carry out their work. Consequently, it can qualify as a disability.
Legal Recognition
In the United States, the Social Security Administration (SSA) recognizes Crohn’s disease as a disability under its category for Inflammatory Bowel Disease (source).
However, eligibility is contingent upon satisfying certain criteria.
Crohn’s Disease Disability Criteria
As per the SSA’s guidelines, to be eligible for disability benefits due to Crohn’s disease, you must meet the following conditions:
A. Obstruction of stenotic areas (not adhesions) in the small intestine or colon with proximal dilatation, confirmed by appropriate medically acceptable imaging or in surgery, requiring hospitalization for intestinal decompression or for surgery, and occurring on at least two occasions at least 60 days apart within a consecutive 6-month period.
OR
B. Two of the following despite continuing treatment as prescribed and occurring within the same consecutive 6-month period:
1. Anemia with hemoglobin of less than 10.0 g/dL, present on at least two evaluations at least 60 days apart; or
2. Serum albumin of 3.0 g/dL or less, present on at least two evaluations at least 60 days apart; or
3. Clinically documented tender abdominal mass palpable on physical examination with abdominal pain or cramping that is not completely controlled by prescribed narcotic medication, present on at least two evaluations at least 60 days apart; or
4. Perineal disease with a draining abscess or fistula, with pain that is not completely controlled by prescribed narcotic medication, present on at least two evaluations at least 60 days apart; or
5. Involuntary weight loss of at least 10 percent from baseline, as computed in pounds, kilograms, or BMI, present on at least two evaluations at least 60 days apart; or
6. Need for supplemental daily enteral nutrition via a gastrostomy or daily parenteral nutrition via a central venous catheter.
Keeping thorough medical records and working closely with your healthcare provider is essential in meeting these criteria.
How To Apply For Crohn’s Disease Disability Benefits
Begin by completing an initial disability application with the SSA, which requires detailed information about your medical history, employment record, and how your condition restricts your capacity to work.
Post-application, you may need to attend a disability interview and/or fill in extra forms.
It is important to provide comprehensive and accurate data to maximize your chances of being approved.
Should You Consult a Lawyer for Assistance?
Consulting a disability attorney can be helpful in understanding the process, collating essential evidence, completing forms, and representing you in hearings or appeals. However, it is not mandatory and many individuals successfully go through the process independently.
What Will Your Monthly Benefit Payment Be For Crohn’s Disease?
The monthly benefit payment for disability benefits depends on various factors including:
- The Social Security program you qualify for
- Your employment history
- Average lifetime earnings before the onset of the disability
The SSA provides disability benefits via two programs: Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI).
Typically, SSDI caters to those who have work history, while SSI targets individuals with limited to no work history or income.
You may apply to both programs simultaneously, and the SSA will determine your eligibility for each, or both.
The SSDI benefit amount is based on your average indexed monthly earnings (AIME), which considers your taxable income from previous years. As of 2021, the average SSDI benefit was about $1,277 per month, but it can vary between $800 to $1,800 (source).
SSI benefits are need-based rather than dependent on work history. The maximum federal payment adjusts yearly. As of 2021, the maximum SSI amount was $794 for an eligible individual and $1,191 for an eligible person with an eligible spouse.
Remember, these are average and maximum figures. The exact disability benefit varies individually, and your specific circumstances will influence what you may receive. Moreover, any other income you earn could affect your benefit amount.
Summary
In closing:
- Crohn’s disease can be recognized as a legal disability
- There are specific eligibility criteria for disability benefits, as outlined above
- Individuals can manage the application process independently, but may choose to consult a lawyer
- Applications can be made to both SSDI and SSI programs, with potential eligibility for both.