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A Guide to Disability Benefits and Crohn’s Disease

Disability Benefits and Crohn’s Disease

The inflammation and tissue damage associated with Crohn’s disease requires long-term management. In fact, the condition itself is considered chronic, or lifelong. This form of inflammatory bowel disease (IBD) varies widely in severity among individuals. Some people may show only mild and occasional symptoms, while others experience debilitating and frequent symptoms. These often include abdominal pain, diarrhea, and fatigue. The symptoms may be severe enough to impact your quality of life. They can also increase the risk for additional health problems.

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.

How Crohn’s Disease Qualifies for Disability Benefits

The Social Security Administration (SSA) includes Crohn’s disease under the IBD category. This section can be found in the SSA’s “Digestive System — Adult” criteria for disability evaluation. Crohn’s disease primarily affects the gastrointestinal (GI) tract. Prominent symptoms include:

  • abdominal pain and cramps
  • diarrhea
  • loss of appetite
  • nausea

Crohn’s disease can affect other organ systems and cause additional symptoms, including:

  • malnutrition
  • weight loss
  • fever
  • fatigue
  • anemia
  • neurological symptoms
  • inflammatory arthritis
  • skin rashes
  • oral ulcers
  • vision problems

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:

  • You have a mental or physical impairment directly related to a medical condition (you will need a formal diagnosis from a doctor).
  • Your condition has interfered with job-related activities for at least 12 months.
  • You make less than $800 per month.
  • Your condition has advanced to a stage in which you expect work-related activities to be disrupted for at least 12 months.
  • Your outlook is poor.

Aside from providing basic proof of your condition and possible limitations, you may also need to show detailed documents about your medical history. According to the SSDI Resource Center, you may need one or more of the following to qualify for disability benefits:

  • hospitalization or surgery for blockage in the small intestine or colon
  • chronic abdominal pain that is severe enough to require narcotic drugs for management
  • anemia that is associated with hemoglobin readings below 10.0 gm/dL
  • severe weight loss of 10 percent or more, or an extremely low BMI (under 18.0)
  • proof of malnutrition from a doctor or registered dietitian

It’s also important to note that you may need to prove that these effects have happened at least two times (60 days apart) within a six-month period.

The Disability Benefits You Can Receive

The benefits received from the SSA are monetary. This is designed to help cover the costs of lost wages, increased treatments, and surgeries. The precise amount you receive varies, as it is partially based on your lifetime average earnings. You can get an estimate of this amount directly from the SSA before you apply for disability benefits.

After receiving benefits, the SSA will check in with your progress. You may be required to submit additional documentation to prove your disability, if requested. As a general rule of thumb, the SSA wants recipients to be able to work again. Once you resume work, you would no longer be able to receive SSDI benefits. If your condition makes it impossible for you to continue working, you might receive benefits indefinitely.

How to Get Disability Benefits

SSDI is granted through the SSA. You can apply by phone, online, or in person at a local SSA office. Regardless of the way you choose to apply, you will need to bring the following items with you in order to complete your application:

  • proof of diagnosis, including paperwork from your doctor, imaging tests, and endoscopy results, if applicable
  • medical and laboratory test results that have been done within the last year
  • proof of prescription medications needed for your condition
  • information about all doctors and other health professionals you consult for treatment.
  • recent W-2 forms from the previous year (if you’re self-employed, you will need to provide all of the tax return paperwork)
  • financial records, including bank statements, mortgage or rent statements, paystubs, and insurance policies
  • birth certificate or other proof of U.S. citizenship

Once you are approved, you will start getting benefits on the first day of the sixth month in which the SSA determines your disability began.

The Takeaway

Disability benefits are a great help to those who are battling severe forms of Crohn’s disease. As the disease progresses, treatment becomes more and more expensive. The disruptive, uncomfortable symptoms may also affect your ability to work as much as you did before.

Keep in mind that even if you don’t qualify for the full standard benefits for IBD, the SSA may still allow you to receive a medical allowance to help offset your treatment costs. You also have the right to follow an appeal for your claim, should you feel that you still qualify for SSDI despite being turned down.

For more information, you can contact the SSA’s SSDI services at: 1-800-772-1213. 

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