Table of ContentsView AllTable of ContentsThe Blue Book Listing for IBDCriteriaIBD CriteriaBenefitsWhat Benefits Can I Get for IBD?How to ApplyApplication TipsMaking an AppealOther ConsiderationsExtra-Intestinal Manifestations
Table of ContentsView All
View All
Table of Contents
The Blue Book Listing for IBD
Criteria
IBD Criteria
Benefits
What Benefits Can I Get for IBD?
How to Apply
Application Tips
Making an Appeal
Other Considerations
Extra-Intestinal Manifestations
Inflammatory bowel disease (IBD) disability benefits are allowed when people with IBD meet certain criteria.
Theinflammatory bowel diseasesare incurable, chronic illnesses that include Crohn’s disease, ulcerative colitis, and indeterminate colitis. IBD affects the digestive system, causing inflammation which results in symptoms such as fatigue, abdominal pain, diarrhea, lack of appetite, and in some cases, blood in the stool.
Many people who live with IBD find a treatment that helps stop the inflammation and symptoms. However, for some, the disease can be severe and difficult to treat. The complications can limit life activities and make it difficult to hold a job and work. In those cases, it may make sense to apply for disability benefits.
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IBD is a condition for which people can receive Social Security benefits. The U.S. Social Security Administration (SSA) has a list of medical conditions and descriptions that guide the Social Security application process. This is called the Disability Evaluation Under Social Security or as it’s sometimes known, the “Blue Book.”
The Blue Book is very detailed and updated regularly. If a disease or condition is listed, it means that the standards concerning disability have been laid out. IBD is a disease that is listed in the Blue Book. The language in the Blue Book is meant for professionals who work in the Social Security disability space, such as healthcare providers and lawyers.
People may want to get assistance from a disability lawyer or other qualified professional when reviewing the criteria for IBD outlined in the Blue Book. This may help you to understand it better and make a strong case when applying for disability.
Is it hard to get disability for IBD?Social Security disability is more difficult to get for younger people and those without a consistent work history, but it is possible to receive benefits if you have consistent records of medical treatment and meet the specific criteria.
Is it hard to get disability for IBD?
Social Security disability is more difficult to get for younger people and those without a consistent work history, but it is possible to receive benefits if you have consistent records of medical treatment and meet the specific criteria.
Blue Book Criteria
IBD is listed in the digestive system section of the Blue Book. The list of documentation needed to be considered for disability includes:
“Appropriate” means that the test is generally considered to be used for managing that disease. Some of the tests that are often used to diagnose and manage IBD that are listed include:
Documenting that you have pain and discomfort that causes you to miss work isn’t enough to qualify for disability benefits. The specific IBD criteria include either one or both of the following:
2.Two of the followinghave occurred despite prescribed treatment, and they have occurred within the same consecutive six-month period:
Disability Benefits
Disability benefits are monetary payments that are given because a person is unable to earn wages at a job. They are also used to help pay for medical treatments. Qualifying for disability could be a short-term situation or it could be indefinite, depending on the reason and if it’s possible to be healthy enough to return to work.
In the case of IBD, the disease does go through periods of active disease and remission, so short-term disability is possible. However, when the reason for disability is a permanent extra-intestinal (outside the digestive tract) condition or as a result of surgeries (such as short bowel syndrome), the disability may be long-term or indefinite.
There is no one set monthly monetary amount that is allocated for disability. Every case will be different and will be based on that person’s earnings before applying for disability. Disability payments would continue until the recipient can go back to work and earn wages.
The steps for applying for disability include the following:
The type of benefits you qualify for will depend on your specific situation.
Social Security Disability Insurance (SSDI).These benefits are typically available if you’ve worked at least five of the last 10 years. A spouse, former spouse, and your children may be eligible for benefits, which include a monthly payment and Medicare health insurance after a waiting period. The monthly payment amount depends on your employment history, earnings, and how much you’ve paid in Social Security taxes while working.
Supplemental Security Income (SSI).You may qualify for these benefits if you don’t have much work history or monthly income. These benefits provide a monthly payment to cover basic expenses, such as food, clothing, and housing.
Family Medical Leave Act (FMLA).Although this is a separate application process, FMLA is a federal law that allows employees to take up to 12 weeks of unpaid, job-protected leave for specified medical reasons. This may include time off for surgery, hospital stays, mental health, and medical visits. Immediate family members acting as primary caregivers may also qualify.
How to Apply for Benefits
Applying online:
Applying onlinemeans filling out forms, including theAdult Disability ChecklisttheDisability Benefit Application, and a Medical Release form. To use the online application, applicants must:
Some documents must be provided in the original form, such as a birth certificate, but others, such as a W-2, can be photocopied. The paperwork can be mailed in or it can be brought in person to a Social Security office.
Documents that will be needed to apply for disability include:
The process can be challenging because it involves submitting numerous documents and then waiting for a decision. In some cases, states have a backlog of cases and it can take months or years to receive a decision.
Ways to Support Your Application
Some of the steps applicants can take to help their case include:
If your application is denied, there is an appeal process. It is common for a claim to be denied and to make an appeal. An appeal needs to be made in writing within 60 days of the decision.
Surgery and IBD-Specific Considerations
One section of the Blue Book has some wording to be aware of because it is in contrast to how the medical community and gastroenterologists who specialize in IBD write about the disease.
Crohn’s Disease
Ulcerative Colitis
Some gastroenterologists who specialize in IBD consider surgery a treatment for ulcerative colitis, rather than a “cure.” The ACG guidelines for ulcerative colitis refer to a subtotal or a total colectomy and placement of an ileostomy as a “surgical treatment” for acute, severe ulcerative colitis.
The guidelines also reference the other type of surgery done for ulcerative colitis, calledj-pouch surgery(for which the medical term isrestorative proctocolectomywith ileal pouch-anal anastomosis, or IPAA). A j-pouch is called the “surgical procedure of choice for the management of refractory UC.”
This means it is a type of surgery that is commonly used to treat a case of ulcerative colitis that isn’t going into remission with medications.
Ostomy Surgery
The Blue Book also considers ileostomy andcolostomy surgeryto “not preclude gainful activity if you are able to maintain adequate nutrition and function of the stoma.” Meaning that a good surgical outcome with an ostomy where everything is going well is not considered a reason for disability.
However, a note is made for those who are not able to maintain adequate nutrition. The criteria define this as having abody mass index(BMI) under 17.50. The BMI needs to be measured on two separate occasions in a six-month period at least 60 days apart.
BMI is a dated, flawed measure. It does not take into account factors such asbody composition, ethnicity, sex, race, and age. Even though it is a biased measure, BMI is still widely used in the medical community because it’s an inexpensive and quick way to analyze a person’s potential health status and outcomes.
Short Bowel Syndrome
Short bowel syndromeis a condition associated with severe Crohn’s disease and some other conditions. It occurs when the body cannot absorb enough nutrients from foods because part of the small intestine is missing, damaged, or has been surgically removed.
The wording in the Blue Book specifies half of the small intestine being removed and that a person is dependent on parenteral nutrition with the use of a central venous catheter.
People who live with IBD are also at risk for developing other conditions outside of the digestive tract.These are often called extra-intestinal manifestations because they involve other parts of the body such as the joints, eyes, skin, liver, or kidneys.
The Blue Book makes a note of these types of complications and says that they will be considered if the IBD alone isn’t enough to make a case for disability. Extra-intestinal manifestations sometimes get worse when the IBD gets worse, and sometimes they don’t track with the course of the IBD at all.
Some of the extra-intestinal manifestations that are mentioned in the Blue Book include:
Summary
IBD disability benefits are available for people with the condition who meet the Blue Book criteria. Being organized with the required documentation and submitting your application promptly may help your chances of receiving benefits in a timely way. Many people have to appeal the initial decision which needs to occur within 60 days of receiving the decision letter.
8 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Social Security Administration.Fact sheet: Social Security Disability Insurance (SSDI).USA.gov.SSDI and SSI benefits for people with disabilities.Crohn’s & Colitis Foundation.Employee and Employer Resources.Social Security Administration.Disability Evaluation Under Social Security. 5.00 Digestive System - Adult.Lichtenstein G, Loftus EV, Isaacs K, Regueiro MD, Gerson LB, Sands BE.ACG clinical guideline: management of Crohn’s disease in adults.Amer J Gastro. 2018;4:481-517. doi:10.1038/ajg.2018.27Rubin DT, Ananthakrishnan AN, Siegel CA, Sauer BG, Long MD.ACG clinical guideline: Ulcerative colitis in adults.Amer J Gastro. 2019;3:384-413. doi:10.14309/ajg.0000000000000152National Organization of Rare Disorders.Short bowel syndrome.Vavricka SR, Schoepfer A, Scharl M, Lakatos PL, Navarini A, Rogler G.Extraintestinal manifestations of inflammatory bowel disease.Inflamm Bowel Dis. 2015;21:1982-1992. doi:10.1097/MIB.0000000000000392Additional ReadingBogle D.Things to Think About Before Applying for Disability Benefits. Social Security Administration.Borland J.Prepare for your disability interview: tips from Social Security. Social Security Administration.Social Security Administration.Disability benefits.Social Security Administration.Disability benefits. Appeal a decision.
8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Social Security Administration.Fact sheet: Social Security Disability Insurance (SSDI).USA.gov.SSDI and SSI benefits for people with disabilities.Crohn’s & Colitis Foundation.Employee and Employer Resources.Social Security Administration.Disability Evaluation Under Social Security. 5.00 Digestive System - Adult.Lichtenstein G, Loftus EV, Isaacs K, Regueiro MD, Gerson LB, Sands BE.ACG clinical guideline: management of Crohn’s disease in adults.Amer J Gastro. 2018;4:481-517. doi:10.1038/ajg.2018.27Rubin DT, Ananthakrishnan AN, Siegel CA, Sauer BG, Long MD.ACG clinical guideline: Ulcerative colitis in adults.Amer J Gastro. 2019;3:384-413. doi:10.14309/ajg.0000000000000152National Organization of Rare Disorders.Short bowel syndrome.Vavricka SR, Schoepfer A, Scharl M, Lakatos PL, Navarini A, Rogler G.Extraintestinal manifestations of inflammatory bowel disease.Inflamm Bowel Dis. 2015;21:1982-1992. doi:10.1097/MIB.0000000000000392Additional ReadingBogle D.Things to Think About Before Applying for Disability Benefits. Social Security Administration.Borland J.Prepare for your disability interview: tips from Social Security. Social Security Administration.Social Security Administration.Disability benefits.Social Security Administration.Disability benefits. Appeal a decision.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Social Security Administration.Fact sheet: Social Security Disability Insurance (SSDI).USA.gov.SSDI and SSI benefits for people with disabilities.Crohn’s & Colitis Foundation.Employee and Employer Resources.Social Security Administration.Disability Evaluation Under Social Security. 5.00 Digestive System - Adult.Lichtenstein G, Loftus EV, Isaacs K, Regueiro MD, Gerson LB, Sands BE.ACG clinical guideline: management of Crohn’s disease in adults.Amer J Gastro. 2018;4:481-517. doi:10.1038/ajg.2018.27Rubin DT, Ananthakrishnan AN, Siegel CA, Sauer BG, Long MD.ACG clinical guideline: Ulcerative colitis in adults.Amer J Gastro. 2019;3:384-413. doi:10.14309/ajg.0000000000000152National Organization of Rare Disorders.Short bowel syndrome.Vavricka SR, Schoepfer A, Scharl M, Lakatos PL, Navarini A, Rogler G.Extraintestinal manifestations of inflammatory bowel disease.Inflamm Bowel Dis. 2015;21:1982-1992. doi:10.1097/MIB.0000000000000392
Social Security Administration.Fact sheet: Social Security Disability Insurance (SSDI).
USA.gov.SSDI and SSI benefits for people with disabilities.
Crohn’s & Colitis Foundation.Employee and Employer Resources.
Social Security Administration.Disability Evaluation Under Social Security. 5.00 Digestive System - Adult.
Lichtenstein G, Loftus EV, Isaacs K, Regueiro MD, Gerson LB, Sands BE.ACG clinical guideline: management of Crohn’s disease in adults.Amer J Gastro. 2018;4:481-517. doi:10.1038/ajg.2018.27
Rubin DT, Ananthakrishnan AN, Siegel CA, Sauer BG, Long MD.ACG clinical guideline: Ulcerative colitis in adults.Amer J Gastro. 2019;3:384-413. doi:10.14309/ajg.0000000000000152
National Organization of Rare Disorders.Short bowel syndrome.
Vavricka SR, Schoepfer A, Scharl M, Lakatos PL, Navarini A, Rogler G.Extraintestinal manifestations of inflammatory bowel disease.Inflamm Bowel Dis. 2015;21:1982-1992. doi:10.1097/MIB.0000000000000392
Bogle D.Things to Think About Before Applying for Disability Benefits. Social Security Administration.Borland J.Prepare for your disability interview: tips from Social Security. Social Security Administration.Social Security Administration.Disability benefits.Social Security Administration.Disability benefits. Appeal a decision.
Bogle D.Things to Think About Before Applying for Disability Benefits. Social Security Administration.
Borland J.Prepare for your disability interview: tips from Social Security. Social Security Administration.
Social Security Administration.Disability benefits.
Social Security Administration.Disability benefits. Appeal a decision.
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