Applying for Disability Insurance With IBD

Applying for Disability Insurance With IBD
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In a previous column, I discussed how the Americans with Disabilities Act (ADA) protects invisible disabilities, including inflammatory bowel disease (IBD) and IBD-related disorders and conditions. Under the ADA, employees with Crohn’s or ulcerative colitis can request workplace accommodations. Even minor adjustments, such as flexible work hours or the ability to telecommute, allow IBD patients with mild to moderate symptoms to have a career while managing their disease.

Unfortunately, severe symptoms can become so debilitating that someone can no longer do their job or work at all. When this happens, an IBD patient may be able to receive Social Security Disability Insurance benefits.

What is Social Security Disability Insurance?

President Franklin D. Roosevelt signed the Social Security Act into law 85 years ago on Aug. 14, 1935. Almost 21 years later, on Aug. 1, 1956, President Dwight D. Eisenhower amended the act to include disability insurance benefits for disabled workers ages 50 and up, as well as for adult children. Coincidentally, doctors had diagnosed Eisenhower with Crohn’s disease three months earlier.

In 1960, Eisenhower expanded the law to cover disabled workers of all ages and their dependents.

I didn’t know much about Social Security Disability Insurance except that I paid into the system with the federal taxes deducted from my paychecks. I wasn’t aware that I might qualify for benefits until after my liver transplant in 2017. My caseworker explained that I could apply for disability to take time off work to recuperate. I didn’t look into it because I was earning my full salary through sick leave.

When my sick pay ran out months later, I told my gastroenterologist that I was considering applying for disability. He laughed and said I might not be eligible anymore because I was doing so well after my transplant.

Who’s eligible for Social Security Disability Insurance?

The Social Security Administration (SSA) uses a five-step process for determining eligibility. The first step looks at an applicant’s recent work history and salary. For someone who worked in 2020, their monthly salary must have been $1,260 or less to qualify. If a person didn’t work, then the SSA sends the application to the Disability Determination Services office for approval.

The second step examines the severity of a person’s disability. The applicant’s disability must have prevented gainful employment for at least a year. If so, the administration then verifies the disability is a covered medical condition.

Once the SSA confirms the disability, the final two steps consider the probability of the applicant’s ability to return to work. Someone with a partial or short-term disability won’t meet the administration’s strict definition of a disability. To be considered disabled, the applicant can’t perform their current job, they can’t find other work or a different job, and the disability has or is expected to last a minimum of one year or result in death.

Is IBD a qualifying disability?

IBD is covered specifically under Section 5.06 of the SSA’s qualifying digestive system medical disorders. However, a Crohn’s or ulcerative colitis patient isn’t eligible automatically with an IBD diagnosis alone. The applicant also must meet one of two additional criteria.

The first qualifying condition is having a bowel obstruction in the small intestine or colon. The patient must have been hospitalized because of the obstruction at least twice within 60 days during a six-month period.

The other deciding factor is experiencing two or more of the following during a six-month period despite continuous treatment:

  • Anemia caused by a hemoglobin level less than 10 g/dL at least twice, and at least 60 days apart
  • A serum albumin level of 3.0 g/dL or less at least twice, and at least 60 days apart
  • An abdominal mass with uncontrollable pain or cramping during at least two evaluations, at least 60 days apart
  • Involuntary weight loss of at least 10% at least twice, and at least 60 days apart
  • Receiving daily supplemental nutrition by feeding tube or catheter

If an IBD patient doesn’t qualify under Section 5.06, they might be eligible under Section 5.08. This criterion determines disability when the applicant’s body mass index unintentionally drops below 17.50 during at least two evaluations at least 60 days apart, during a six-month period.

Application and determination of payment

IBD patients can apply for Social Security Disability Insurance in person or online at the administration’s website. The website provides a checklist and answers common questions to help applicants. The Crohn’s & Colitis Foundation also offers resources to assist IBD patients with the process.

If approved, the SSA will calculate the benefit amount by looking at the applicant’s lifetime average earnings and years of employment and how recently someone worked before becoming disabled.

Never too old to learn something new

I wish doctors employed a patient advocate specifically for explaining legal and financial protections that IBD patients can access. I may have learned about my rights mid-career, but I still have 18 years to exercise them before I can retire.

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Note: IBD News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health providers with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of IBD News Today, or its parent company, BioNews, and are intended to spark discussion about issues pertaining to IBD.

Emmeline is a 47-year-old Crohn’s warrior and primary sclerosing cholangitis survivor. Her column encourages patients and caregivers to advocate for better healthcare and educates readers about her rare autoimmune diseases. She also freelances as a communication specialist, offering writing, editing, and graphic design services. Emmeline (an Auburn fan) and her husband Patrick (an Alabama fan) enjoy watching SEC football and spending time with loved ones in Austin, Texas. Thanks to a liver transplant in 2017, Emmeline is training for her third-degree black belt in the Korean martial art Mu Sool Won.
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Emmeline is a 47-year-old Crohn’s warrior and primary sclerosing cholangitis survivor. Her column encourages patients and caregivers to advocate for better healthcare and educates readers about her rare autoimmune diseases. She also freelances as a communication specialist, offering writing, editing, and graphic design services. Emmeline (an Auburn fan) and her husband Patrick (an Alabama fan) enjoy watching SEC football and spending time with loved ones in Austin, Texas. Thanks to a liver transplant in 2017, Emmeline is training for her third-degree black belt in the Korean martial art Mu Sool Won.

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