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Digestive System Conditions

How Do I Get Social Security Disability Benefits for Digestive System Diseases?Digestive System Diseases and Disability

Disorders of the digestive system include gastrointestinal hemorrhage, liver dysfunction, inflammatory bowel disease, short bowel syndrome, and malnutrition. Most digestive disorders respond to treatment, and therefore few people satisfy the 12-month duration requirement to receive disability.

If you are suffering from a digestive system condition, unable to work and have been denied social security disability benefits, call the experienced Santa Ana social security disability attorneys at Howard Law to help you fight for the benefits you deserve.

Chronic Liver Disease

Most people seeking social security disability on the basis of liver disease have alcoholic liver damage. However, any type of chronic liver disease could potentially qualify. Many disorders can damage the liver including genetic disorders, toxins, poisons, drugs, bacterial infections, heart failure, fungi, ulcerative colitis, parasites, and viruses. Hepatitis C may cause chronic viral hepatitis.

If you suffer from a chronic liver disease including Hepatitis C, to qualify for Social Security Disability Benefits you must present any one of the following;

(1) Bleeding from esophageal, gastric, or ectopic varices or from portal hypertensive gastropathy, requiring hospitalization for transfusion of at least two units of blood must be at least 30 days apart,

(2) Ascites or hydrothorax not attributable to other causes, despite continuing treatment as prescribed, present on at least two evaluations at least 60 days apart within a consecutive six-month period,

(3) Spontaneous bacterial peritonitis infection with ascitic peritoneal fluid containing an absolute neutrophil count of at least 250 cells/mm3,

(4) Hepatorenal syndrome, defined as functional renal failure associated with chronic liver disease in the absence of underlying kidney pathology, with any one of the following; serum creatinine elevation of at least 2mg/dL, oliguria with 24 hour urine output less than 500 mL, or sodium retention with urine sodium less than 10 mEq per liter,

(5) Hepatopulmonary syndrome defined as arterial deoxygenation (hypoxemia) associated with chronic liver disease with arterial oxydenation on room air of 60 mm Hg or less at test sites less than 3000 feet above sea level, or 55 mm Hg or less, at test sites from 3000 to 6000 feet, or 50 mm Hg or less, at test sites above 6000 feet or documentation of intrapulmonary arteriovenous shunting by contrast-enhanced echocardiography or macroaggregated albumin lung perfusion scan,

(6) Hepatic encephalopathy usually indicated by severe loss of hepatocellular function and is defined as a recurrent or chronic neuropsychiatric disorder, characterized by abnormal behavior, cognitive dysfunction, changes in mental status, or altered state of consciousness, present on at least two evaluations at least 60 days apart within a six-month consecutive period,

(7) End-stage liver disease is evaluated with SSA CLD scores of 22 or greater, calculated using a formula that includes three laboratory values: Serum total bilirubin (mg/dL), serum creatinine (mg/dL), and International Normalized Ratio (INR). All of the required laboratory values must have been obtained within 30 days of each other.

For more information on chronic liver disease and the Social Security Administration Guidelines, visit the Social Security Administration website.

Liver Transplant

If you have had a liver transplant, the Social Security Administration will automatically consider you to be disabled for one year following surgery. After the year, any conditions or illnesses will be evaluated under the particular illness or condition you are suffering from at the time.

Upper Gastrointestinal Bleeding

This disability refers to bleeding anywhere in the GI tract, meaning the esophagus, stomach, small intestine, or large intestine. Because most sources of upper GI bleeding can be successfully treated in less than 12 months, Social Security Administration requires more than just bleeding to qualify as disabled.

To qualify for Social Security Disability benefits due to upper gastrointestinal bleeding, you must have severe and recurrent GI bleeding from any location with (1) at least three blood transfusions over a period of six consecutive months; (2) the transfusions must be at least two units of blood, and (3) the transfusions must be at least 30 days apart. You will be considered disabled for one year after the last transfusion and then your case will be reevaluated.

For more information on upper gastrointestinal bleeding and the Social Security Administration Guidelines, visit the Social Security Administration website.

Inflammatory Bowel Disease

Inflammatory bowel disease (IBD) refers to any kind of chronic and inflammatory intestinal disorder. The most common types of IBD are Chron’s disease and ulcerative colitis.

To qualify for Social Security Disability benefits, you must have your diagnosis of IBD documented by endoscopy, biopsy, other appropriate medically acceptable imaging, or operative findings. In addition, the Social Security Administration requires suffering from other specific abnormalities sometimes associated with severe cases of IBD.

For more information on IBD and the Social Security Administration Guidelines, visit the Social Security Administration website.

Short Bowel Syndrome

Short bowel syndrome describes the condition of someone who cannot properly absorb nutrients because the person has had an extensive portion of their small intestine removed. Such resection can become necessary as a result of regional enteritis, trauma, or a thrombosis that interrupts the blood supply to the intestine.

In order to qualify for Social Security Disability Benefits, you must have had a surgical resection of more than one half of the small intestine, with dependence on daily parenteral nutrition via central venous catheter.

For more information on short bowel syndrome and the Social Security Administration Guidelines, visit the Social Security Administration website.

Weight Loss

Weight loss caused by a gastrointestinal disorder may qualify you for social security disability benefits. To qualify for Social Security Disability Benefits, you must have weight loss due to any digestive disorder despite continuing treatment as prescribed, with BMI of less than 17.50 calculated on at least two evaluations at least 60 days apart within a consecutive 6-month period.

For more information on weight loss and the Social Security Administration Guidelines, visit the Social Security Administration website.

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Listing vs. Residual Functional Capacity (RFC): How Does the Social Security Administration Determine Whether I Qualify for Disability Benefits for Digestive System Diseases?

Social Security disability benefits may be available for people who suffer from Digestive System Diseases. The Social Security Administration must first determine whether your Digestive System Disease is severe enough to meet or equal a listing at Step 3 of the Sequential Evaluation Process. The Social Security Administration will conclude that you are disabled and eligible for disability benefits if it determines that you meet or equal a listing because of your Digestive System Disease.

If the Social Security Administration decides that your Digestive System Disease is not severe enough to equal or meet a listing, it must assess the work that you are still capable of doing, in spite of your illness or disease. The work that you are able to do in spite of your illness or disease is called residual functional capacity (RFC). You may qualify for benefits at Step 4 and Step 5 of the Sequential Evaluation Process if you are able to do in spite of your illness or disease.

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How Can I Meet a Listing and Win Social Security Disability Benefits for a Digestive System Disease?

The Social Security Administration will determine whether you are disabled at Step 3 of the Sequential Evaluation Process by evaluating whether your Digestive System Disease is severe enough to equal a listing.

The term “listing” refers to a compiled list of common impairments. The Social Security Administration created a set of guidelines called the Listing of Impairments that contains the most common impairments. For each listing of a particular impairment, there is an explanation regarding the degree of severity that the Social Security Administration presumes would prevent a person from performing substantial work.

The Social Security Administration will consider you disabled if your Digestive System Disease is severe enough to meet or equal a listing.

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What is Your Residual Functional Capacity Assessment for your Digestive System Disease?

If the Social Security Administration decides that your Digestive System Disease is not severe enough to equal or meet a listing, it must assess the work that you are still capable of doing, in spite of your illness or disease. The work that you are able to do in spite of your illness or disease is called residual functional capacity (RFC). You may qualify for benefits at Step 4 and Step 5 of the Sequential Evaluation Process if you are able to do in spite of your illness or disease.

The Social Security Administration expressesan RFC for physical impairments in terms of whether the Social Security Administration believes you are able to do heavy, medium, light, or sedentary work in spite of your impairments. The lower your RFC, the less the Social Security Administration believes you can do.

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Can Your Doctor’s Medical Opinion Help You Qualify for Social Security Disability Benefits for a Digestive System Disease?

The role of the Social Security Administration is to conclusivelyestablish whether you are disabled based on your education, work experience, medical evidence, and your age.

The role of your doctor is to provide the Social Security Administration with informationconcerning the degree of your medical impairment by providing the Social Security Administration medical source statement that describes your capacity for work which is part of your residual functional capacity assessment. Your residual functional capacity is what you can still do despite your limitations.

The Social Security Administration must consider your treating physician’s opinion because the Social Security Administration considers it to be controlling when making its decision.

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What is the 5 Step Sequential Evaluation Process?

The Social Security Administration has created a five (5) step sequential process to determine whether an adult claimant is entitled to receive disability benefits. Children have a different test to determine eligibility.

Step 1: Substantial Gainful Activity

The Social Security Administration presumes that if you are working and that you make a certain amount of money that you are engaging in what it determines to be a substantial gainful activity (SGA). The Social Security Administration considers a person to be engaged in a SGA if that person is earning more than a certain amount of money each month (i.e. net of impairment - related work related expenses).

In 2013, the Social Security Administration has determined that a statutorily blind individual is engaged in a SGA if they earn more than $1740.00 per month while a non-blind individual must earn more than $1040.00 per month. Changes in the national average wage index usually affect the aforementioned SGA amounts.

Step 2: Severe Impairment

The Social Security Administration has determined that each claimant must either have a severe impairment or a combination of impairments. The impairment or combination of impairments must drastically limit the claimant's physical or mental ability to do basic work activities without regard to age, work history, or education. For many claimants, the level of proof at this level is minimal; therefore, they usually satisfy the Step 2 requirements and proceed to Step 3.

Step 3: Listing of Impairments

The Listing of Impairments details specific impairments that the Social Security Administration considers severe enough to prevent an adult claimant from engaging in a substantial gainful activity and in the case of a minor, the impairment has to be severe enough to cause functional limitations. There is also a durational requirement. The Social Security Administration has determined that the impairment must last for 12 months or long or result in the death of the claimant. If the claimant fails Step 3 because they do not meet or equal a listing then the case will proceed to Step 4.

Step 4: Past Relevant Work

At Step 4, if your condition is severe enough to meet the requirements of Step 2 (Severe Impairment); however, your severe impairment does not meet or equal a listed impairment that is the subject of Step 3 (Listing of Impairments), then the Social Security Administration must decide whether your severe impairment interferes with your ability to do any of the work you previously performed. The Social Security Administration likes to look at the work you performed over the past 15 years prior to the onset of your disability. If the Social Security Administration determines that your impairment does not interfere with work you previously did then you must proceed to Step 5.

Step 5: Ability to Perform Other Work

A majority of disability claims are decided at this level. If you cannot perform work you did in your past, then a determination must be made as to whether you can adjust to different types of work. The determination at this level takes into consideration your education, age, and prior work and is better known as your residual functional capacity.

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