Pittsburgh
Inflammatory Bowel Disease Lawyer

On This Page

1. What does the SSA evaluate under the inflammatory bowel disease section?
2. Is my IBD serious enough for me to get disability benefits?
3. What if my IBD does not meet the criteria for Section 5.06?
4. I meet the severity requirements. Do I qualify?
5. How can a lawyer help me with my claim?
6. Call Berger and Green today for a free consultation.

REVIEWED BY

C. William Kenny

December 12, 2023

Board certified by National Board of Trial Advocacy

What does the SSA evaluate under the inflammatory bowel disease section?

If you suffer from inflammatory bowel disease to such an extent that it prevents you from being able to work, you may be eligible for Social Security disability benefits. You will need to meet certain medical requirements as well as rules regarding income, work credits, and inability to work. These criteria are hard to understand and often even harder to meet. For help getting Social Security disability for inflammatory bowel disease in Pittsburgh, call a disability lawyer at Berger and Green today: 412-661-1400.

In Section 5.06 of the Blue Book, the Social Security Administration (SSA) lays out the severity criteria for types of inflammatory bowel disease (IBD). The SSA evaluates several types of IBD under this section, including, but not limited to:

• Crohn’s disease
• Ulcerative colitis

Note: You might be able to use the criteria for IBD to evaluate other gastrointestinal disorders, such as diverticulitis.

Is my IBD serious enough for me to get disability benefits?

To meet the severity criteria in Section 5.06, your IBD must be documented by surgical findings, endoscopy, biopsy, or appropriate medical imaging. You must also provide evidence of one of the two following findings:

1. Obstruction in the small intestine or colon that required at least two separate hospitalizations within a six-month period either for surgery or intestinal decompression. These hospitalizations must have been at least 60 days apart; OR
2. Despite medical treatment, you have ongoing problems (i.e., two or more episodes at least 60 days apart) of two or more of the following:

10. Anemia (hemoglobin lower than 10.0 g/dL);
11. Serum albumin of 3.0 g/dL or lower;
12. Abdominal pain or cramping combined with a palpable tender abdominal mass, for which narcotics do not provide complete pain control;
13. Painful perineal disease with a draining fistula or abscess, for which narcotics do not provide complete pain control;
14. Involuntary weight loss of 10 percent or more from baseline (measurable in pounds, kilograms, or BMI); or
15. Daily supplemental enteral nutrition by means of a gastronomy or daily parenteral nutrition by means of a central venous catheter is necessary

These criteria are complicated; our team can help you determine if you meet the criteria for Section 5.06.

What if my IBD does not meet the criteria for Section 5.06?

You have two options to qualify for benefits if you do not meet the severity criteria for Section 5.06.

Satisfy the Criteria for Another Listing

IBD can manifest itself in other parts of the body. If you do not qualify for benefits under Section 5.06, the SSA can evaluate your case by considering “the effects of your extraintestinal manifestations” in other places on the body. We can help you determine what part(s) of the body the SSA might evaluate and help you prove you qualify.

Prove Your Condition is So Severe It Keeps You from Working

If you cannot prove your condition satisfies the severity criteria for Section 5.06 or a related condition, then you will need to prove that your condition prevents you from being able to work at all.

The SSA has strict guidelines about what it means to not be able to work. Many people assume that if they are not able to continue performing their current job, they are unable to work, but that is not enough the satisfy the SSA. For the SSA to deem you disabled, you must be:

• Unable to perform your current job, with or without modifications;
• Unable to do a related type of work;
• Unable to do any type of work for which your work history, job skills, and education would make you qualified; AND
• Unable to do any type of work at all, even if you received additional education or job training or have transferrable job skills.

I meet the severity requirements. Do I qualify?

Perhaps. There are a few more hurdles. You must also meet certain criteria depending on the type of benefit for which you are applying.

If you are applying for Social Security Disability Insurance (SSDI) benefits, you must meet income and work credit requirements. The income requirement simply states that you cannot make more than $1,170 a month. To satisfy the work credit requirement, you must have worked for a long enough time in a job that paid into Social Security.

If you do not have enough work credits, then we can explore whether you are eligible for Supplemental Security Income (SSI). To qualify for SSI, you must have:

• Low income (lower than the year’s Federal Benefit Rate)
• Limited assets ($2,000 per person, $3,000 per couple)

How can a lawyer help me with my claim?

Applying for benefits is a long and difficult process. The criteria are full of confusing jargon that only a doctor or disability lawyer is likely to understand. But you do not need to go through this process alone. A disability lawyer can:

• Examine your medical records to determine if you qualify
• Analyze your claim for mistakes
• File an appeal if the SSA denies your application, which is very common
• Help the SSA get the evidence it needs to accept your application
• Represent you in front of an administrative law judge or at any other step of the appeals process

Call Berger and Green today for a free consultation.

The Social Security disability lawyers at Berger and Green are always ready to help disabled people get the benefits they deserve. We will treat you with respect and dignity. Our Social Security disability team will review your case and handle your claim for you.

And we do not charge for consultations and you will not pay us at all unless you win your benefits. There is truly no risk or obligation. Call us for help winning your disability benefits today: 412-661-1400.