Qualifying for Disability Benefits (SSDI) with Crohn’s Disease in Pennsylvania

When you are living with a severe disability, it can be impossible to maintain steady employment due to pain, fatigue, and other health issues.  However, you still need to pay for your utilities, groceries, and housing costs.  This can create a stressful financial situation at a time when you need to focus on your mental and physical health.

Fortunately, assistance is available in the form of SSI (Supplemental Security Income) or SSDI (Social Security Disability Insurance) benefits, both of which are regulated and overseen by the SSA (Social Security Administration).  For those who cannot work due to a serious ongoing medical problem, such as Crohn’s Disease, these monthly benefits can make a tremendous positive difference when it comes to covering the costs of daily living.

Unfortunately, it is not always easy to qualify for these benefits.  In fact, the SSA rejects a far greater percentage of claimants than it accepts, particularly during the first two stages of the process.  After making an initial application, approximately 70% of Americans applying for benefits will be denied, while during the next stage, Reconsideration, approximately 86% will be denied.  

However, while approval may be difficult to obtain, it is not necessarily an impossible goal. An experienced disability benefits lawyer can help. To set up a free and confidential legal consultation, call the law offices of Young, Marr & Associates at (609) 755-3115 in New Jersey or (215) 701-6519 in Pennsylvania. Let’s start a conversation about how we can assist you.

Abdominal Pain 1024x684 - Qualifying for Disability Benefits (SSDI) with Crohn's Disease in Pennsylvania

SSA Requirements for Disability Claims

Before we discuss how you qualify for benefits with Crohn’s Disease in particular, it is important to review the more generic points of eligibility.  These criteria are not necessarily connected to any specific health condition and apply to all claimants.

  1. You must not be making more than $721 per month, unless you are a couple, in which case the limit is $1,082 per month.  (If you are applying for SSDI, the monthly limit is $1,070.)
  2. Your disability will not be eligible if it is mild and easy to manage: it must be severe, in such a way that it prohibits you from working.  This includes not only your customary job, but also alternative, less physically taxing jobs.
  3. Your health issue must have either lasted for a minimum of 12 months, be expected to last for a minimum of 12 months, or to eventually end in death.  (It should be noted that certain conditions which are extremely rare or severe may be fast-tracked for review via the SSA’s expedited Compassionate Allowances program.)
  4. Your disability should be found in the Listing of Impairments, which acts as a medical catalog.  However, if it is not on the Listing, you could still potentially qualify with a Medical-Vocational Allowance.

This final point is less of a concern for applicants citing Crohn’s Disease, which is currently a listed condition.  But how is Crohn’s evaluated in the Listing, and what sort of medical evidence must you supply to the SSA’s medical examiners in order to be approved?

How to Qualify for Disability Benefits for Crohn’s Disease in Pennsylvania

Crohn’s Disease is a specific type of inflammatory bowel disease (IBD) which the Crohn’s & Colitis Foundation of America (CCFA) estimates affects some 700,000 Americans, particularly among the 15-35 age range.

As a bowel disease, Crohn’s can be found under Section 5.00 of the Listing, which covers the digestive system.  More specifically, this condition is noted under Section 5.06, which covers IBD.

If you are submitting a disability claim related to IBD, your condition should be “documented by endoscopy, biopsy, appropriate medically acceptable imaging, or operative findings,” and should also be accompanied by either:

  • “Obstruction of stenotic areas (not adhesions) in the small intestine or colon with proximal dilatation.”
  • Any two of the following, “despite continuing treatment as prescribed and occurring within the same consecutive 6-month period”:
    • Anemia.
    • “Serum albumin of 3.0 g/dL or less.”
    • “Tender abdominal mass palpable on physical examination with abdominal pain or cramping.”
    • Perineal disease.
    • “Involuntary weight loss of at least 10 percent from baseline.”
    • “Need for supplemental daily enteral nutrition via a gastrostomy or daily parenteral nutrition via a central venous catheter.”

It should also be noted that some of the above listed criteria are abridged, and come with their own sets of highly specific requirements.  Your doctor can help you with unfamiliar medical language.  You can view the full text of the IBD listing here.

It is also worth highlighting the phrase “medically acceptable imaging” mentioned above. This could include (but is not limited to):

  • X-Rays
  • CAT Scans
  • Sonography
  • MRIs
  • Radionuclide Scans

Philadelphia + Bucks County Disability Lawyers Offering Free Consultations

If you are one of the hundreds of thousands of Americans living with Crohn’s, you could potentially be a strong candidate for monthly benefits. To arrange a free, completely confidential case evaluation, call Young, Marr & Associates at (609) 755-3115 in New Jersey or (215) 701-6519 in Pennsylvania, or contact us online today.

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